A Study of Brief Behavioral Activation for the Treatment of Depression in Older Adult Cancer Survivors

Status: closed to accrual

This clinical trial compares the effect of behavioral activation (BA) to supportive psychotherapy (SP) in treating depression in older adult cancer survivors (OACS). BA is a therapeutic technique that guides people to set goals and engage in enjoyable or rewarding activities as a way of changing behavior and reducing symptoms of depression. BA has been shown to be effective in treating depression, including in older adults but, because OACS often have difficulty with mobility or face other challenges in traveling to receive face-to-face treatment, researchers want to learn if BA can be delivered remotely instead. Researchers also want to compare remote delivery of BA with remote delivery of SP, a standard psychotherapeutic intervention that has been shown to be an effective form of treatment for depression in OACS.

Inclusion Criteria

As per self-report or medical record, >= 65 years old
As per self-report or medical record, has a history of cancer
As per medical record and/or clinician confirmation: * a patient in Memorial Sloan Kettering (MSK) survivorship clinics and/or * no evidence of disease (NED) and/or * 6 months or more post-treatment (patients on maintenance hormonal therapies are eligible)
Fluent in English, as per self-reported fluency of “well” or "very well" * Language verification: Prior to enrollment, patients will be asked the following two questions by research staff to verify English fluency necessary for participation in the study: ** How well do you speak English? (must respond “well” or “very well” when given the choices of very well, well, not well, not at all, don’t know, or refused) ** What is your preferred language for healthcare? (must respond English)
As per self-report, able to communicate over video-conference and/or phone for sessions
Elevated score on the Patient Health Questionnaire 9 (PHQ-9): >= 5 (not applicable [N/A] for training case participants)
Received a Blessed Orientation-Memory-Concentration Scale (BOMC) score of =< 11 (N/A for training case participants)

Exclusion Criteria

As per principal investigator (PI) determination, requires a higher level of care for current passive or active suicidal ideation than current protocol is able to provide. If a participant receives a score of > 0 on item 9 of the PHQ-9, they will be referred to study PI for further evaluation. They will be excluded from participation in this study if the PI determines they would be appropriate for a higher level of care than BA may be able to provide
As per self-report or as documented in the medical record, current untreated (e.g., no medication, no therapy) major psychotic disorder (schizotypal personality disorder, schizophreniform disorder, schizoaffective disorder). Patients diagnosed with a major psychiatric disorder will be reviewed by the study PI to determine eligibility prior to consent
As per self-report or medical record, currently taking antidepressant medication for < 3 month
As per medical record, patient has impaired decision-making capacity

PRIMARY OBJECTIVES:

I. To evaluate implementation outcomes (i.e., acceptability, feasibility, fidelity) of BA, relative to SP, in older adult cancer survivorship.

II. To determine the preliminary effects of BA on depression (primary outcome), anxiety, coping, and behavioral activation (secondary outcomes) compared to SP.

OUTLINE: Patients are assigned to 1 of 2 arms during interventionist training. Patients are randomized to 1 of 2 arms during the randomized controlled trial.

ARM I: Patients participate in 10 30-50 minute BA sessions remotely over 5-20 weeks.

ARM II: Patients participate in 10 30-50 minute SP sessions remotely over 5-20 weeks.

After completion of study intervention, patients are followed up at 2 months.

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A Study of Brief Behavioral Activation for the Treatment of Depression in Older Adult Cancer Survivors

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