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University of Michigan team presents online CBT program to help older adults with depression
Summary
A University of Michigan researcher briefed the Washtenaw County Commission on Aging about Empower at Home, a nine-lesson internet cognitive behavioral therapy program for older adults that includes coaching, workbooks, device support with cellular data, NIH sponsorship and trial results showing reduced depression scores and high satisfaction.
Sadma Habash, research project coordinator at the University of Michigan School of Social Work, told the Washtenaw County Commission on Aging that Empower at Home is an internet-based cognitive behavioral therapy program tailored to older adults, with nine lessons designed to take 20–30 minutes each and optional weekly coaching to support skill practice.
Habash said the program was developed with community partners (named in the presentation) and designed for ease of use so no previous computer experience is required. The model pairs an online curriculum and workbook with trained community coaches (students, social workers, or case managers) who call weekly to review lessons, tailor approaches and provide accountability.
In describing evidence from earlier trials, Habash said a randomized controlled trial completed in 2022 with more than 70 older adults found a larger drop in depression scores among those who received the program immediately. In a larger analysis of more than 250 participants she reported that roughly 90% completed the program, 91% were satisfied and most respondents would recommend the program to someone in their life.
Habash said the study is sponsored by the National Institutes of Health and the National Institute of Mental Health. Eligibility criteria include being at least 50 years old, having mood concerns or at least mild depressive symptoms (assessed with the PHQ), and not having dementia-like symptoms, unstable medical conditions that require frequent hospitalization, current substance use disorder, or moderate-to-high suicidal risk. Habash said clinical screening and a licensed social worker are used to determine suitability and to route higher-risk individuals to community mental health authorities or other providers.
To reduce access barriers, Habash said the project can mail a tablet preloaded with cellular data to participants who lack a device, and that study participants receive modest compensation (about $30) for completing periodic 40-minute research surveys. She said the workbook is kept by participants and that the program remains free of charge for users.
Commissioners asked about referrals and follow-up for participants who need more intensive care; Habash said referrals to local community mental health authorities or referring agencies are part of the clinical pathways and that clients referred by agencies would be coordinated through HIPAA-compliant processes and pre-screening forms. She said the program is not yet available in multiple languages and suggested grief may be an appropriate use for some participants depending on timing and individual needs.
The commission was provided with contact information and promotional materials would be shared with the Commission on Aging website and via staff for broader outreach. Habash said current funding for the research continues for about two and a half years and that the team is recruiting through community partners.
