PROTECT (Providing Options To Elderly Clients Together)¹ is an ALACRITY funded intervention designed by Dr. Jo Anne Sirey in collaboration with the New York City Department for the Aging. This evidence based intervention focuses on supporting older adults who have experienced elder abuse and are exhibiting symptoms of depression. PROTECT is built on a model of depression that hypothesizes that depression presents itself differently in older adults and should be treated in unique ways, rather than using the same treatments for depression in all age groups.
PROTECT is a short-term, 9 week intervention, designed to target the specific problem experienced by abused older adults. It is delivered by trained clinical social workers who provide services in the most accessible way possible, with the assistance of elder abuse social workers who collaborate with therapists to support clients. Currently, PROTECT is being delivered remotely for the safety of participants and research staff.
We have completed various projects in the past in order to test the efficacy of PROTECT. Our current PROTECT study investigates the effectiveness of PROTECT when delivered virtually. During the COVID-19 pandemic, we hope that the data collected from this research will help us better understand how to best provide services to older adults while in-person services are not available.
Tele-PROTECT Therapy: Effectiveness, Empowerment, and Implementation (NIMH R01132757)
The WHO estimates that 1 in 6 older adults have experienced elder abuse in the past year with rates in the community increasing by as much as 83.6% during the pandemic. Elder abuse (EA) takes a serious physical and emotional toll on older adults, including premature mortality, physical injuries and financial losses. EA victims in NYC are more likely to be women than men, and more likely to be women of color.
Previous work by the SireyLab has demonstrated that 1/3 of victims have clinically significant depressive symptoms. Abused older adults with depression have higher rates of mortality and suicidal ideation. Depression is an additional barrier to implementing safety steps to reduce victimization. PRoviding Options To Elderly Clients Together (PROTECT) is a behavioral intervention for depressed elder abuse victims. It is the only manualized therapy for depressed elder abuse victims designed to be integrated with elder abuse services.
The investigators developed PROTECT to work in synergy with abuse resolution services. PROTECT reduces depression by increasing engagement in pleasurable and rewarding activities and taking steps towards goals to reduce threat. In the investigators' pilot randomized controlled trial, PROTECT showed an increase in behavioral activation and significantly decreased depression as compared to a referral control condition.
In collaboration with partnering elder abuse agencies, the investigators propose a fully powered effectiveness trial of video-delivered PROTECT (Tele-PROTECT) compared to a video- delivered depression education (DepEd) control condition to be delivered to 140 English- and Spanish- speaking elder abuse victims. In partnership with a national elder abuse organization (NAPSA), and using the CFIR, the investigators will examine factors that could affect future implementation of Tele-PROTECT nationally.
Publications:
PROTECT: a novel psychotherapy for late-life depression in elder abuse victims.
Resources:
New York City Department for the Aging
The Department for the Aging (DFTA) provides a wide range of services for older adults living in New York City. DFTA resources include over 200 senior centers across all 5 boroughs, caregiving support, elder abuse support, employment assistance for older adults, and much more.
JASA is a non-profit agency that serves older adults Manhattan, Queens, the Bronx, and Brooklyn. JASA provides a variety of services including legal assistance, case management services, home care services, housing assistance, mental health support, and much more.
PACE Women's Justice Center (PWJC) is a non-profit legal center based out of Westchester New York. PWJC provides free legal services to those who have experienced elder abuse, domestic violence, and sexual assault.
OHEL is a social service agency that provides support services to people of all ages, from camp services for children to mental health services for older adults.
Westchester Behavioral Health Center
Westchester Behavioral Health Center provides psychiatric evaluations and inpatient as well as outpatient services.
Older Adults Technology Services (OATS) is a program through Senior Planet by AARP that aims to help older adults to better understand and use technology. The OATS Senior Center in Manhattan is a technology focused senior center that provides access to technology for New York City older adults.
The ALACRITY grant that funds our PROTECT project is supported by the National Institute of Mental Health.
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1. PROTECT is a proprietary intervention developed by our PI Dr. Jo Anne Sirey. For more information about PROTECT, please email Dr. Sirey at jsirey@med.cornell.edu or Clare Culver at clc4008@med.cornell.edu.