Modular Psychotherapy for Anxiety in Older Primary Care Patients

Objective: To develop and test a modular psychotherapy protocol in older primary care patients with anxiety disorders. Design: Randomized, controlled pilot study. Setting: University-based geriatric medicine clinics. Participants: Thirty-one elderly primary care patients with generalized anxiety disorder or anxiety disorder not otherwise specified. Intervention: Modular form of psychotherapy compared with enhanced community treatment. Measurements: Self-reported, interviewer-rated, and qualitative assessments of anxiety, worry, depression, and mental health-related quality of life. Results: Both groups showed substantial improvements in anxiety symptoms, worry, depressive symptoms, and mental health-related quality of life. Most individuals in the enhanced community treatment condition reported receiving medications or some other form of professional treatment for anxiety. Across both conditions, individuals who reported major life events or stressors and those who used involvement in activities as a coping strategy made smaller gains than those who did not. Conclusions: Results suggest that modular psychotherapy and other treatments can be effective for anxiety in older primary care patients. Results further suggest that life events and coping through increased activity may play a role in the maintenance of anxiety in older adults.