This uncontrolled single-group pilot study evaluated the feasibility, acceptability, and safety of MCT-Silver — an 8-session weekly group intervention targeting (meta)cognitive beliefs — in 29 Portuguese adults aged ≥60 with depressive symptoms (BDI-II ≥14) recruited from three primary care health units in the Alentejo region (June–August 2025).
Participants attended an average of 6 out of 8 sessions (75%); 100% rated the program as useful and important. Statistically significant pre-post improvements were seen across all outcomes: depressive symptoms (PHQ-9, BDI-II), metacognitive beliefs, rumination, self-esteem, dysfunctional attitudes, and quality of life (WHOQOL-Bref item 1, effect size r=0.90). Each additional session attended predicted ~1-point reduction on the PHQ-9 (β=1.06, p=0.004, R²=0.27). No adverse events were reported.
- No control group: improvements cannot be attributed to MCT-Silver vs. spontaneous remission, placebo, group effects, or concurrent psychiatric medication (used by ~55% of participants). - Sample restricted to a rural Portuguese region (Alentejo); findings may not generalize to urban populations. - No follow-up assessment; durability of effects is unknown.
MCT-Silver appears feasible, safe, and highly acceptable for older adults with depression in a primary care setting, but efficacy is unproven — clinicians should await results from the planned Portuguese RCT before adopting it as a standalone treatment. The freely available, structured 8-session format makes it a low-barrier add-on to explore in geriatric mental health programs.
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