Telephone-based cognitive behavioral therapy for depression in Parkinson's disease release_dh4plqbuhbdvlj3ti3vbp3f5yu

by John Durland

Published by No Publisher Supplied.

2017  

Abstract

Four patients treated by the author as part of a telehealth cognitive behavioral treatment program (GSH-dPD) for depression in Parkinson's disease pioneered by Dr. Roseanne Dobkin were selected as subjects for pragmatic case studies. These case studies used the Pragmatic Case Study methodology to combine within each case a) quantitative data, comprised of demographic information, psychiatric diagnostic data, neurocognitive data, treatment outcome measures, and feasibility/adherence data, and b) qualitative data, consisting of post-treatment patient interviews and the author's treatment notes and observations. This study aims to provide a nuanced portrait of the TH-CBT treatment process, to explore the presence and influence of barriers and facilitators of treatment in an idiographic context, and to generate hypotheses regarding potential mediators and moderators of treatment outcome that might be tested empirically or used to guide clinical decision-making within this treatment paradigm. The Pragmatic Case Study approach was seen as an important complement to controlled empirical clinical research through its focus on the individual case rather than the sample, its emphasis on idiographic detail, its capacity to provide clinicians with hypotheses regarding clinical treatment questions for which empirical research is lacking or inconclusive, and its long-term potential to inductively generate clinical knowledge through the development of a cross-referenced case study database. Literature relevant to the treatment of depression in Parkinson's disease (dPD) was reviewed, a description and rationale for the application the Pragmatic Case Study approach was presented, a systematic case write-up for each of 4 the selected patients was presented, and clinical implications of these cases in the context of the dPD population and the TH-CBT treatment paradigm were explored. The themes addressed in the analysis of the four case studies included: caregiver involvement, cognitive impairment, management of tangentiality, [...]
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