title: Effectiveness of acceptance and commitment therapy for depression: comparison among older and younger veterans.
abstract: OBJECTIVE
  Limited data exist on outcomes of older adults receiving psychotherapy for depression in real-world settings. Acceptance and Commitment Therapy for depression (ACT-D) offers potential utility for older individuals who may experience issues of loss, reduced control, and other life changes. The present article examines and compares outcomes of older and younger Veterans receiving ACT-D nationally in the U.S. Department of Veterans Affairs health care system.
  
  
  METHODS
  Patient outcomes were assessed using the Beck Depression Inventory-Second Edition and the World Health Organization Quality of Life-BREF. Therapeutic alliance was assessed using the Working Alliance Inventory-Short Revised.
  
  
  RESULTS
  Six hundred fifty-five Veterans aged 18-64 and 76 Veterans aged 65+ received ACT-D. Seventy-eight percent of older and 67% of younger patients completed all sessions or finished early. Mean depression scores declined from 28.4 (SD = 11.4) to 17.5 (SD = 12.0) in the older group and 30.3 (SD = 10.6) to 19.1 (SD = 14.3) in the younger group. Within-group effect sizes were d = .95 and d = 1.06 for the two age groups, respectively. Quality of life and therapeutic alliance also increased during treatment.
  
  
  CONCLUSIONS
  The findings suggest that ACT-D is an effective and acceptable treatment for older Veterans treated in routine clinical settings, including those with high levels of depression.
authors.affiliation: Mental Health Services, U.S. Department of Veterans Affairs Central Office, Washington, DC, United States. bradley.karlin2@va.gov
authors.forename: Bradley E
authors.initials: BE
authors.lastname: Karlin
authors.forename: Robyn D
authors.initials: RD
authors.lastname: Walser
authors.forename: Jerome
authors.initials: J
authors.lastname: Yesavage
authors.forename: Aimee
authors.initials: A
authors.lastname: Zhang
authors.forename: Mickey
authors.initials: M
authors.lastname: Trockel
authors.forename: C Barr
authors.initials: CB
authors.lastname: Taylor
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003863:Depression / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011613:Psychotherapy / Q000379:methods*; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014481:United States; D014728:Veterans / Q000523:psychology*; D055815:Young Adult