Presentation on theme: "Evidence-based Practices in Mental Health and Aging June 22, 2010 Cheryl Evans-Pryor, M.A.-G Aging Resources of Central Iowa 5835 Grand Avenue, Suite 106."— Presentation transcript:
Evidence-based Practices in Mental Health and Aging June 22, 2010 Cheryl Evans-Pryor, M.A.-G Aging Resources of Central Iowa 5835 Grand Avenue, Suite 106 Des Moines, IA. 50312-1437 (515) 255-6714, ext.322 Cheryl.firstname.lastname@example.org www.agingresources.com
Evidence-based Practices in Depression Care Management Goal: Present condensed overview of two models of depression care treatment. Objectives: 1. Present model components. 2. Present behavioral activation & problem-solving approaches. 3. Discuss model outcomes/ success.
Evidence-based practices: Offer brief treatment- time sensitive Structured approach Researched, proven to work Flexible implementation – 1:1 or groups Redefines issues/ current focus Meets people where they are in life Small, manageable steps Cost-effective
Evidence-based practice model overview (PEARLS & HEALTHY IDEAS) Both models are grounded in Behavioral Activation & Change. PEARLS - Program to Encourage Active, Rewarding Lives for Seniors. Addresses Minor Depression & Dysthymia. Is not designed to address situational depression or grief issues. Built on Medical/Psychiatric foundation with team approach to chronic care.
Patient-centered and patient directed, can participate in 1 or all 3 components. Serves persons 60+ with physical impairments and social isolation. Purpose= There is a direct connection between unresolved problems & depression. PEARLS
Theory= Depression has many causes, and failed attempts to solve problems leads to learned helplessness. Goal= Increase confidence and feelings of self-control. Increase understanding of causal link btw. symptoms and current problems. Increase pleasant, social, and physical activities. Problem Solving Therapy
Adopt attitude of goals being attainable=increased success. Decreases prolonged episodes/relapses. Shift in thinking pattern that facilitates change (contemplation to action). Fosters a sense of HOPE. Problem Solving Therapy – cont.
7 Steps of PST: 1.Identifying problem-what does it look like/ how does it impact your life? 2.Set realistic goals - attainable 3.Generate possible solutions 4.Consider Pro’s /Con’s of each solution 5.Select a solution of choice 6.Develop an action plan/steps to achieve solutions 7.Review & evaluate progress. Problem Solving Therapy
Healthy Ideas=Identifying Depression, Empowering Activities for Seniors Reduce symptoms of depression in older adults with chronic health conditions and functional limitations through existing community-based case management or counseling services. Goal= to insure a systematic identification of depression through routine screenings (PHQ-2 & PHQ-9) from counselor or case managers.
Utilizes case management staff that already have an existing relationship with the client. Screening and assessments occur at regular intervals/visits by case manager. Utilizes Behavioral Activation method. Behavioral Activation= Re-establishes routines, reinforces experiences, overcome avoidance patterns (Jacobson et al., U. Wash). Healthy Ideas- cont.
Behavioral Model of Depression Lowered Mood Decreased Activity Decreased Pleasant Activities Depression results in behaviors that limit positive outcomes → reduced pleasure, reduced accomplishment Healthy Ideas
Behavioral Activation Rewarding Activities Improved Mood Decreased Depressive Symptoms. Improve mood by: Increasing frequency of behaviors that lead to positive outcomes Doing activities that “feel good” or are pleasurable or reduce stress (may involve a task, something social or an activity) Healthy Ideas
HEALTHY IDEAS- Core Components: Screening and assessment Helps clients examine own mood and relationship to behavior by self monitoring symptoms. Encourages clients to examine current and/or meaningful activities. Educates clients to recognize symptoms and how to ask for help or talk to providers. Referral, link to treatment as needed, follow-up Empower through Behavioral Activation. Accountability to engage in change by assessing likelihood of follow-through. (Readiness Ruler) Assess client progress
Outcomes Track and review data for each client. Provide telephone follow-up btw. visits. Brief intervention period= 6-9 months. Examine both qualitative and quantitative outcomes.
Resources PEARLS : http://depts.washington.edu/pearlspr/http://depts.washington.edu/pearlspr/ University of Washington Health Promotion Research Center, Seattle, WA. HEALTHY IDEAS : www.careforelders.org/healthyideaswww.careforelders.org/healthyideas Huffington Center on Aging, Baylor College of Medicine, Houston, TX. www.cdc.gov/agingwww.cdc.gov/aging and www.chronicdisease.orgwww.chronicdisease.org SAMHSA National Registry of Evidence-Based Programs & Practices http://mentalhealth.samhsa.gov