BE-ACTIV: A Staff-Assisted Behavioral Intervention for Depression in Nursing Homes

Abstract

Because depression among nursing home residents is prevalent, heterogeneous, and often treatment resistant, there is a need for effective, low-cost interventions that are ecologically acceptable and efficient. BE-ACTIV is a promising intervention; it is brief, addresses institutional barriers, involves facility staff in treatment, and is acceptable to residents. As such, BE-ACTIV merits further evaluation to establish efficacy and effectiveness.

Behavioral activation for depression in older adults: Theoretical and practical considerations

“…Studies in the community included outpatient clinics (Acierno et al, 2012;Bottonari, Roberts, Thomas, & Read, 2008;Gallagher & Thompson, 1982;Lazzari, Egan, & Rees, 2011;Rokke, Tomhave, & Jocic, 1999;Thompson, Gallagher, & Breckenridge, 1987;Turner & Leach, 2009) and the client's home (Quijano et al, 2007;Teri, Logsdon, Uomoto, & McCurry, 1997;Yon & Scogin, 2009). Studies in residential care settings included assisted living (Cernin & Lichtenberg, 2009;Dozeman et al, 2011), nursing homes (Meeks, Looney, Van Haitsma, & Teri, 2008;Meeks, Teri, Van Haitsma, & Looney, 2006), a shortterm rehabilitation unit (Sood, Cisek, Zimmerman, Zaleski, & Fillmore, 2003), and inpatient psychiatric care facilities (Clignet, Van Meijel, Van Straten, Lampe, & Cuijpers, 2012;Snarski et al, 2011).…”

“…Several studies demonstrated the successful implementation of behavioral activation interventions by nonmental-health professionals such as case managers (Quijano et al, 2007), occupational therapists (Sood et al, 2003), residential care staff (Cernin & Lichtenberg, 2009;Dozeman et al, 2011;Meeks et al, 2006Meeks et al, , 2008, and family caregivers (Teri et al, 1997). Acierno et al (2012) showed that individuals with varied levels of training and expertise (ranging from recent graduates of bachelor programs in psychology to experienced social workers) were able to implement behavioral activation.…”

“…They presented with major or minor depression, and comorbid anxiety was assessed in five studies (Acierno et al, 2012;Dozeman et al, 2011;Meeks et al, 2006;Thompson et al, 1987;Turner & Leach, 2009). Few studies included older adults with cognitive impairment (Snarski et al, 2011;Teri et al, 1997), chronic medical illness (Dozeman et al, 2011;Meeks et al, 2008;Quijano et al, 2007), chronic pain Meeks et al, 2006;Quijano et al, 2007), or diagnoses of psychiatric disorders such as schizophrenia (Snarski et al, 2011); thus, there is limited evidence for the effectiveness of behavioral activation with such individuals. Conclusions are also limited for individuals of more advanced age (85 years and older) and older adults with severe depression.…”

“…This study also collected data from a pedometer as an objective measure of the client's physical activity. Several studies assessed self-rated engagement in terms of frequency and pleasantness of activities (Meeks et al, 2006(Meeks et al, , 2008Rokke et al, 1999;Thompson et al, 1987;Yon & Scogin, 2009) and frequency and duration of social and physical activity (Quijano et al, 2007). Only two studies included staff-reported activity participation and direct observation of activity participation and affective responses (Meeks et al, 2006(Meeks et al, , 2008.…”

“…Several studies described the use of measures such as activity inventories (Cernin & Lichtenberg, 2009;Meeks et al, 2006Meeks et al, , 2008Sood et al, 2003;Teri et al, 1997), activity lists included in treatment manuals (Clignet et al, 2012;Dozeman et al, 2011), and lists of community activities and resources (Acierno et al, 2012) to provide suggestions for planning activities. Other studies used collaborative activity selection based on individual goal setting (Bottonari et al, 2008;Lazzari et al, 2011;Quijano et al, 2007;Rokke et al, 1999;Snarski et al, 2011;Turner & Leach, 2009;Yon & Scogin, 2009).…”