(PS10-3) Older Adults' and Lay Providers' Appraisal of CBT Based Guided Self-help for Generalized Anxiety Disorder

Generalized anxiety disorder (GAD) is highly prevalent in late life but relatively few older adults receive treatment. Provider-related factors (e.g. shortage of geriatric mental health care specialists) and extrinsic barriers (e.g. lack of transportation) may contribute to older adults' lower rates of mental health care utilization. CBT based self-help (CBT-SH) guided by a lay provider (LP) is a promising treatment which can help overcome some barriers to accessing mental health care. The satisfaction of persons receiving treatment is an important aspect of its effectiveness but considering different sources, including the perception of providers, allows a more complete view of its value. We documented and compared the satisfaction of older adults with GAD (≥ 60 years, n = 129) who received CBT-SH and the perception of trained and supervised LPs (n = 17) who guided them. The 15-week treatment consisted of readings and exercises, as well as weekly support calls from the same LP. At post-treatment, older adults assessed their experience of CBT-SH and LPs evaluated the intervention for each older adult they guided. Individuals in both groups rated the same 19 statements covering various aspects of CBT-SH. The proportion of older adults reporting satisfaction with the different aspects of treatment ranged from 74.22% to 100% while the proportion of LPs reporting positive perception ranged from 80.47% to 99.22%. Correcting false beliefs about worry and cognitive exposure to worry were among the aspects rated least favorably. Group differences on the rating of individual statements were mostly small and nonsignificant. Prevalence- and bias-adjusted kappa coefficients showed strong or almost perfect agreement between older adults and LPs on most statements. Taken together, these findings indicate a favorable perception of CBT-SH guided by a LP for GAD in older adults and suggest useful avenues for clinical practice and future research.