Women Physical Disability and Depression: Communities Responding Now!

Rates of depression and suicide in women with physical disabilities (WPD) are up to five times higher than in the general population. Despite this disparity, few intervention studies that address the specific needs of this population are available. To begin to address objective 6-3 of Healthy People 2010 and reduce the proportion of WPD who experience depressive symptoms, interventions relevant to the lives of WPD are urgently needed. In keeping with national priorities and the need for consumer participation in the development of mental health therapies, the proposed project will use an existing cognitive behavioral therapy (CBT) intervention that has demonstrated effectiveness in reducing depressive symptoms in women as a starting point from which to co-create an intervention that addresses the specific needs of WPD. The co-creation process will occur in the context of a partnership between the investigators, WPD in the community, and three Oregon Centers for Independent Living (CILs). This partnership will be expanded to include four additional Oregon CILs during the last year of the proposed project for the purpose of developing a peer mentored train-the-trainer program that will facilitate consumer control and promote the sustainability of the intervention. The specific aims of the proposed project are to: 1. Modify an existing cognitive behavioral group therapy intervention to address the specific needs of WPD who experience depressive symptoms; 2. Conduct an efficacy trial using a mixed-methods approach. The proposed study outcomes were derived from our previous work with WPD as well as from members of the disability community. An efficacy trial of the modified intervention with a total of 135 participants will be conducted using a wait list control design; and 3. Develop a peer mentored train-the-trainer program to facilitate consumer control and promote the sustainability of the intervention. A long-term goal of the proposed project is to increase the capacity of CILs across the country to offer a relevant, effective, accessible, and affordable intervention to help WPD with depression overcome this debilitating secondary condition.