Introduction

Contributing Factors

Identifying Symptoms of Depression

Treatment

“Real” Intersection of Systems

Action Ideas That Work

Resource Links

Resource Pages

References

Action Ideas That Work

Understanding Depression: A free series of educational forums provided by six south Minneapolis churches

Health Fair – Understanding Mental Health and Depression

Tele-Group for Depression

Friendly Visitor Programs

Befriender and Stephen Minister Lay Ministry Programs

A Card Ministry

Tele-Group for Depression

The Tele-Group for Depression program was developed by the University of Minnesota School of Nursing in association with the Minnesota Nursing Association Foundation. It is a way for those who don’t have easy transportation, those who live in very rural areas, and those who wish to remain “anonymous” to participate in an interactive, structured activity to help them learn new skills to manage depression.

The Tele-Group was developed by an advanced practice psychiatric mental health nurse at the University of Minnesota, Dr. Merrie Kaas, who has worked with the elderly for more than 30 years. Throughout her career, Dr.. Kaas found that help for depression was largely an access issue. She also experienced that cognitive/behavioral therapy worked for geriatric depression. Utilizing materials developed by Palo Alto Veterans Affairs for in-person geriatric depression support groups, Merrie adapted the materials so they could be used by phone.

Up to four individuals, along with two therapists, participate in the structured telephone calls over the course of 12 weeks. Anonymity is an important feature of the program – there are no phone numbers, last names or addresses published about the participants. To make it more personal, though, each participant completes and biographical sketch and is asked to share that and their picture with the others in the group.

The coordinator connects each participant into a conference service once a week, the same time and day every week. During the call, participants and therapists review the weekly manual topic, and have a structured discussion about it. Using a cognitive behavioral therapy approach, participants learn new skills for coping with depression as well as find a support group of others experiencing the same disease.

Other key aspects of the program:

• The project coordinator takes a brief history of each participant, either in person or on the telephone, prior to the start of the 12-week session.
• Each participant completes the depression scale evaluation to determine the severity of the depression. The program focuses on individuals with mild to moderate depression, as it has been found that the severely depressed have trouble concentrating on the material and completing the assignments.
• Participants receive 12 weeks of manuals printed in a larger typeface. They are required to read two to three pages of the manual and complete a worksheet prior to the telephone call each week.
• So far, the program has focused on women only, because depression is higher in women and older women are typically comfortable talking on the telephone.
• Currently, the program is free for participants. Individuals are required to have a telephone – however, the University of Minnesota has speaker phones, hands-free head sets, and hand set amplifiers that it will loan to groups members for the duration of the 12 weeks. Ms. Kaas forms and holds group sessions as enough individuals sign up to participate.

A recent evaluation of the program found that those who actively participated each week, who did their background reading and worksheet, fared better at changing their behavior and managing their depression. Others who were not as committed to the program, or who were not ready to make changes, did not see such a positive change in their depression scores. Overall, participants have evaluated the program to be accessible and user-friendly.

If you would like to refer someone to this program, or for more information on this topic, contact Dr. Merrie Kaas, DNSc, Associate Professor at the University of Minnesota School of Nursing, kaasx002@umn.edu. Dr. Kaas is also an accomplished speaker on the topic of geriatric depression, and makes presentations across the state, at no charge.

While the Tele-Group program is fairly intense, there are ways that congregational nurses can learn how to implement it, or to adapt it, to fit their needs:

• If you are interested in becoming a trained to implement this program, Merrie Kaas is planning to train co-leaders who could conduct their own tele-groups. It is important that you have some prior background in psychology and be knowledgeable and sensitive to the aspects of depression.
• For those elders with depression who are located in remote locations or have mobility difficulties, consider setting up a dedicated time each week for a telephone call. You could follow-up on issues that you’ve discussed in the past, check on medication compliance if needed, and simply be a listener. You could also continue to connect there individuals to other services as needed.
• Many community agencies have developed “Telefriend” programs. In these programs, trained volunteers place calls to persons daily or weekly to check in and make sure they are well. Some programs match senior volunteers to seniors while some match senior volunteers to youth. Often volunteers simply chat or read books, or give the person an outlet to talk.