title: Treating late-life generalized anxiety disorder in primary care: an effectiveness pilot study.
abstract: To increase the sustainability of cognitive behavior therapy (CBT) in primary care for late-life anxiety, we incorporated nonexpert counselors, options for telephone meetings, and integration with primary care clinicians. This open trial examines the feasibility, satisfaction, and clinical outcomes of CBT delivered by experienced and nonexperienced counselors for older adults with generalized anxiety disorder (GAD). Clinical outcomes assessed worry (Penn State Worry Questionnaire), GAD (Generalized Anxiety Disorder Severity Scale), and anxiety (Beck Anxiety Inventory and Structured Interview Guide for Hamilton Anxiety Scale). After 3 months of treatment, Cohen's d effect sizes for worry and anxiety ranged from 0.48 to 0.78. Patients treated by experienced and nonexperienced counselors had similar reductions in worry and anxiety, although treatment outcomes were more improved on the Beck Anxiety Inventory for experienced therapists. Preliminary results suggest that adapted CBT can effectively reduce worry. The piloted modifications can provide acceptable and feasible evidence-based care.
authors.affiliation: Houston VA Health Service Research and Development Service Center of Excellence, Houston, TX, USA. jcalleo@bcm.tmc.edu
authors.forename: Jessica S
authors.initials: JS
authors.lastname: Calleo
authors.forename: Amber L
authors.initials: AL
authors.lastname: Bush
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Cully
authors.forename: Nancy L
authors.initials: NL
authors.lastname: Wilson
authors.forename: Cynthia
authors.initials: C
authors.lastname: Kraus-Schuman
authors.forename: Howard M
authors.initials: HM
authors.lastname: Rhoades
authors.forename: Diane M
authors.initials: DM
authors.lastname: Novy
authors.forename: Nicholas
authors.initials: N
authors.lastname: Masozera
authors.forename: Susan
authors.initials: S
authors.lastname: Williams
authors.forename: Matthew
authors.initials: M
authors.lastname: Horsfield
authors.forename: Mark E
authors.initials: ME
authors.lastname: Kunik
authors.forename: Melinda A
authors.initials: MA
authors.lastname: Stanley
mesh_terms: D000368:Aged; D001007:Anxiety / Q000523:psychology / Q000628:therapy; D001008:Anxiety Disorders / Q000523:psychology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010865:Pilot Projects; D011320:Primary Health Care / Q000379:methods*; D011569:Psychiatric Status Rating Scales; D016896:Treatment Outcome