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Treating Depression in the Prison Nursing Home

Demonstrating Research-to-Practice Translation

University of Louisville

Robin Sublett

Kentucky State Reformatory

Irene Kostiwa

University of Louisville

James R. Rodgers

University of Louisville

Donna Haddix

Kentucky State Reformatory

We describe a theoretically grounded and empirically developed intervention for depression with older men in a state reformatory nursing home. As the number of prisoners "aging in place" rises, there is a critical need for research on mental health interventions in prison nursing homes where inmates may be at high risk for depression and suicide. The participants in this project were four male residents in the Kentucky state prison system nursing home; all four had diagnoses of major depressive episodes. BE-ACTIV, a behavioral treatment for depression, is a hybrid approach that combines one-to-one sessions with the depressed resident and work with staff. One-to-one sessions motivate the resident to engage in new activities, while meetings with nursing home staff break down barriers to completion of pleasant events. Over the 10-week treatment, depressive symptoms declined, and global functioning increased an average of 13 points per participant. Two of the participants showed improved self-reported negative affect. Study results suggest that BE-ACTIV is feasible in the prison nursing home and has the potential to improve the quality of life for medically frail prisoners by helping them to identify meaningful or pleasant activities. The cases illustrate importance of therapeutic relationships in the context of improving depressive symptoms, and the possibility of building effective relationships in a setting with multiple barriers to effective treatment.

Key Words: nursing homes • prisoners • depression • treatment

This version was published on December 1, 2008

Clinical Case Studies, Vol. 7, No. 6, 555-574 (2008)
DOI: 10.1177/1534650108321303


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