UA Researchers Strive to Improve Patients’ Moods by Changing Negative Thoughts

TUSCALOOSA, Ala. – With the rural elderly facing many obstacles in seeking services to improve their quality of life, The University of Alabama is bringing some of these services to them.

A combination of poor physical health and an isolated residence can make it particularly difficult for the rural elderly to attend adequate mental health therapy sessions, so UA researchers are offering services in the homes of qualified participants who live in the rural areas surrounding Tuscaloosa and Montgomery.

In a five-year study funded by the National Institute on Aging, the UA researchers are measuring the effectiveness of techniques designed to change the negative thoughts of participants. The techniques, known as cognitive behavioral therapy, are administered during brief, in-home visits.

“A lot of our clients have pretty significant health problems,” said Dr. Forrest Scogin, professor of psychology in the College of Arts and Sciences, and co-principal investigator in the Project to Enhance Aged Rural Living, or PEARL.

“Because of their impairments, their range of opportunities has become much more limited,” Scogin said “It’s easy for them to believe they will never do some of those things they most enjoyed, and some people also have a tendency to trivialize those things they can do.” This can lead to stress and depression.

Clinical social workers visit the patients in their homes, involving the patient’s caregiver, and during therapy sessions help the patient consider a different perspective.

“You may not see that what you are involved in can be enjoyable,” Scogin said. “And some things that might be pleasurable, they might not have considered.”

The ongoing study is open to additional participants. Those interested in learning more should phone 205/348-0274, or toll-free, 1-866-827-3275, or write to: The University of Alabama, PEARL Project, Box 870348, Tuscaloosa, Ala. 35487-0348. As compensation, $25 gift certificates are offered intermittently during the program.

Scogin cited bird watching as an example of something that some home-bound elderly people might find a great deal of enjoyment in, but might not have previously considered. Field guides and fancy binoculars are not necessities, oftentimes just a window and an appreciation of nature is all that’s needed.

According to Dr. Allan Kaufman, professor of social work and another of the principal investigators for PEARL, this type of cognitive behavior therapy among the rural homebound has not been studied elsewhere.

“If we can prove that this works,” Kaufman said, “it could set a model for the rest of the country in terms of delivering mental health services to home-bound elders.”

Other UA researchers involved in the study are Dr. Louis Burgio, distinguished research professor in psychology; Dr. Robert Pieroni, a physician and professor of internal medicine and family medicine in the College of Community Health Sciences, and Dr. Jeri Dunkin, professor and Martha Saxon Memorial Endowed Presidential Chair in UA’s Capstone College of Nursing.

In addition, the study hopes to prove that this approach can lessen the burden now put on medical services by the rural elder population.

“We know from previous research that older people who are medically frail and have emotional issues, tend to make more use of medical services that are not necessarily for medical reasons,” explains Kaufman.

“What we’re predicting is that if we’re successful in improving their emotional well being, they will make fewer demands on the medical system which would be a cost-benefit analysis that works in our favor,” he added.

The effort is paid for via a $3 million grant awarded to the UA researchers from the National Institute on Aging.