Problem-Solving Therapy for Older Adults at Risk for Depression: A Qualitative Analysis of the Depression in Later Life Trial

Fredric Azariah, Miriam Sequeira, Alex Cohen, Amit Dias, Jennifer Q. Morse, Stewart J. Anderson, Pim Cuijpers, Vikram Patel, Charles F. Reynolds

Research output: Contribution to JournalArticleAcademicpeer-review


OBJECTIVE: As a sequel to the Depression in Later Life trial of lay counselor-delivered problem-solving therapy for depression prevention among older adults in Goa, India, this qualitative study aimed to explore participant experiences to illuminate the reasons for the trial's positive findings and implications for further efforts at depression prevention in low-resource settings. METHODS: In-depth interviews were conducted with 19 participants (21% of those randomly assigned to the original intervention). Two independent raters coded the data and organized narratives according to broad themes. RESULTS: Most participants valued their relationship with the lay counselor, learned self-care strategies to cope with illnesses, and increased engagement in pleasurable social and physical activities. Some participants reported needing assistance with managing financial strain and family conflicts. CONCLUSIONS: The lay-counselor-delivered intervention was well received. The relationship with the counselor and behavioral activation toward better self-care and more-pleasurable activities may have been keys to the intervention's success.

Original languageEnglish
Pages (from-to)88-94
Number of pages7
JournalAmerican Journal of Psychotherapy
Issue number4
Publication statusPublished - 1 Dec 2019


This research was funded by the U.S. National Institute of Mental Health (grants R34-MH-096997 and P30-MH-90333).

FundersFunder number
U.S. National Institute of Mental Health
National Institute of Mental HealthR34-MH-096997, P30-MH-90333


    • Depression prevention
    • lay counselor
    • low-resource setting


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