Older people are vulnerable to sustained high levels of psychosocial distress following a crime. A Cognitive Behavioural Therapy (CBT) informed psychological therapy, the Victim Improvement Package (VIP) may aid recovery. The VIP trial aims to test the clinical and cost effectiveness of the VIP for alleviating depressive and anxiety symptoms in older victims of crime.
People aged 65 years or more who report being a victim of crime will be screened by Metropolitan Police Service Safer Neighbourhood Teams within a month of the crime for distress using the Patient Health Questionnaire-2 and the Generalized Anxiety Disorder-2. Those who screen positive will be signposted to their general practitioner for assistance, and rescreened at 3 months. Participants who screen positive for depression and/or anxiety at re-screening are randomised to a CBT informed Victim Improvement Package added to treatment as usual (TAU) compared to TAU alone. The intervention consists of 10 individual 1-hour sessions, delivered weekly by therapists from the mental health charity Mind.
The primary outcome measure is the Beck Depression Inventory-II (BDI-II) and the Beck Anxiety Inventory (BAI), used as a composite measure, assessed at 6 months after the crime (post therapy) with a 9-month post-crime follow-up. Secondary outcome measures include the EQ-5D, and a modified Client Service Receipt Inventory. A total of 226 participants will be randomised VIP:TAU with ratio 1:1, in order to detect a standardised difference of at least 0.5 between groups, using a mixed effects linear regression model with 90% power and a 5% significance level (adjusting for therapist clustering and potential drop-out).
A cost-effectiveness analysis will incorporate intervention costs to compare overall healthcare costs and quality of life years between treatment arms. An embedded study will examine the impact of past trauma and engagement in safety behaviours and distress on the main outcomes.
This trial will provide data on the clinical and cost effectiveness of a CBT- informed psychological therapy for older victims of crime with anxiety and/or depressive symptoms and will demonstrate a model of integrated cross-agency working. Our findings will provide evidence for policy-makers, commissioners and clinicians responding to the needs of older victims of crime.