(PS1-D76) A Literature Review: The Role of Remotely-delivered Cognitive Behavioral Therapy in Addressing Older Adults’ Psychological Well-being During the COVID-19 Pandemic

Introduction: Older adults (OAs) are vulnerable during crises and need psychological services. Few studies examined the effect of using CBT-based interventions remotely with OAs during COVID. This review outlined the current literature on using remotely delivered CBT with OAs during the pandemic.

Objectives:
- To identify the intervention design, type, techniques, strategies, and targeted intervention outcomes of CBT used with OAs during COVID.

- To discuss interventions’ effectiveness, feasibility, and special considerations relating to the population or the pandemic conditions.

Methodology: Searched the databases of APA PsycInfo, APA PsycArticles, SocINDEX with Full Text, Academic Search Complete, MEDLINE and Psychology and Behavioral Sciences Collection, which were accessed on Feb 10, 2023. A search was performed using the terms “Cognitive Behavioral Therapy” or “Cognitive behavioral Treatment” or “CBT”, “older adults” or “elderly” or “geriatrics” or “seniors”, and “Covid” or “coronavirus” or “covid-19” or “pandemic” filtered by peer-reviewed journals between 2019 to 2023 with (37 results). Duplicates, Case studies, systemic reviews, letters, and non-directly relevant studies (33 studies) were excluded. The analysis was conducted based on a total of (4 Studies) that met the inclusion criteria.

Results: All studies utilized short-term ( 4 to 9 weeks) interventions through telephone, video conference (Zoom), and an online program (WeChat). Used strategies included behavioral activation, relaxation, guided imagery, cognitive restructuring, and psychoeducation. Interventions targeted depression, anxiety, distress, loneliness, functional disability, social support and health-related quality of life. Two randomized control trial studies found remotely delivered CBT effective in improving OAs’ mental health compared to control groups in both group and individual therapy settings. Two pre/post single-group feasibility trial studies showed the feasibility of Internet-based CBT in ameliorating mental health issues and improving the quality of life of OAs with chronic obstructive pulmonary disease and those living in a nursing home without cognitive impairments. These results support the adaptation of CBT to address older adults’ mental health needs during times of crisis.

Discussion:  Internet-based treatment, like the clinician-guided ICBT using WeChat, assumes a set of abilities that some OAs may not have (vision). Some older adults find videoconferencing technologically challenging, but Shapira et al. (2021) showed they could be successfully trained. It's important to choose the CBT delivery type based on the the population characteristics and available resources. Telephone-delivered CBT may be more accessible and feasible with OAs (Pellas et al., 2022).

Conclusion: Reviewed remotely-delivered CBT interventions showed feasibility in promoting older adults coping during COVID time and alleviating mental health effects, especially depression. These promising results suggest potential benefits in helping homebound, socially isolated, or lonely older adults in routine times. Randomized clinical trial studies are needed to examine remotely-delivered CBT effectiveness in this population.