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NCT Number: NCT06910267

Leveraging Adult Protective Service Interaction to Offer Evidence-Based Treatment for Depression in Elder Neglect/Self Neglect

The purpose of this study is to test the feasibility and acceptability of an evidence-based treatment for depression delivered over an ipad, computer, or smartphone can help Adult Protective Services (APS) clients with their activities of daily living to evaluate whether reductions on measures of depression and apathy (a) mediate reduced Elder Neglect/Self Neglect (EN/SN) behaviors; and (b) whether secondary posited mediating mechanisms are also active in impacting depression and apathy

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Key information

Conditions

Depression in Old Age

Age range

65 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • APS Case in APS Region VI- Must have open case
  • PHQ 9 score- Must have score of nine (9) or more

Exclusion criteria

  • Previous mental health diagnosis of bipolar disorder, psychotic disorders, and moderate to severe dementia
  • Assessment of Consent Proxy- Those who need assessment of consent proxy
  • Suicidal Intent (as indexed by PhQ-9 question 9)- Those scoring 2 or 3
  • Current Alcohol and Drug Dependency- As evidenced by Cut down, Annoyed, Guilty, and Eye-opener (CAGE) score of 3 or more

Treatment and study plan

APS Treatment as Usual

Behavioral

APS agencies conduct in-home investigations of alleged abuse and neglect against disabled and older adults. Investigations result in short-term stop-gap measures, primarily brief case-management centering on referral linkage to community-based services and provision of resource allocation. No direct psychological services or treatments are provided by APS, however referral to other services is also standard.

Intervention-Behavioral Activation (BA)

Behavioral

Participants will be will be guided through 8 one-hour sessions via home telehealth by the study community health worker. Each weekly < 60 minute BA session will include modules focusing on 1) Psychoeducation for depression and techniques for self-management, including pharmacologic and psychosocial treatment options; 2) Introduction of BA and guided problem-solving techniques to enhance self efficacy for managing depression and other chronic illnesses; 3) BA and problem-solving techniques to support medication management and adherence strategies; 4) BA to develop strategies and techniques for communicating with health providers and/or support resources to foster positive mood and self management; and 5) Developing a relapse prevention plan, which includes identifying triggers for lower functioning, support resources, and practice of BA techniques.

Primary outcomes

  1. Change in depression as assessed by the Patient Depression Questionnaire (PHQ-9)

    Time frame: baseline, post-treatment ( 8 weeks after baseline), and 3 months

    This is 9 item questionnaire and each is scored from 0 (not at all) to 3 (nearly every day), for a maximum score of 27, higher score indicating more depression

  2. Change in apathy as assessed by the Apathy Motivations Index (AMI)

    Time frame: baseline, post-treatment ( 8 weeks after baseline), and 3 months

    This is an 18 item questionnaire and each item is scored on a scale from 0(completely true) to 4(completely untrue), for a maximum score of 72, with higher scores indicating greater apathy

  3. Change in Elder Neglect/Self Neglect (EN/SN) as evidenced by study developed goal attainment scale

    Time frame: baseline, post-treatment ( 8 weeks after baseline), and 3 months

    Participants will be given a list of 19 common daily activities and will be asked to pick one or more activities form the list that they would like to start doing or do more regularly each day or week.Each activity will be then scored based on the following scoring criteria, higher score indicating better outcome :

    (Much less than expected)-2 (Somewhat less than expected)-1 (Expected client outcome)0 (Somewhat better than expected)+1 (Much better than expected)+2

Secondary outcomes

  1. Change in social connection as assessed by the Lubben Social Network Scale

    Time frame: baseline, post-treatment ( 8 weeks after baseline), and 3 months

    This is a 6 item questionnaire and each is scored from 0(none) to 5(none or more contacts) for a total score range of 0-30 higher scores indicating better outcome

  2. Change in social isolation as assessed by Patient-Reported Outcomes Measurement Information System (PROMIS 8)

    Time frame: baseline, post-treatment ( 8 weeks after baseline), and 3 months

    This is an 8 item questionnaire and each is cored from 1(never) -5 (always) for a maximum score of 40, higher score indicating worse outcome

Study contacts

Contact information is provided by the study sponsor or research team.

Jason Burnett

CONTACT

[email protected]

(713) 873-4685

Leila Wood, PhD, MSSW

CONTACT

[email protected]

(713) 486-2700

Sponsors and collaborators

Lead sponsor

The University of Texas Health Science Center, Houston

Other

Collaborators

  • National Institute on Aging (NIA)

Registry information

Important dates

Study start
2026
Primary completion
2026
Study completion
2027
First posted
Apr 4, 2025
Registry last updated
Jun 30, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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