Intervention for Anxiety After Falls

Falls are the most commonly occurring cause of traumatic injury among older adults. For many, the consequences include reduced mobility, difficulty performing basic self-care, social isolation, deteriorating health, or even death. Most interventions for falls do not address anxiety in the aftermath of falling.

After an initial study assessment, participants will complete 8 home-based sessions of a Cognitive-Behavioral therapy (CBT). The sessions will be led by a study clinician who will cover the 5 intervention components:(a) education (learning about anxiety and the rationale for treatment); (b) relaxation training (learning skills to reduce tension); (c) cognitive restructuring (learning skills needed to cope better with distressing thoughts); (d) behavioral activation (learning to initiate healthy activity); and (e) exposure (coaching in how to confront avoided thoughts, situations, and people).

Participants will also complete assessments following completion of the intervention and 3 months after completion of the intervention.

Inclusion criteria

• age > or = 65 years
• English-speaking
• injured due to fall
• hospitalized
• returned home < or = 3 months
• ambulatory
• full or subsyndromal PTSD or Fear of Falling
• residing in one of the five boroughs of New York City

Exclusion criteria

• Inability to understand assessment questions
• Marked cognitive impairment
• Dementia
• Schizophrenia
• Bipolar Disorder
• Depression with psychotic features
• Delusional Disorder
• Substance Use Disorder or Dependence
• Active suicidal ideation, intent, or plan
• Active homicidal ideation, intent or plan
• Aphasia
• Acute or severe medical illness or life expectancy < 6 months
• Initiated psychotropic medications < 6 weeks prior
• Initiated mental health treatment < 6 weeks prior
• Psychosocial factors that would compromise study participation (such as not having a telephone)