The Thai Group Cognitive Behavior Therapy Intervention Program for Depressive Symptoms among Older Women: A Randomized Controlled Trial
Keywords:
Cognitive behavior therapy, Depressive symptoms, Intervention program, Older women, Primary care unit, Randomized controlled trial, ThailandAbstract
Depression is a mental health problem worldwide, often a co-occurring condition with disabilities and contributes to a low quality of life and suicide. Older women are more likely to experience depression than older men and need specific interventions to reduce their depressive symptoms. This randomized controlled trial examined the effect of a group administered cognitive behavior therapy program for reducing depressive symptoms among older women. Sixty Thai older women living in the community, who met the inclusion criteria and presented at primary care units in Northern Thailand, were randomly assigned into either a group undertaking a cognitive behavior therapy program (n=30) or a usual care control condition (n=30). Depression was measured using the Patient Health Questionnaire-9, Thai version at baseline, immediately after the time needed to complete The Thai Group CBT Intervention Program, and then at 1 and 3 months follow-up. Repeated measures analysis of variance (ANOVA) and independent sample t-test were used to test the program efficacy.
Results indicated that the mean depression scores in the CBT condition at every point were significantly lower than at baseline and also statistically lower than those of the usual care condition after completing the program. Thus, The Thai Group CBT Intervention Program was found to be efficacious in reducing depression. Nurses should consider integrating this intervention for older persons with depression into primary care; however, further study is needed to demonstrate the durability of the depression reduction effects.
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34. American Psychiatric Association. Older adults’ health and age-related changes. [cited September 2016]. Available from https://www.apa.org/pi/aging/resources/guides/ older.aspx.
35. Niewsma JA, Trivedi RB, McDuffie J, Kronish I, Benjamin D,Williams JW. Brief psychotherapy for depression: A systematic review and meta-analysis. Int J Psychiatry Med. 2012; 43(2): 129-151.
36. Waller R, Trepka C, Collerton D, Hawkins J. Addressing spirituality in CBT. The Cognitive Behavior Therapist. 2010; 3: 95-106.
37. Ekers D, Webster L, Van Straten A, Cuijpers P, Richards D, Gilbody S. Behavioural activation for depression; An update of meta-analysis of effectiveness and sub group analysis. PLOS ONE. 2014; 9(6): 1-11.
2. Sheets DJ, Gallagher EM. Aging in Canada: State of the art and science. The Gerontologist. 2013; 53(1): 1-8.
3. Humphreys G. Bull world health organization, Thailand. The health care challenges posed by population ageing. Bull World Health Organization. 2012; 90: 82-83.
4. Knodel J, Teerawichitchainan B, Prachuabmoh V, Pothisiri W. The Situation of the Thailand’s older population: An update based on the 2014 survey of older persons in Thailand [cited September 2016]. Available from https:// www.psc.isr.umich.edu/pubs/pdf/rr15-847.pdf
5. Department of Economic and Social Affairs. Current status of the social situation, well-being, participation in development and rights of older persons worldwide. United Nations: New York; 2011.
6. Marcus M, Yasamy MT, van Ommeren M, Chisholm D, Saxena S. Depression: A global public health concern. [cited September 2016]. Available from https://www. who.int/mental_health/management/depression/who_ paper_depression_wfmh_2012.pdf.
7. Steel Z, Marnane C, Iranpour C, Chey T, Jackson JW, Patel V, Silove D. The global prevalence of common mental disorders: a systematic review and meta-analysis 1980- 2013. Int J Epidemiol. 2014; 43(2): 476-493.
8. World Health Organization. Mental health and older adults. [cited September 2016]. Available from https://www. who.int/mediacentre/factsheets/fs381/en/.
9. Trangle M, Gursky J, Haight R, Hardwig J, Hinnenkamp T, Kessler, et al. Health care guideline depression in primary care. Institute for Clinical Systems Improvement. [cited June 2016]. Available from https://www.icsi. org/_asset/fnhdm3/depr-interactive0512b.pdf.
10. Lotrakul M, Saipanish R. How do general practitioners in Thailand diagnose and treat patients presenting with anxiety and depression? Psychiatry and Clinical Neurosciences. 2009; 63: 37- 42.
11. Wongpoom T, Sukyimg C, Udomsubpayakul U. Prevalence of depression among the elderly in Chiang Mai Province. J Psychiatr Assoc Thailand. 2011; 56(2): 103-116.
12. Hofmann SG, Asnaani A, Vonk IJJ, Sawyer AT, Fang A. The efficacy of cognitive behavioral therapy: A review of meta-analyses. Cognit Ther Res. 2012; 36(5): 427- 440.
13. Cox D, D’Oyley H. Cognitive-behavioral therapy with older adults. BC Medical Journal. 2011; 53(7): 348- 352.
14. Beck AT, Rush AJ, Shaw BF, Emery G. Cognitive therapy of depression: A treatment manual. New York, Guilford Press; 1979.
