Project: Research project

Project Details


This research addresses an issue of considerable clinical and theoretical
interest which has received relatively little research attention, that of
treatment of depression in non-institutionalized elderly. Two distinctly
different brief therapy modalities will be systematically studied in an
experimental design to determine their relative effectiveness as well as to
compare both with a control condition. The control condition is designed
to represent the type of naturally occurring interaction typical in social
settings of elders. Both short- and long-term effectiveness will be
investigated, as will client characteristics differentially predictive of
outcome and maintenance.

The two treatment modalities are Life Enhancement Counseling (LEC) and Time
Limited Dynamic Psychotherapy (TLDP). LEC views depression in the elderly
as frequently associated with a loss of meaning or purpose that results
from environmental and/or late life developmental changes. LEC uses two
types of interventions, verbal and ecological. The verbal interventions
are non-psychodynamic, and are designed to help the elder rediscover past
strengths and explore the potential for current reenactment. The
ecological interventions structure current environmental resources to
support these reenactments which provide a source of new meaning and
purpose in life. TLDP views depression and other presenting problems as
originating in disturbances in human relationships with significant others,
both past and present, that result in maladaptative interpersonal
patterns. The major focus of TLDP rests on the dynamics of the
patient-therapist relationship, with the transactions between patient and
therapist receiving primary attention throughout therapy. The goal of TLDP
is to work toward changes that are experienced by the patient as
significant improvements in her/his feeling state, day-to-day social
functioning, and greater satisfaction in interpersonal relationships.

The subject population will consist of 120 Cuban elders, 60-75, diagnosed
under the Research Diagnostic Criteria classification as suffering from a
Major Depressive Disorder Subjects will be randomly assigned to either LEC,
TLDP or a Naturalistic Control Condition (NCC). Forty subjects per
condition will be assessed using a standardized battery at intake,
termination, and 3, 6, and 9 month follow-ups. The assessment battery
covers three major areas of client functioning: (1) depressive
symptomatology; (2) psychosocial/ecological functioning; and (3) level of
life satisfaction. The assessment battery will be administered blind by a
clinical evaluator to maintain independence from treatment modality. The
treatment modalities will be closely monitored to insure their adherence to
research protocols. The research plan includes a comprehensive strategy to
disseminate project findings.
Effective start/end date12/31/8912/31/89


  • National Institute of Mental Health
  • National Institute of Mental Health


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