Cognitive Behaviour Therapy with Older People

Laidlaw, Ken; Thompson, Larry W.; Dick-Siskin, Leah P.; Gallagher‐Thompson, Dolores

doi:10.1002/9780470713402

Cited by 193 publications

(88 citation statements)

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“…Cognitive-behavioral therapy (CBT) tends to emphasize the role of unhelpful, negative thoughts in maintaining depressive symptoms and aims to gently challenge these cognitions in an effort to promote more rational thinking and improved mood. Notably, CBT treatments also tend to incorporate behavioral strategies (e.g., increasing pleasant activities, relaxation) and protocols have been developed that are specifically designed for older adults (Laidlaw et al, 2003). …”

Section: Introductionmentioning

confidence: 99%

Pretreatment cortisol levels predict posttreatment outcomes among older adults with depression in cognitive behavioral therapy

Holland

Schatzberg

O’Hara

et al. 2013

Psychiatry Research

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Previous studies suggest that individuals with elevated levels of cortisol (the “stress hormone”) could be particularly resistant to treatment for depression. However, most of these studies have been conducted in the context of antidepressant medications, and no study has examined pretreatment cortisol levels as a predictor of treatment outcomes among older adults with depression in cognitive-behavioral therapy (CBT), despite the relevance of this population for such a research question. The current study includes 54 older adults with depression who provided salivary cortisol samples at baseline and completed measures of depression at pretreatment and posttreatment, following a 12-week course of CBT. Structural equation modeling results suggest that those with higher daily outputs of cortisol and flatter diurnal slopes were less likely to benefit from CBT—a finding which if replicated could have important implications for clinical practice and future research.

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Section: Introductionmentioning

confidence: 99%

Pretreatment cortisol levels predict posttreatment outcomes among older adults with depression in cognitive behavioral therapy

Holland

Schatzberg

O’Hara

et al. 2013

Psychiatry Research

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“…They will be offered a maximum of 15 sessions of BA over 4 months, with an expected average of 10 sessions. Therapy sessions will be delivered face to face on an individual basis, at the participants’ residences and will last about 1 h. A BA treatment manual was developed for CALM based on the behavioural component of CBT for depression in stroke patients [22, 24], behavioural therapy with older people [47] and guidelines on conducting therapy with people who have aphasia [35, 47, 48]. For this trial, this therapy manual will be further revised to cover BA with stroke patients who do not have aphasia and will provide examples and practical guidance relevant to all stroke patients.…”

Section: Methodsmentioning

confidence: 99%

Behavioural Activation Therapy for Depression after Stroke (BEADS): a study protocol for a feasibility randomised controlled pilot trial of a psychological intervention for post-stroke depression

Thomas

Coates

Nair

et al. 2016

Pilot Feasibility Stud

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BackgroundThere is currently insufficient evidence for the clinical and cost-effectiveness of psychological therapies for treating post-stroke depression.Methods/DesignBEADS is a parallel group feasibility multicentre randomised controlled trial with nested qualitative research and economic evaluation. The aim is to evaluate the feasibility of undertaking a full trial comparing behavioural activation (BA) to usual stroke care for 4 months for patients with post-stroke depression. We aim to recruit 72 patients with post-stroke depression over 12 months at three centres, with patients identified from the National Health Service (NHS) community and acute services and from the voluntary sector. They will be randomly allocated to receive behavioural activation in addition to usual care or usual care alone. Outcomes will be measured at 6 months after randomisation for both participants and their carers, to determine their effectiveness. The primary clinical outcome measure for the full trial will be the Patient Health Questionnaire-9 (PHQ-9). Rates of consent, recruitment and follow-up by centre and randomised group will be reported. The acceptability of the intervention to patients, their carers and therapists will also be assessed using qualitative interviews. The economic evaluation will be undertaken from the National Health Service and personal social service perspective, with a supplementary analysis from the societal perspective. A value of information analysis will be completed to identify the areas in which future research will be most valuable.DiscussionThe feasibility outcomes from this trial will provide the data needed to inform the design of a definitive multicentre randomised controlled trial evaluating the clinical and cost-effectiveness of behavioural activation for treating post-stroke depression.Trial registrationCurrent controlled trials ISRCTN12715175

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“…Literature on CBT in later life has often focused on the adaptations that may be required to address commonly occurring barriers to participation, such as sensory deficits (e.g., large, clear typeface, ensuring functioning hearing aids), mobility problems (e.g., organization of transport, or provision of home visits), physical health difficulties (e.g., modification of behavioral experiments, breaks in session to allow movement for people with chronic pain and other physical discomforts, organization of sessions around physical health care appointments), and cohort differences in awareness of psychological constructs and therapy process (e.g., inclusion of an extended socialization to therapy phase, use of the client's own words, minimizing the use of "CBT-jargon"). Given the extent to which these issues have been covered elsewhere (e.g., Evans, 2007;James, 2010;Laidlaw, Thompson, Gallagher-Thompson, & Dick-Siskin, 2003), we do not rehearse them here. People with dementia, by definition, have neurocognitive impairments.…”

Section: The Interventionmentioning

confidence: 99%

Cognitive Behavior Therapy for Anxiety in People With Dementia

et al. 2014

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This article describes a 10-session cognitive-behavioral therapy (CBT) used in a randomized controlled trial with people with anxiety and mild-to-moderate dementia. The aim of the therapy is to reduce symptoms of anxiety by increasing a sense of safety and self-efficacy. The therapy is characterized by a person-centered approach to CBT, using individual tailoring to accommodate for cognitive deficits and other challenges. Three phases of therapy are described: (a) socialization to model (including overcoming barriers to participation), goal setting, and formulation; (b) application of cognitive and behavioral change techniques to address unhelpful autonomic reactions, "strategic" reactions, "rules for living," and interpersonal aspects; and (c) consolidation and ending in the context of chronic, deteriorating illness. The approach prioritizes direct work with the person with dementia, with the involvement of a "supportive other" where available and when necessary. The protocol is designed for use by therapists with prior experience in CBT.

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Cognitive Behaviour Therapy with Older People

Cited by 193 publications

References 0 publications

Pretreatment cortisol levels predict posttreatment outcomes among older adults with depression in cognitive behavioral therapy

Pretreatment cortisol levels predict posttreatment outcomes among older adults with depression in cognitive behavioral therapy

Behavioural Activation Therapy for Depression after Stroke (BEADS): a study protocol for a feasibility randomised controlled pilot trial of a psychological intervention for post-stroke depression

Cognitive Behavior Therapy for Anxiety in People With Dementia

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