{"title":"Internet-Based Cognitive Behavioral Therapy with Layperson Support: A mixed-Methods Evaluation of Empower@Home.","authors":"Xiaoling Xiang, Xinyin Zhang, Elyse Narbut, Skyla Turner, Samson Ash, Caroline Ciagne, Dexia Kong","doi":"10.1080/07317115.2025.2528238","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>This study evaluates Empower@Home, an older adult-centered, layperson-supported internet-based cognitive behavioral therapy (iCBT) program for depression using a concurrent mixed-methods design.</p><p><strong>Methods: </strong>Adults aged 50+ with at least mild depressive symptoms enrolled in the program and were assessed pre- and post-treatment (<i>N</i> = 224). A subset participated in qualitative interviews post-treatment (<i>N</i> = 148). Paired t-tests and mixed-effects modeling assessed quantitative program effects, while qualitative data identified key themes of impact.</p><p><strong>Results: </strong>Program completion was 90%. Depression symptoms significantly decreased (Cohen's d = 0.9 overall; d = 1.4 for those with moderate depression at baseline). Anxiety and social isolation also declined significantly. Moderation analyses showed that participants with lower education, antidepressant use, and more childhood adversities experienced faster symptom reduction. Qualitative findings aligned with quantitative results, highlighting acquisition and application of CBT skills and improved emotional well-being. Additional themes included increased insight and self-awareness, improved social relationships, empowerment, self-worth, and self-care.</p><p><strong>Conclusions: </strong>Older adult-centered, layperson-supported iCBT shows promise in reducing depression and improving mental well-being in older adults.</p><p><strong>Clinical implications: </strong>Findings offer insights for improving mental health treatment and outcomes for older adults.</p>","PeriodicalId":10376,"journal":{"name":"Clinical Gerontologist","volume":" ","pages":"1-15"},"PeriodicalIF":2.4000,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12233185/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Gerontologist","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/07317115.2025.2528238","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Objectives: This study evaluates Empower@Home, an older adult-centered, layperson-supported internet-based cognitive behavioral therapy (iCBT) program for depression using a concurrent mixed-methods design.
Methods: Adults aged 50+ with at least mild depressive symptoms enrolled in the program and were assessed pre- and post-treatment (N = 224). A subset participated in qualitative interviews post-treatment (N = 148). Paired t-tests and mixed-effects modeling assessed quantitative program effects, while qualitative data identified key themes of impact.
Results: Program completion was 90%. Depression symptoms significantly decreased (Cohen's d = 0.9 overall; d = 1.4 for those with moderate depression at baseline). Anxiety and social isolation also declined significantly. Moderation analyses showed that participants with lower education, antidepressant use, and more childhood adversities experienced faster symptom reduction. Qualitative findings aligned with quantitative results, highlighting acquisition and application of CBT skills and improved emotional well-being. Additional themes included increased insight and self-awareness, improved social relationships, empowerment, self-worth, and self-care.
Conclusions: Older adult-centered, layperson-supported iCBT shows promise in reducing depression and improving mental well-being in older adults.
Clinical implications: Findings offer insights for improving mental health treatment and outcomes for older adults.
期刊介绍：
Clinical Gerontologist presents original research, reviews, and clinical comments relevant to the needs of behavioral health professionals and all practitioners who work with older adults. Published in cooperation with Psychologists in Long Term Care, the journal is designed for psychologists, physicians, nurses, social workers, counselors (family, pastoral, and vocational), and other health professionals who address behavioral health concerns found in later life, including:
-adjustments to changing roles-
issues related to diversity and aging-
family caregiving-
spirituality-
cognitive and psychosocial assessment-
depression, anxiety, and PTSD-
Alzheimer’s disease and other neurocognitive disorders-
long term care-
behavioral medicine in aging-
rehabilitation and education for older adults.
Each issue provides insightful articles on current topics. Submissions are peer reviewed by content experts and selected for both scholarship and relevance to the practitioner to ensure that the articles are among the best in the field. Authors report original research and conceptual reviews. A unique column in Clinical Gerontologist is “Clinical Comments." This section features brief observations and specific suggestions from practitioners which avoid elaborate research designs or long reference lists. This section is a unique opportunity for you to learn about the valuable clinical work of your peers in a short, concise format.
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