Intervention for Anxiety After Falls

The purpose of this study is to determine whether a brief intervention for disabling anxiety is practical to conduct and beneficial for older adults injured by falls.

Falls are the most commonly occurring cause of traumatic injury among older adults. For many, the consequences include reduced mobility, difficulty performing basic self-care, social isolation, deteriorating health, or even death. Most interventions for falls do not address anxiety in the aftermath of falling. After an initial study assessment, participants will complete 8 home-based sessions of a Cognitive-Behavioral therapy (CBT). The sessions will be led by a study clinician who will cover the 5 intervention components:(a) education (learning about anxiety and the rationale for treatment); (b) relaxation training (learning skills to reduce tension); (c) cognitive restructuring (learning skills needed to cope better with distressing thoughts); (d) behavioral activation (learning to initiate healthy activity); and (e) exposure (coaching in how to confront avoided thoughts, situations, and people). Participants will also complete assessments following completion of the intervention and 3 months after completion of the intervention.

The Clinician Administered PTSD Scale (CAPS) and Survey of Activities and Fear of Falling in the Elderly (SAFE) will be primary outcomes.

At initial assessment, following completion of intervention, and 3 months after completion of intervention

Beck Anxiety Inventory, Beck Depression Inventory, Reintegration to Normal Living, Health Related Quality of Life, and other measures will be included.

At initial assessment, following completion of intervention, and 3 months after completion of intervention

Inclusion Criteria: age > or = 65 years English-speaking injured due to fall hospitalized returned home < or = 3 months ambulatory full or subsyndromal PTSD or Fear of Falling residing in one of the five boroughs of New York City Exclusion Criteria: Inability to understand assessment questions Marked cognitive impairment Dementia Schizophrenia Bipolar Disorder Depression with psychotic features Delusional Disorder Substance Use Disorder or Dependence Active suicidal ideation, intent, or plan Active homicidal ideation, intent or plan Aphasia Acute or severe medical illness or life expectancy < 6 months Initiated psychotropic medications < 6 weeks prior Initiated mental health treatment < 6 weeks prior Psychosocial factors that would compromise study participation (such as not having a telephone)