Projects

PATH-Pain - Currently recruiting new participants

Funded by the National Institute of Aging

Grant #: 1R01AG070055

This research study assesses whether a specialized program involving talk therapy is effective in improving attention and concentration, mood, and pain in older adults who suffer with cognitive difficulties, low or sad mood, and pain-related difficulties. PATH-PAIN differs from standard psychotherapy by offering a combination of emotion regulation techniques with the provision of environmental adaptation tools (notes, checklists, calendars, etc.), and the participation of a willing and available study partner. PATH-PAIN utilizes techniques to improve communication between patients and primary care providers and overcome obstacles in adherence to pain treatment. Study participants are randomized into one of two study groups: PATH-PAIN or Usual Care. PATH-PAIN focuses on the participant, the study partner, and the participant's home environment to encourage problem solving and adaptive functioning and to improve low or sad mood. 

Problem Adaptation Therapy (PATH) - Not currently recruiting new participants

Funded by the National Institute of Mental Health

Grant #: K23 MH074659; R01MH091045

Principal Investigator: Dimitris Kiosses, Ph.D.

Dr. Kiosses has developed Problem Adaptation Therapy (PATH), an emotion regulation psychosocial intervention for older adults with depression and cognitive impairment, which aims to reduce depression and disability in this population. PATH focuses on improving the functioning of older adults with cognitive deficits in their actual environment. PATH therapists use environmental adaptation tools (i.e. signs, calendars, notes, etc.) to help cognitively impaired older adults bypass their functional and cognitive limitations, and incorporate caregiver or family member involvement, if necessary.  PATH was developed as a home-delivered intervention but it can also be administered in the therapist’s office.   

PATH-MCI - Currently recruiting new participants

Funded by the National Institute on Aging

Collaboration with Johns Hopkins University School of Medicine and Montefiore Medical Center

Grant #: R01 AG050514

Principal Investigators: Dimitris Kiosses, Ph.D. (Cornell); Paul Rosenberg, M.D. (Johns Hopkins)

This study compares Problem Adaptation Therapy for Mild Cognitive Impairment and Depression (PATH-MCI) with Supportive Therapy for Cognitively Impaired Older Adults (ST-CI) in improving cognitive, affective and functioning outcomes among older adults with depression and cognitive impariment. PATH-MCI differs from standard of care psychotherapy by offering a combination of emotion regulation techniques with the provision of environmental adaptation tools (notes, checklists, calendars, etc.), the use of the WellPATH app, and the participation of a willing and available caregiver. Supportive Therapy incorporates standard of care approaches by using non-specific techniques to provide a supportive environment and help patients to express their feelings & focus on their strengths and abilities. Study participants are randomized to either 12 weekly sessions and 3 monthly booster sessions of PATH-MCI or ST-CI.

PATH in the United Kingdom (PATHFINDER) - For participation please contact UCL

Collaboration with University College London to integrate PATH into the National Health Service

Investigators: Robert Howard, Rebecca Gould, Liz Cort

This study focuses on implementing PATHFINDER. It is funded by the National Institute for Health Research – Health Technology Assessment of the UK. It is designed to be a version of PATH adapted for people in the UK with mild to moderate dementia. Patients are randomly assigned to either the adapted version of PATH therapy or usual care. They receive 8 weeks of the adapted version of PATH therapy, the first two sessions are in the patient’s home.

PATH in Homecare - For participation please contact Montefiore Medical Center

Collaboration with Montefiore Medical Center

Investigators: Jessica Zwerling, M.D., Mirnova Ceide, M.D., Janice Korenblatt, M.S.W.

This study is funded by The Fan Fox & Leslie R. Samuels Foundation. Patients eligible for this project are moderately to severely cognitively impaired and have a diagnosis of depression. Patients receive 8 weeks of PATH therapy at their home as part of the Montefiore Home Care Program.

PATH with Geriatric Resilience - For participation please contact Florida State University

Collaboration with Florida State University

Investigators: Natalie Sachs-Ericsson, Ph.D., Greg Hajcak, Ph.D.

The study focuses on using PATH to increase resilience in older adults.

WellPATH Prevent - Currently recruiting new participants

Funded by the National Institute of Mental Health

Grant #: 1R61MH128516

WellPATH-PREVENT is a novel tablet-app intervention that aims to reduce suicide risk by employing simplified, personalized, easy to administer and use, cognitive reappraisal strategies during emotional crises and at scheduled brief training sessions. The WellPATH-PREVENT intervention is based on the assumptions that using personalized cognitive reappraisal techniques during an emotional storm, and practicing these techniques during scheduled training sessions will increase cognitive reappraisal ability and reduce suicide risk. WellPATH-PREVENT focuses on middle-aged and older adults at risk of suicide.

CRISP (Cognitive Reappraisal for Suicide Prevention) - Currently recruiting new participants

Funded by the National Institute of Mental Health

Grant #: R61MH110542 and 5R33MH110542

Principal Investigator: Dimitris Kiosses, Ph.D. Co-Investigators: Greg Hajcak, Ph.D. and James Gross, Ph.D.

