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. 2018 Sep;28(3):292-309.
doi: 10.1037/int0000121.

Effects of Integrated Telehealth-Delivered Cognitive-Behavioral Therapy for Depression and Insomnia in Rural Older Adults

Forrest Scogin  1 , Kenneth Lichstein  1 , Elizabeth A DiNapoli  2 , Julie Woosley  3 , S Justin Thomas  4 , Michael A LaRocca  5 , Haley D Byers  6 , Lisa Mieskowski  1 , Christina Pierpaoli Parker  1 , Xin Yang  7 , Jason Parton  7 , Anna McFadden  8 , James D Geyer  9
Affiliations

Effects of Integrated Telehealth-Delivered Cognitive-Behavioral Therapy for Depression and Insomnia in Rural Older Adults

Forrest Scogin et al. J Psychother Integr. 2018 Sep.

Abstract

Background: We examined the effects of integrated cognitive-behavioral therapy for depression and insomnia (CBT-D + CBT-I) delivered via videoconferening in rural, middle aged and older adults with depressive and insomnia symptoms.

Method: Forty patients with depressive and insomnia symptoms were randomized to receive either 10 sessions of CBT-D + CBT-I or usual care (UC). Patients in the integrated CBT condition were engaged in telehealth treatment through Skype at their primary care clinic. Assessments were conducted at baseline, post-treatment, and 3-month follow-up.

Results: CBT-D +CBT-I participants had significantly greater improvements in sleep at post-treatment and 3-month follow-up as compared to the UC participants. The time by group interaction for depression was not significant; both the CBT-D + CBT-I and UC conditions had a decrease in depressive symptoms over time.

Conclusion: While integrated CBT benefits both depression and insomnia symptoms, its effects on depression are more equivocal. Further research should consider expanding the depression treatment component of integrated CBT to enhance effectiveness.

Keywords: Integrated CBT; depression; insomnia; middle-aged and older adults; telehealth.

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Conflict of interest statement

The authors report no conflicts of interest. The attitudes expressed are those of the authors and do not necessarily reflect those of the Tuscaloosa VA Healthcare System, Palo Alto VA Healthcare System, Pittsburgh VA Healthcare System, Department of Veterans Affairs, or US government.

Figures

Figure 1
Figure 1
Flow of participants through the course of the study
Figure 2
Figure 2
HAM-D adjusted mean scores in the ingegrated CBT and UC conditions at baseline, post-treatment, and 3-month follow-up.
Figure 3
Figure 3
ISI adjusted mean scores in the integrated CBT and UC conditions at baseline, post-treatment, and 3-month follow-up.
See this image and copyright information in PMC

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