15. Pinquart M, Sorensen S. How effective are psychotherapeutic and other psychosocial interventions with older adults? center for reviews and dissemination, national institute for health research, University of York. [cited June 2016]. Available from https://www.crd.york.ac.uk/CRDWeb/ ShowRecord.asp?ID=12001005478
16. Thapinta D. Depression: Cognitive behavior counseling and cognitive behavior therapy. 2nd ed. Chiang Mai: Wanida; 2013.
17. Kitsumban V, Thapinta D, Sirindharo PB, Anders RL. Effect of cognitive mindfulness practice program on depression among elderly Thai women. Thai J Nurs Res. 2009; 13(2): 95-108.
18. McCann TV, Songprakul W, Stephenson J. Effectiveness of guided self-help in decreasing expressed emotion in family caregivers of people diagnosed with depression in Thailand: A randomized controlled trial. BMC Psychiatry. 2015; 15: 1-8.
19. Laidlaw K, Davidson K, Toner H, Jackson G, Clark S, Law J, et al. A randomized controlled trial of cognitive behavior therapy vs treatment as usual in the treatment of mild to moderate late life depression. International Journal of Geriatric Psychiatry.2008; 23: 843- 850.
20. Beck JS. Cognitive behavior therapy: Basic and beyond. 2nd ed. New York: Guilford Press; 2011.
21. Mokekhaw S. The effect of cognitive behavioral therapy program on depression of patient with major depressive disordered. Thai Journal of Nursing Council. 2011; 26(2): 126-136.
22. Songprakul W., McCann TV. Evaluation of a bibliotherapy manual for reducing psychological distress in people with depression: a randomized controlled trial. Journal of Advanced Nursing. 2012; 68(12): 2674-2684.
23. Department of Mental health, Ministry of Public Health, Thailand. Clinical practice guideline of major depressive disorder for general practitioner: CPG-MDD-GP. Ubonratchathani: Siritham offset; 2010.
24. Department of Mental Health, Ministry of Public Health, Thailand. Guidebook of depressive disorders surveillance and care: Provincial level. 3rd ed. Nonthaburi: Department of Mental Health; 2014.
25. Kongsuk T. Prevention and management of major depressive disorders for accessibility service problem: Financial year 2012. Ubon Ratchathani: Prasrimahabhodi Psychiatric Hospital; 2012.
26. Srisurapanont M, Pityaratstian N, Kittiranapaiboon P, Charatsigha A. Cognitive-behavioral therapy for the treatment of major depressive disorder: Workforce developmentand service evaluation in Thailand. J Psychiatr Assoc Thailand. 2009; 54(4): 367-374.
27. Wannachaiyakul S, Thapinta D, Sethabouppha H, Thungjaroenkul P, Likhitsathian S. Randomized controlled trail of computerized cognitive behavioral therapy program for adolescent offenders with depression. Pacific Rim Int J Nurs Res. 2017; 21(1): 32-43.
28. Polit DF, Beck CT. Essentials of nursing research. 6th ed. Philadelphia: Lippincott Williams & Wilkins; 2004.
29. Lotrakul M, Sumrithe S, Saipanish R. Reliability and Validity of the Thai version of the PHQ-9. BMC Psychiatry. 2008; 8(46): 1-7.
30. Thew GR, Krohnert N. Formulation as intervention: Case report and client experience for formulating in therapy the cognitive behaviour therapist. 2015; 8(e25): 1-14.
31. Mumma GH, Fluck J. How valid is your case formulation? Empirically testing your cognitive behavioural case formulation for tailored treatment. The Cognitive Behaviour Therapist. 2016; 9(e12): 1-25.
32. Kazantzis N, Whittington C, Dattilio F. Meta-analysis of homework effects in cognitive and behavioral therapy: Replication and extension. Clinical Psychology: Science and Practice. 2010; 17: 144-156.
33. Foo KH, Kazantzis N. Integrating Homework Assignments Based on Culture: Working with Chinese patients. Cognitive and behavioral practice. 2007; 14: 333-340.
34. American Psychiatric Association. Older adults’ health and age-related changes. [cited September 2016]. Available from https://www.apa.org/pi/aging/resources/guides/ older.aspx.
35. Niewsma JA, Trivedi RB, McDuffie J, Kronish I, Benjamin D,Williams JW. Brief psychotherapy for depression: A systematic review and meta-analysis. Int J Psychiatry Med. 2012; 43(2): 129-151.
36. Waller R, Trepka C, Collerton D, Hawkins J. Addressing spirituality in CBT. The Cognitive Behavior Therapist. 2010; 3: 95-106.
37. Ekers D, Webster L, Van Straten A, Cuijpers P, Richards D, Gilbody S. Behavioural activation for depression; An update of meta-analysis of effectiveness and sub group analysis. PLOS ONE. 2014; 9(6): 1-11.
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2018-01-01
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Longchoopol C, Thapinta D, Ross R, Lertwatthanawilat W. The Thai Group Cognitive Behavior Therapy Intervention Program for Depressive Symptoms among Older Women: A Randomized Controlled Trial. PRIJNR [Internet]. 2018 Jan. 1 [cited 2024 Apr. 19];22(1):74-85. Available from: https://he02.tci-thaijo.org/index.php/PRIJNR/article/view/78778
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