Calmer Life: Testing the Effectiveness of a Treatment for Anxiety
| Status: | Completed |
|---|---|
| Conditions: | Anxiety, Psychiatric |
| Therapuetic Areas: | Psychiatry / Psychology |
| Healthy: | No |
| Age Range: | 50 - Any |
| Updated: | 4/21/2016 |
| Start Date: | October 2012 |
| End Date: | August 2015 |
Calmer Life: A Randomized Controlled Trial of a Participant-Centered Treatment for Anxiety in Low-Income, Older Adults
The overall goals of the proposed research study are to: (1) examine quantitative outcomes
in a well-conducted randomized clinical trial of Calmer Life, relative to Enhanced Community
Care, an information and referral intervention that represents care in a real-world
community-service environment, and (2) evaluate implementation feasibility, which includes
training community providers; examining program reach, engagement, acceptability, and
barriers-facilitators; and preparing practical tools for replicating the program.
in a well-conducted randomized clinical trial of Calmer Life, relative to Enhanced Community
Care, an information and referral intervention that represents care in a real-world
community-service environment, and (2) evaluate implementation feasibility, which includes
training community providers; examining program reach, engagement, acceptability, and
barriers-facilitators; and preparing practical tools for replicating the program.
Cognitive behavioral treatment (CBT) produces positive outcomes for late-life worry/GAD in
academic and primary care settings, but minorities are significantly underrepresented in
clinical trials, and standard CBT poorly addresses the needs of low-income minority older
adults in underserved communities. More attention needs to be given to service delivery of
anxiety treatments for underserved older adults. Calmer Life (CL) is a culturally tailored,
participant-centered research study that offers a skills-based intervention for late-life
anxiety and includes other elements of care to meet the needs of underserved, minority older
adults, including the option to integrate religion/spirituality (R/S), flexible delivery
modes, and modular treatment format.
Participants will be randomly assigned to CL or Enhanced Community Care(ECC). CL and ECC
will be provided by behavioral health clinicians recruited from partner organizations,
psychology trainees, and other research staff over 3 months. Assessments will occur at
baseline and 3 months.
Participants in the CL condition can choose up to 12 individual skill sessions, and will be
recommended to complete a minimum of 6 sessions. If participants desire to incorporate R/S,
an R/S assessment occurs during session 2 to help the provider understand the participant's
beliefs and practices. R/S can be integrated into any of the skills learned during the
intervention (e.g., deep breathing, self-statements, sleep management) or omitted entirely.
Participants in the ECC condition will receive brief biweekly check in calls to provide
information about community resources (including mental health), offer emotional support,
and assess symptom severity and need for crisis intervention. Emergency procedures will be
followed in crisis situations. After 3 months of ECC is completed, participants in the ECC
group will be offered the CL intervention.
Outcome measures will be administered for participants in both groups at baseline, 1 month,
and 3 months. Participants in ECC will complete measures at 6 months after completion of CL.
academic and primary care settings, but minorities are significantly underrepresented in
clinical trials, and standard CBT poorly addresses the needs of low-income minority older
adults in underserved communities. More attention needs to be given to service delivery of
anxiety treatments for underserved older adults. Calmer Life (CL) is a culturally tailored,
participant-centered research study that offers a skills-based intervention for late-life
anxiety and includes other elements of care to meet the needs of underserved, minority older
adults, including the option to integrate religion/spirituality (R/S), flexible delivery
modes, and modular treatment format.
Participants will be randomly assigned to CL or Enhanced Community Care(ECC). CL and ECC
will be provided by behavioral health clinicians recruited from partner organizations,
psychology trainees, and other research staff over 3 months. Assessments will occur at
baseline and 3 months.
Participants in the CL condition can choose up to 12 individual skill sessions, and will be
recommended to complete a minimum of 6 sessions. If participants desire to incorporate R/S,
an R/S assessment occurs during session 2 to help the provider understand the participant's
beliefs and practices. R/S can be integrated into any of the skills learned during the
intervention (e.g., deep breathing, self-statements, sleep management) or omitted entirely.
Participants in the ECC condition will receive brief biweekly check in calls to provide
information about community resources (including mental health), offer emotional support,
and assess symptom severity and need for crisis intervention. Emergency procedures will be
followed in crisis situations. After 3 months of ECC is completed, participants in the ECC
group will be offered the CL intervention.
Outcome measures will be administered for participants in both groups at baseline, 1 month,
and 3 months. Participants in ECC will complete measures at 6 months after completion of CL.
Inclusion Criteria:
- Age 50 and older
- Principal or Co-principal diagnosis of GAD or ADNOS
- Must speak English
- Must have a health care or social service provider and provide written authorization
to research team to communicate with their health-care or social service provider
- Must live, work, worship, attend community functions, and/or receive health care in
target geographic areas
Exclusion Criteria:
- Active suicidal intent
- Current psychosis
- Mania or substance abuse within the last month
- Cognitive impairment according to a Mini Cog screener score of 3 or lower
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