Teaching and Practicing Cognitive-Behavioral and Mindfulness Skills in a Web-Based Platform among Older Adults through the COVID-19 Pandemic: A Pilot Randomized Controlled Trial

Abstract

The outbreak of the COVID-19 pandemic has led to an acceleration in the development of web-based interventions to alleviate related mental health impacts. The current study explored the effects of a short-term digital group intervention aimed at providing cognitive behavioral and mindfulness tools and skills to reduce loneliness and depression and to increase social support among older adults in Israel. This pilot randomized controlled trial included community-dwelling older adults (n = 82; aged between 65–90 years; 80% female) who were randomized either to an intervention group (n = 64) or a wait-list control group (n = 18). The intervention included seven online sessions, over 3.5 weeks. Depression, loneliness, and social support measures were administered at baseline, immediately post-intervention, and at 1-month follow-up. Repeated measures ANOVA revealed statistically and clinically significant reductions in depression in the intervention group, with results maintained at one-month follow-up. Loneliness levels also significantly decreased post-intervention; however, this benefit was not maintained at one-month follow-up. Social support slightly increased both post-intervention and 1-month follow-up—but these changes were not statistically significant. There were no overall changes for the wait-list control group. Our intervention provided promising evidence regarding the effectiveness of an online group intervention to alleviate mental health effects and to promote the coping of older adults during the COVID-19 pandemic. This relatively simple model can be effectively utilized by communities globally to help connect lonely and isolated older inhabitants, both during the pandemic and in more routine times.

Efficacy of Internet-Based Cognitive Behavioral Therapy for Depression and Anxiety among Global Population during the COVID-19 Pandemic: A Systematic Review and Meta-Analysis of a Randomized Controlled Trial Study

“…We found 12 eligible studies for systematic review and extracted 9 for meta-analysis; 10 studies were extracted for depression meta-analysis and eight for anxiety meta-analysis [ 22 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 ]. These studies were included because they contained sufficient data for quantitative analysis.…”

“…The mean age of participants was 22, and they were further randomized into the intervention group and control group, or several follow-up intervention groups. Interventions involved iCBT and were conducted over several sessions, which were then assessed with standardized tools, including the Patient Health Questionnaire-9 (PHQ-9), Beck Depression Inventory-II (BDI-II), Hamilton Rating Scale for Depression (HAMD-17), Generalized Anxiety Disorder (GAD-7) questionnaire, Short Health Anxiety Inventory (SHAI), State Anxiety Inventory-Form Y1 (STAI-Y1), and Hamilton Anxiety Rating Scale (HAMA) questionnaire [ 22 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 ]. Detailed literature search procedures are presented in Table 1 .…”

“…Interestingly, our meta-analysis evaluated adherence, and the results are provided in Table 2 . The results show that adherence serves as a good predictor and moderator, which suggests that clinician-guided delivery is more acceptable than self-guided intervention [ 22 , 33 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 ]. This type of information can be beneficial in considering the implementation strategy.…”

Utilization of Mind–Body Intervention for Integrative Health Care of COVID-19 Patients and Survivors

“…An RCT investigating 155 physicians and advanced practice providers who were lonely (50%) and had sleep problems (97%) found that 4 weeks of daily meditation training significantly reduced loneliness and improved sleep quality [ 134 ]. Another RCT that investigated community-dwelling older adults revealed that 3.5 weeks of cognitive–behavioral and mindfulness practice significantly reduced levels of depression and loneliness compared to the waitlist control group during the pandemic [ 135 ]. Moreover, another RCT exploring the health benefits of tai chi for older adults during the pandemic showed that a 10-week tai chi intervention significantly decreased perceived stress compared to the control group ( n = 30) [ 136 ].…”

The Effect of Positive Intervention Dosing Frequency: Fixed Intervals May Decrease More Depression than Flexible Ones

“…Changes in the cognitive, emotional, and behavioral domains require repeated practice. Shapira et al [ 11 , 12 , 13 , 14 ] conducted a series of studies with older adults and validated that behavioral and cognitive techniques can be learned and practiced via an online program. Research shows that online training in behavioral and cognitive techniques could reduce loneliness, depression [ 11 , 14 ], mental stress and promote well-being [ 12 ].…”