Introduction: With increasing longevity the population of the world is becoming older and there are growing numbers of people over the age of 65 years. This has implications for services providing psychological treatment to older people as there is likely to be an increasing demand for evidenced-based treatments such as Cognitive Behaviour Therapy (CBT) in the coming years. There are, however, relatively few clinical psychologists specialising in working with older people and therefore additional ways of dealing with the growing demands are essential. Computerised Cognitive Behaviour Therapy (CCBT) offers one potential option and NICE recommends Beating the Blues (BTB) as the most clinically and cost-effective package for treating depression. However, no study to date has explored the use of BTB with older people. Objective: The objective of the study was to address this gap in the literature and had the following aims: 1) to explore the uptake rate of BTB with older people; 2) to explore the characteristics of older people opting to receive BTB; 3) to explore the drop-out rate from BTB with older people; and 4) to determine if BTB was effective in reducing symptoms of depression and anxiety in older people experiencing these difficulties. The findings were compared to previous research on BTB with younger adults. Methodology: A between-groups, repeated measures design (with assessment time as the repeated measure) was used. Participants were given a free choice of receiving BTB plus treatment as usual (BTB+TAU) or treatment as usual alone (TAU). Treatment as usual was provided by clinicians from older people community mental health teams (e.g. psychiatric nurses) and the only constraint that was placed in this was that no face-to-face psychological therapy from an accredited therapist could be provided. The participants opting to receive BTB also completed eight sessions of BTB on a weekly basis. All participants completed a range of outcome measures prior to commencing treatment (pre), after eight weeks (post) and after a further 4 weeks (one month follow-up). Results & Discussion: The results indicated that 56.9 per cent of the participants opted to receive BTB and they reported having significantly more experience and confidence using a computer than those who declined BTB. It was also found that 72.7 per cent of older people completed all eight sessions of BTB (27.3 per cent discontinuation rate). This was comparable to what has been found in previous studies of BTB with younger adults. A two (treatment group) x three (time) repeated measures ANOVA revealed that, in comparison to the TAU group, the BTB+TAU group showed statistically significant greater improvements on measures of depression and anxiety by the end of treatment. This was maintained at one month follow-up. Furthermore, in comparison to the TAU group the BTB had a higher percentage of participants who met criteria for clinically significant improvement by the end of treatment and at one-month follow-up. The results suggest that BTB is an acceptable and effective treatment for older people experiencing depression and anxiety and the implications of these findings are discussed.

Introduction: Current recommendations by National Institute of Clinical Excellence (Technology Appraisal 51) emphasise the need for future research to examine the effectiveness of CCBT across the age span. Kaltenthaler et al. (2008) recommended future research focuses on acceptability of CCBT through using ‘survey and intensive qualitative methods, include the process of initial engagement, continuation versus drop-out, and in those completing, satisfaction or regret undertaking CCBT’ (p.1528). The pilot study by McMurchie (2011) was the first to explore the acceptability and effectiveness of the CCBT package Beating the Blues (BTB) solely with older people. Using qualitative methodology, the aim of the current study was to explore the experiences of older people who, when participating in the pilot study chose to use BTB compared to those who chose to remain with their treatment as usual (TAU). The current study aimed to gain a deeper understanding of the acceptability of BTB as well as factors that influence decisionmaking in terms of uptake to BTB and discontinuation from BTB. Method: Individual semi-structured interviews were carried out with 20 older people who took part in the pilot study (McMurchie, 2011). Participants were in one of three groups, these were: BTB-completers, BTB-discontinuers and TAU. Transcripts were analysed using Interpretative Phenomenological Analysis (IPA) (Smith et al., 2009). Findings: Five master themes emerged from the interviews: Beating the Blues as a Process of Change; Relevance of Beating the Blues to Older People; Challenges of Using Beating the Blues; Motivation to Try Something New and Barriers to Beating the Blues at Time of Uptake. Conclusions: Overall, the master themes reflected the experiences of either “regaining control” or a sense of “hopelessness” when opting whether or not to use BTB in the first instance and to then continue with the treatment. Experiences of using BTB appeared to be linked to the outlook participants had about using a novel treatment with either a sense of hope or impending failure. Participants who chose BTB had a more positive outlook which impacted their ability to manage perceived challenges and work towards recovery. The sense of impending failure seemed to be linked to participants perceiving more barriers to using BTB and struggling to overcome these challenges, resulting in them either declining BTB or feeling they were not benefiting from BTB and therefore discontinuing it.

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