An implementation demonstration of Engage, a behavioral intervention for depression, in a geriatric mental health care setting

OBJECTIVES: Engage is an empirically-supported brief behavioral intervention for later-life depression yet to translate from randomized controlled trials to implementation. This study evaluated a real-world implementation demonstration of Engage across a geriatric mental health care setting. METHOD: The exploration, preparation, implementation, sustainment framework guided this demonstration. Interprofessional case managers received training and ongoing consultation in Engage and applied it with older adults with depression over four months. Upon completion of the implementation trial, providers participated in a 1-h focus group to provide feedback about training, treatment perceptions, and facilitators and barriers to implementation. Focus group transcripts were double-coded using thematic analysis to extract themes informed by the Consolidated Framework for Implementation Research (CFIR). RESULTS: Thirteen themes emerged from focus groups (N = 21 provider participant respondents) related to CFIR constructs of innovation adaptability, innovation design, critical incidents, compatibility, access to knowledge and information, need, and capability. Findings suggest that Engage is feasible and fits the needs of providers, patients, and the healthcare system. Implementation barriers included depressive symptom burden, patient complexity, and therapist concerns related to self-efficacy and previous experiences. CONCLUSION: Provider feedback can inform and strengthen implementation of evidence-based psychotherapies such as Engage.