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Symposia

Treatment - CBT

Expanding Access to Evidence-Based Intervention: Adapting Behavioral Activation for Diverse Groups Across the Lifespan

3 - (SYM 39) Lay-delivered Behavioral Activation for Senior Center Clients with Depression: Preliminary Clinical Outcomes from a Multisite Randomized Controlled Trial

Saturday, November 22, 2025
12:41 PM - 1:00 PM CST
Location: Celestin B, Level 3
Keywords: Behavioral Activation, Depression, Underserved Populations
Recommended Readings: Anvari, M. S., Hampton, T., Tong, M. P., Kahn, G., Triemstra, J. D., Magidson, J. F., & Felton, J. W. (2023). Behavioral activation disseminated by non–mental health professionals, paraprofessionals, and peers: A systematic review. Behavior therapy, 54(3), 524-538.,   Martin, F., & Oliver, T. (2019). Behavioral activation for children and adolescents: a systematic review of progress and promise. European child & adolescent psychiatry, 28, 427-441.,   Rethorst, C. D., Trombello, J. M., Chen, P., Carmody, T. J., Lazalde, A., & Trivedi, M. H. (2023). Adaption of tele-behavioral activation to increase physical activity in depression: Protocol for iterative development and evaluation. Contemporary clinical trials communications, 33, 101103.,   Raue, P. J., Sirey, J. A., Dawson, A., Berman, J., & Bruce, M. L. (2019). Lay‐delivered behavioral activation for depressed senior center clients: Pilot RCT. International journal of geriatric psychiatry, 34(11), 1715-1723.,  
Abstract Body



Introduction: Older adult lay volunteers represent a promising group to address the unmet mental health needs of community-dwelling older adults. The aim of this presentation is to present preliminary clinical outcome findings from an ongoing Collaborative R01 RCT comparing a streamlined version of lay-delivered Behavioral Activation (BA) called “Do More, Feel Better” (DMFB) to clinician-delivered BA for English and Spanish-speaking senior center clients.



Method: Across three sites (University of Washington, Weill Cornell Medicine, and University of South Florida), 316 older adults (255 English-speaking and 61 Spanish-speaking) to date have been randomized to receive 9 sessions of DMFB or BA.  Participants were assessed using the PHQ-9 at baseline and weekly as part of delivery of each intervention. All assessment and intervention activities were conducted virtually or in-person. A mixed model with maximum likelihood was used to examine PHQ-9 scores over time. The time*condition interaction was the parameter of interest.



Results: Both groups exhibited reductions in PHQ-9 total scores from baseline (MDMBF=14.4, SDDMBF=3.8; MBA=14.6, SDBA=3.9) to 9 weeks (MDMBF=4.8, SDDMBF=4.1; MBA=5.5, SDBA= 4.4). The time*condition interaction was not statistically significant (B=-0.09; SE=0.05; p=0.05) indicating no between-group difference over time. There was no statistically significant difference in symptom reduction patterns between Spanish vs English-speaking clients (B=-0.48; SE=0.55; p=0.38).



Conclusions: We designed lay-delivered “Do More, Feel Better” to address the lack of available and acceptable mental health services for community-dwelling older adults. Findings lend preliminary empirical support for the comparative effectiveness of DMFB to clinician-delivered BA among both English- and Spanish-speaking older adults with depression.