Computer-Assisted Cognitive Behavioral Therapy for Depressed Dialysis Patients, Principal Investigator: Joseph A. Himle, PhD

This project, funded by the University of Michigan Health Sciences Council, utilizes an experienced interprofessional team (Joseph Himle – Social Work; Bonnie Haggerty – Nursing; Jonathan Segal – Medicine) to address two commonly co-occurring health and mental health conditions, end-stage renal disease (ESRD) and depression. ESRD patients require either dialysis treatment or a kidney transplant to survive. Depression is common in this group of patients and when depression and ESRD co-occur, patients experience a range of hardships including problems adhering to dialysis and other care regimens. Patients with depression and ESRD also experience increased hospitalization and mortality rates compared to ESRD patients without depression. Despite these potential hardships, most ESRD patients do not receive appropriate treatment for their depression.

Medications for depression are often a challenge to prescribe and manage given the number of medications taken by ESRD patients and the presence of many co-occurring medical conditions. Psychosocial interventions are often preferred by ESRD patients and providers but access to evidence-based interventions, like cognitive-behavioral therapy (CBT), is challenging.

This project has two specific aims. First, we seek to design and develop a computer-assisted intervention specifically designed for dialysis patients with depression. The treatment will be designed for delivery during dialysis sessions. Our second specific aim is to pilot test the newly developed treatment with ten dialysis patients who suffer from depression. Lessons learned from the pilot study will inform further modifications of the computer-assisted treatment. If the pilot study yields promising results, a larger trial of the refined intervention will follow. If the computer-assisted treatment is ultimately found to be effective, it could be a sustainable, low-cost method to bring potentially life-saving depression treatment to ESRD patients.