# Age-sensitive telehealth group therapy for depression in older adults with and without comorbid anxiety (VISION-AGE): study protocol for a randomized controlled trial in an embedded mixed-methods design

## TL;DR

This study tests an online group therapy for depression in older adults, comparing it to a control group to see if it improves mental health outcomes.

## Contribution

The study introduces an age-sensitive telehealth group therapy for older adults with depression and anxiety, combining quantitative and qualitative methods.

## Key findings

- The intervention group receives psychotherapy focused on self- and developmental regulation strategies.
- The control group participates in a non-clinical discussion program promoting social interaction.
- Outcomes will be measured through self-reported and clinician-rated assessments at multiple time points.

## Abstract

There is a necessity to enhance psychotherapeutic treatment approaches for older adults with depression, particularly those exhibiting comorbid anxiety, in both clinical practice and healthcare provision. The aim of the clinical study VISION-AGE is to investigate the efficacy and mechanisms of action of an age-sensitive online group psychotherapy for adults aged 68 + with clinically significant depression (with or without anxiety).

In a two-arm randomised controlled trial, the hypothesis that enriched life-review therapy, offered in a video-conference group setting, is superior to an active control group, will be tested. Following randomisation into the intervention or control group, all participants attend weekly manual-guided online group sessions for 20 weeks (plus four additional individual meetings) in fixed groups of four participants. In the intervention group, participants are administered psychotherapy, with a focus on promoting self- and developmental regulation strategies (i.e., positive self-perceptions of ageing next to reminiscence, life management and life planning). The active control group takes part in a standardised non-clinical discussion programme promoting peer support and socializing, similar to typical social care services for older adults. The planned sample size is N = 250 (n = 125 participants per arm). The hypothesized reduction of self-reported depressive symptoms (primary outcome), anxiety as well as clinician-rated depressive symptoms and the hypothesized improvement of psychological well-being (secondary outcomes) will be assessed at baseline, post-treatment and at the 6-month follow-up. Furthermore, qualitative interviews will be conducted with participants of the intervention group in order to gain a more profound understanding of the subjective change processes experienced during the intervention.

VISION-AGE explores the potential of online group psychotherapy to address the needs of older adults with clinical depression. Whilst online therapy facilitates convenient access for patients, group therapy format enables therapists to extend their reach. The study will provide practical implications to improve access to and quality of psychotherapeutic care for this under-resourced population. The long-term objective is the development of a transdiagnostic psychotherapeutic programme that is both efficient and cost-effective, and which is accessible and appealing to older patients in regular mental health care.

at The German Register of Clinical Studies (DRKS); 13 November 2025 (Identifier: DRKS00038366; https://www.drks.de/DRKS00038366). Scientific title: Efficacy and modes of action of an age-sensitive telehealth group therapy to reduce clinical depression (with and without anxiety) in older adults (VISION-AGE).

The online version contains supplementary material available at 10.1186/s12888-026-07851-2.