Digital Cognitive Behavioural Therapy for Older Adults with symptoms of depression: a feasibility study (Preprint)

BACKGROUND Depressive symptoms are common among older adults and can significantly impact their quality of life. Yet, many older adults face barriers to accessing psychological treatment. Internet-based cognitive behavioural therapy (iCBT) is a promising alternative to face-to-face treatments, but its feasibility among older adults is less researched. OBJECTIVE This study evaluated the feasibility of guided iCBT for adults aged 55 and older with mild to moderate depressive symptoms recruited from the general population. METHODS Single-group, pretest-post-test design (N = 21) in which all participants received guided iCBT for 8 weeks. Assessments were taken at baseline (T0), and postintervention (T1). The primary outcome is feasibility conceptualized as satisfaction, usability, engagement and uptake with iCBT. Secondary outcome measures included depression severity, working alliance, and technical alliance. RESULTS Participants were mostly highly educated (62%), female (86%), had an average age of 59.85 (range 55 – 68), and reported moderate digital literacy on average. Feasibility outcomes indicated high satisfaction and engagement, and moderate usability. Working alliance was rated as good by both participants and coaches and technical alliance was rated as moderate by the participants. There was a non-significant modest decrease in depressive symptoms (Cohen’s d=0.47). Of the 20 participants that started the intervention, all completed the first two modules, but completion declined across the remaining six modules, with only one participant completing all modules. CONCLUSIONS This study found that guided iCBT can be a feasible option for older adults experiencing depressive symptoms, with participants reporting generally positive satisfaction, engagement and a moderate therapeutic bond with their coaches. However, below average usability ratings and a moderate technical alliance suggest that some aspects of the platform require improvement. Future research should focus on improving usability, adherence, and testing the intervention in larger, more diverse population.