A Study of Brief Behavioral Activation for the Treatment of Depression in Older Adult Cancer Survivors

Inclusion criteria

• Phase I:
• As per self-report or medical record, ≥65 years old
• As per self-report or medical record, has a history of cancer
• As per medical record and/or clinician confirmation:
• a patient in MSK Survivorship Clinics AND/OR
• no evidence of disease (NED) AND/OR
• 6 months or more post-treatment (patients on maintenance hormonal therapies are eligible)
• Fluent in English, as per self-reported fluency of "well" or "very well"\*
• As per self-report, able to communicate over video-conference and/or phone for sessions
• Elevated score on the PHQ-9: ≥5 (N/A for Training Case participants)
• Received a Blessed Orientation-Memory-Concentration Scale (BOMC) score of ≤ 11 (N/A for Training Case participants)
• Phase II:
• As per self-report or medical record, ≥18 years old
• Fluent in English, as per self-reported fluency of "well" or "very well"\*
• As per self-report or medical record, has a history of cancer
• Elevated score on the PHQ-9: ≥5
• Received a Blessed Orientation-Memory-Concentration Scale (BOMC) score of ≤ 11 (N/A for Training Case participants)
• Note. The eligibility criteria for Phase II allows inclusion of younger participants and those receiving active treatment due to the theoretical rationale that a single-session intervention will remove certain barriers that are believed to exist for these groups in receiving the longer, 10-session intervention.

Exclusion criteria

• Phase I:
• As per PI determination, requires a higher level of care for current passive or active suicidal ideation than current protocol is able to provide. If a participant receives a score of \> 0 on item 9 of the PHQ-9, they will be referred to study PI for further evaluation. They will be excluded from participation in this study if the PI determines they would be appropriate for a higher level of care than BA may be able to provide.
• As per self-report or as documented in the medical record, current untreated (e.g., no medication, no therapy) major psychotic disorder (schizotypal personality disorder, schizophreniform disorder, schizoaffective disorder). Patients diagnosed with a major psychiatric disorder will be reviewed by the study PI to determine eligibility prior to consent.
• As per self-report or medical record, currently taking antidepressant medication for \< 3 month
• As per medical record, patient has impaired decision-making capacity
• Phase II:
• As per PI determination, requires a higher level of care for current active suicidal ideation than current protocol is able to provide. If a participant receives a score of \> 0 on item 9 of the PHQ-9, they will be referred to study PI for further evaluation. They will be excluded from participation in this study if the PI determines they would be appropriate for a higher level of care than BA may be able to provide.
• As per self-report or medical record, current weekly psychotherapy or currently taking an antidepressant for \<3 months.
• As per medical record, patient has impaired decision-making capacity
• Language verification: Prior to enrollment, patients will be asked the following two questions by research staff to verify English fluency necessary for participation in the study:
• How well do you speak English? (must respond "Well" or "Very well" when given the choices of Very well, Well, Not well, Not at all, Don't know, or Refused)
• What is your preferred language for healthcare? (must respond English)