This two-phase preliminary study funded the development and initial testing of a psychosocial intervention, entitled “Cognitive Reappraisal Intervention for Suicide Prevention (CRISP)”, designed to reduce suicide risk in middle-aged and older adults. CRISP aims to improve cognitive reappraisal ability (i.e. ability to modify the appraisal of a situation to alter its emotional significance), and reduce suicide risk. Our conceptual model views suicidal ideation and behavior as failed attempts to regulate negative emotions. Thus, by improving cognitive reappraisal ability, a well-documented and effective emotion regulation strategy, we expect to reduce suicide risk.  Studies show that unsuccessful attempts to regulate emotions and decreased cognitive reappraisal are associated with increased suicidal ideation. The study recruits subjects who have been hospitalized for suicide ideation or suicide attempt. Certified Licensed social workers administer 12 weekly sessions of CRISP post-discharge, and research assistants conduct assessments over 12 weeks.

R33 Phase

This is a follow-up randomized clinical trial that evaluated whether CRISP participants have greater reduction in suicidal ideation within 12 weeks post-discharge than Supportive Therapy participants.  Assessments are conducted on admission, at discharge, and at 6, 12 and 24 weeks post-discharge.

AFSP - Not currently recruiting new participants

Funded by the American Foundation for Suicide Prevention

Grant #: SRG-1-072-14

Principal Investigator: Dimitris Kiosses, Ph.D.

This study compares two different forms of talk therapy, PATH-SP and Supportive Therapy, and their effectiveness in reducing thoughts that life is not worth living, thoughts of self-harm or thoughts of suicide in middle-aged and older adults that have been hospitalized because of a suicide attempt or thoughts of harming themselves in middle-aged and older adults, including those with cognitive impariment. The two different forms of therapy are PATH-SP and Supportive Therapy. PATH-SP offers a combination of emotion regulation techniques with the provision of environmental adaptation tools (notes, checklists, calendars, etc.), and the involvement of family member or caregiver. Supportive Therapy incorporates standard of care approaches by using non-specific techniques to provide a supportive environment and to help participants express their feelings and focus on their strengths and abilities. This study is being done because effective psychotherapies are needed for older adults who are at high risk for harming themselves.

PATH-SP - Not currently recruiting new participants

Funded by the Brain & Behavior Research Foundation

Grant #: NARSADMH091045

Principal Investigator: Dimitris Kiosses, Ph.D.

This study compares two psychosocial interventions, PATH-SP (Problem Adaptation Therapy for Suicide Prevention) and ST-CI (Supportive Therapy for Cognitively Impaired Older Adults), in reducing suicide ideation in older adults who have had poor response to depression drug treatment and difficulties in executive functioning, i.e. in planning, organizing or memory-like deficits. The study is conducted with older adults with varying degrees of cognitive impairment, from intact cognition to moderate dementia. Participants are recruited from the community and are randomly assigned to 12 weekly sessions of PATH-SP or ST-CI, administered by social workers. PATH-SP utilizes environmental adaptations and compensatory strategies to improve emotion regulation and bypass cognitive and functional impairments. Research assessments are conducted over 24 weeks to evaluate subjects’ suicide ideation, mood, and cognition.

PATH-Pain - Currently recruiting new participants

Funded by the National Institute of Aging

Grant #: 1R01AG070055

This research study assesses whether a specialized program involving talk therapy is effective in improving attention and concentration, mood, and pain in older adults who suffer with cognitive difficulties, low or sad mood, and pain-related difficulties. PATH-PAIN differs from standard psychotherapy by offering a combination of emotion regulation techniques with the provision of environmental adaptation tools (notes, checklists, calendars, etc.), and the participation of a willing and available study partner. PATH-PAIN utilizes techniques to improve communication between patients and primary care providers and overcome obstacles in adherence to pain treatment. Study participants are randomized into one of two study groups: PATH-PAIN or Usual Care. PATH-PAIN focuses on the participant, the study partner, and the participant's home environment to encourage problem solving and adaptive functioning and to improve low or sad mood.

PATH-PAIN Preliminary Study - Not currently recruiting new participants

Collaboration with the Wright Center

Funded by the National Institutes of Health and National Institute on Aging

Grant Number: OMB No. 0925-0001/0002

This research study tests if a specialized program involving talk therapy is effective in decreasing negative emotions and improving pain and physical functioning in older adults (including cognitively impaired older adults) who suffer with chronic pain. PATH-PAIN differs from standard psychotherapy by offering a combination of emotion regulation techniques with the provision of environmental adaptation tools (notes, checklists, calendars, etc.), and the participation of a willing and available study partner. PATH-PAIN utilizes techniques to improve communication between patients and primary care providers and overcome obstacles in adherence to pain treatment. Study participants are randomized into one of two study groups: PATH-PAIN or Usual Care. PATH-PAIN focuses on the subject, the study partner, and the subject’s home environment to encourage problem solving and adaptive functioning and to reduce negative emotions.

RELIEF - Not currently recruiting new participants

Funded by the National Institute of Mental Health

Grant Number: 1P50MH113838-01

This is a 3-month research study investigating whether a specialized program involving talk therapy is effective in reducing depression and improving pain and physical functioning in cognitively intact older adults with clinical depression who suffer from chronic pain. Participants are randomized into the Relief study group or the Usual Care study group. The goals of Relief are to: a) shift attention away from pain, discomfort and negative feelings; b) Increase involvement in pleasurable activities; c) use techniques to reduce negative emotions associated with pain; and d) modify unrealistic expectations and enhance communication between the subject and primary care physician. Relief utilizes mobile technology to help patients reduce their depression and pain-related disability.