Bridging the Rural Mental Health Gap: Telehealth Delivery of Specialized CBT and MBCT for Veterans With Parkinson's Disease.
John R Purcell, Rokas Perskaudas, Rachael B Miller, Lauren M St Hill, Arlene King, Vibha Reddy, Kait Gilleran, Laura Marsh, Aliya Sarwar, Joel Mack, John E Duda, Jessica Lehosit, Petty Tineo, Marilyn Hinojosa-Lindsey, Kristi Ketchum, Solomon Kalkstein, Meredith Shouse, Kayla Maloney, Christopher Liong, Autumn Makin, Gretchen Glenn, Dawn McHale, Susan O'Connor, Alejandro Interian, Roseanne D Dobkin
The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association March 2026 DOI: 10.1111/jrh.70175 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Implementation-effectiveness study (hybrid type 2 framework), program evaluation with pre-post outcome measures Peer reviewed |
|---|---|
| Sample size | 522 |
| Population | Underserved rural Veterans with Parkinson's disease enrolled in a VA telehealth psychotherapy hub; 240 completed treatment and pre-post measures |
| Interventions | Cognitive Behavioral Therapy (CBT-PD) Mindfulness-Based Cognitive Therapy (MBCT-PD) |
| Duration | First 5 years of operation (10/2020 to 09/2025) |
| Topics | Anxiety Depression Meditation |
| Keywords | Cognitive behavioral therapy |
| Key points | Among 522 rural Veterans with Parkinson's disease, most met criteria for a mood disorder (86%) but only 9% were receiving psychotherapy at enrollment. CBT-PD significantly reduced depression and anxiety, and MBCT-PD reduced depression; treatment engagers reported 94% satisfaction. |
Abstract
The Veteran Affairs (VA) New Jersey Parkinson's Disease (PD) Telepsychotherapy Hub (PD Telepsych Hub) delivers virtual mental health treatments to underserved rural Veterans in partnership with VA Parkinson's Disease Research, Education, and Clinical Centers (PADRECCs). This manuscript outlines the PD Telepsych Hub's hybrid type 2 implementation-effectiveness framework then presents the clinical and demographic characteristics of Enrolled Veterans along with mental health outcomes for Treatment Engagers receiving individual Cognitive Behavioral Therapy (CBT-PD) or group Mindfulness-Based Cognitive Therapy (MBCT-PD) over the first 5 years of operation (10/2020 to 09/2025). Underserved rural Veterans with PD were primarily directly outreached by the PD Telepsych Hub (64%) or referred by VA clinicians. Veterans who met screening criteria and completed a psychiatric consult were enrolled and offered CBT-PD or MBCT-PD via telehealth according to preferences and needs. Enrolled Veterans completed baseline questionnaires assessing demographics and health characteristics. Treatment Engagers completed pre-and-post measures of mood, anxiety, loneliness, functional change, and treatment satisfaction. Enrolled Veterans (N = 522 across 31 states) were rural (72%), 6% Hispanic, 8% people of color, and on average 71-years-old. They reported an average of 7 years since PD diagnosis. Although most met criteria for a mood disorder (86%) and 43% had psychiatric comorbidities, only 9% were receiving psychotherapy at time of program enrollment. CBT-PD (n = 202) significantly reduced depression and anxiety, while MCBT-PD (n = 38) reduced depression. Treatment Engagers (n = 240) overall reported high treatment satisfaction (94%). At baseline, the mismatch between care access and clinical need was striking. Results highlight a growing foundation for real-world effectiveness in delivering empirically supported, PD-adapted interventions via telehealth to the highest-need, lowest-access populations.
Comparable studies
Other non-randomized and open-label trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Mindfulness-Based Stress Reduction in Relation to Quality of Life, Mood, Symptoms of Stress, and Immune Parameters in Breast and Prostate Cancer Outpatients Early-stage breast and prostate cancer patients | 2003 | Pre-post intervention study | n = 59 |
| Exploring self‐compassion and empathy in the context of mindfulness‐based stress reduction (MBSR) Community sample | 2010 | Pre-post intervention study | |
| Mindfulness-Based Stress Reduction Lowers Psychological Distress In Medical Students Second-year medical students | 2003 | Prospective nonrandomized cohort-controlled study | n = 302 |
| Intensive meditation training, immune cell telomerase activity, and psychological mediators. Retreat participants and matched controls | 2011 | Controlled trial with wait-list control group | n = 60 |
| The Effectiveness of Mindfulness Training for Children with ADHD and Mindful Parenting for their Parents Children aged 8-12 with ADHD and their parents | 2011 | Within-group waitlist controlled trial | n = 22 |
Citations in the library
Cites 3
- A Pilot Study of Telehealth Mindfulness-Based Cognitive Therapy for Depression in Parkinson's Disease. Journal of geriatric psychiatry and neurology March 2023
- Mindfulness for Motor and Nonmotor Dysfunctions in Parkinson's Disease. Parkinson's disease April 10, 2016
- Mindfulness-based cognitive therapy for depression: trends and developments. Psychology Research and Behavior Management 2016