A RANDOMIZED CONTROLLED TRIAL OF SELF-HELP GUIDED BY LAY PROVIDERS FOR GENERALIZED ANXIETY DISORDER IN OLDER ADULTS

Abstract

Low use of professional help for anxiety disorders in older adults may be due in part to limited access to mental health services. Self-help guided by lay providers (LPs) could help improve access to treatment. This study evaluated the efficacy and long-term outcomes of self-help guided by LPs for generalized anxiety disorder (GAD) in older adults. Participants (≥ 60 years) with threshold or subthreshold GAD were randomly assigned to an intervention group (n = 75) or a wait-list control group (n = 75). Intervention group participants used a manual presenting readings and exercises based on principles of cognitive-behavioral therapy and received weekly support calls by LPs. Groups were similar in terms of sociodemographic characteristics and initially did not differ significantly on outcomes. At post-treatment, the intervention group had decreased significantly on various measures while the wait-list group remained stable: Generalized Anxiety Disorder 7-item (GAD-7): -4.8 vs -.03; Penn State Worry Questionnaire (PSWQ): -11.7 vs .07; Geriatric Anxiety Inventory (GAI): -5.3 vs -.07. Probability of having a diagnosis of threshold GAD decreased significantly more in the intervention group (79% to 16% vs 74% to 53%). Intervention group scores on the GAD-7, the PSWQ, and the GAI as well as probability of having a diagnosis of threshold GAD remained stable at 6- and 12-month follow-ups. Results provide evidence of the efficacy of self-help guided by LPs for GAD in older adults as well as of the maintenance of improvement following this treatment.