Stepped Care Treatment of Anxiety and Depression in Older Adults

Stepped Care Treatment of Anxiety and Depression in Older Adults

The 2018 Australian Rural & Remote Mental Health Symposium will this year be held over 15-17 October at the Hotel Grand Chancellor, Hobart, Tasmania.

Joining us at the conference is Associate Professor Viviana Wuthrich from the Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney who will present on ‘Stepped Care Treatment of Anxiety and Depression in Older Adults’.

Associate Professor Viviana Wuthrich


Introduction: A universal challenge for evidence-based treatment is to integrate validated programs into routine health service delivery. Evidence-based treatments are more likely to be incorporated within public services when they can demonstrate maximum cost-effectiveness. Stepped care delivery is increasingly promoted as an innovative system by which to optimise the balance between outcomes and costs. Stepped care relies on provision of low intensity (lower cost) evidence-based services first, followed by higher intensity (higher cost) evidence-based services only to those who need additional assistance.

Method: This study will evaluate whether evidence-based treatments for older-adult anxiety and depression can be delivered through existing public and private older adult mental health services utilising a stepped care model; whether this model reduces costs and/or increases outcomes over existing treatments; and whether this model of service delivery is acceptable and viable for consumers and providers. This model is currently being tested across five Australian sites within existing services representing public (urban, regional) and private organisations in a 4-year randomised controlled trial. We will examine effectiveness and cost effectiveness of these stepped psychological interventions compared to treatment as usual.

Results and Conclusions: This study is in the recruitment phase and so no results will be available for this trial, but the literature for evidence-based low intensity interventions (computerised and telephone based) and higher intensity (face to face CBT) will be outlined, and the project design will be presented along with information about the trials progress and the key challenges.

Key Learnings:
1. Stepped Care models for older adult anxiety and depression have the potential to increase efficiency and effectiveness of interventions delivered.
2. Options for low intensity interventions are highly feasible in remote and rural locations.
3. Stepped care is likely to be cost-effective.


Associate Professor Viviana Wuthrich is a clinical psychologist and researcher in the Centre for Emotional Health, Department of Psychology, Macquarie University. Her research expertise is in understanding, assessing and treating anxiety disorders across the lifespan, with particular interests in older adult mental health.

For more information on the 2018 Australian Rural & Remote Mental Health Symposium and to secure early bird discounted rates currently on offer please visit

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