Pains, Joys, and Secrets: Nurse-Led Group Therapy for Older Adults with Depression

Nance, Douglas C.

doi:10.3109/01612840.2011.624258

Cited by 13 publications

(14 citation statements)

References 22 publications

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“…Cappeliez (2000) tracked the intensity of depression during weekly group CBT, finding a gradual decrease in depressive symptoms. Nance (2012) found mild to moderate improvement for depression and overall improvements in personal growth, changing negative thoughts and relationships with family members.…”

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confidence: 99%

Group psychoeducative cognitive-behaviour therapy for mixed anxiety and depression with older adults

Bains

Scott

Kellett

et al. 2014

Aging & Mental Health

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Objectives. There is a dearth of older adult literature regarding group treatment for comorbid anxiety and depression. This research evaluated the effectiveness of a low intensity group psychoeducational approach. Method.Patients attended six sessions of a manualised cognitive-behavioural group programme. Validated measures of anxiety, depression and psychological well-being were taken at assessment, termination and short-term follow-up and staff rated patients regarding their functioning at the same time points. Patients rated the alliance and their anxiety and depression at each group session. Outcomes were categorised according to whether patients had recovered, improved, deteriorated or been harmed. Effect sizes were compared to extant group interventions for anxiety and depression.Results. Eight groups were completed with 34 patients, with a drop-out rate of 17%.Staff and patient rated outcome measures showed significant improvements in assessment to termination and assessment to follow-up comparisons. Over one quarter (26.47 %) of patients met the recovery criteria at follow-up and no patients were harmed. Outcomes for anxiety were better than for depression and the alliance was stable over time.Conclusion. The intervention evaluated shows some clinical and organisational promise. The group approach needs to be further explored and tested in research with greater methodological control.Keywords: older adult, CBT, group, co-morbid anxiety/depression. RUNNING HEAD: Group CBT for mixed anxiety and depression in older adults Depression and anxiety co-occur at high rates in older adult populations; Beekman et al., (2000) found that 47.5% of those with major depressive disorder had co-morbid anxiety disorders and 26.1% of people with anxiety disorders had co-morbid major depressive disorders. Katona, Manela and Livingstone (1997) found high rates of co-morbid generalised anxiety disorder (GAD) in older adults diagnosed with depression and Flint (1999) noted that late-life GAD was typically associated with depression. Co-morbidity in older adults is twice more likely in women than men, with more severely depressed individuals more likely to suffer with severe anxiety and vice versa (Schoevers, Beekman, Deeg, Jonker & van Tilburg, 2003).Despite this well evidenced overlap between anxiety and depression in older people, there is a relative lack of research regarding one-to-one and group psychotherapy interventions. Whilst group cognitive behaviour therapy (CBT) is recommended by NICE for working age adults with anxiety and depression for example (NICE Guideline 90, 2009), there are no specific guidelines in relation to older adults due to lack of evidence. Only one study has evaluated group CBT treatment of mixed anxiety and depression (Schimmel-Spreeuw, Linssen & Heeren, 2000) with outpatient elderly depressed women. Statistically significant reductions in depression, anxiety and neuroticism were observed from pre to post pre to follow-up comparisons.A recent review of older adult group CBT specifically ...

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Group psychoeducative cognitive-behaviour therapy for mixed anxiety and depression with older adults

Bains

Scott

Kellett

et al. 2014

Aging & Mental Health

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“…Further, a 25-year follow-up of nurses administering CBT found a considerable contribution to mental health service provision, specifically in primary care settings [8]. Other studies have also demonstrated the efficacy of nurse-led CBT for a wide range of mental disorders [[9], [10], [11], [12], [13], [14]]. According to a document from Horatio (European Psychiatric Nurses), currently in the UK 90% of all CBT therapists have a psychiatric nursing background [15].…”

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confidence: 99%

Nurse-led group cognitive behavioral therapy for major depressive disorder among adults in Japan: A preliminary single-group study

Tanoue

Yoshinaga

Kato

et al. 2018

International Journal of Nursing Sciences

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Objectives The prevalence and burden of disease of depression necessitates effective and accessible treatment options worldwide. Since April 2016, Japanese national health insurance has covered nurse-administered cognitive behavioral therapy (CBT) for mood disorders. However, empirical support for nurse-led CBT for depression in Asian countries, especially in Japan, is still lacking. This preliminary study aimed to examine the feasibility and acceptability of nurse-led group CBT for Japanese patients with depression. Methods In this single-arm study, we evaluated the effects of a 6-week group CBT, led by trained nurses, on patients with major depression. The primary outcome was the Beck Depression Inventory-II (BDI-II). Assessments were conducted at the beginning and end of the intervention. Results Of 25 participants screened, 23 were eligible for the study (of these, three dropped out during the trial but were included in the analysis). Nurse-led group CBT led to significant improvements in the severity of depression (BDI-II, P < 0.001). The mean total BDI-II score improved from 23.1 ( SD = 7.56) to 12.4 ( SD = 8.57), and the pre-to post-effect size was large (Cohen's d = 1.33). After CBT, 45% of the participants were judged to be treatment responders, and 34% met the remission criteria. Conclusions Our preliminary findings indicate that 6 weeks of nurse-led group CBT produced a favorable treatment outcome for individuals with major depression in a Japanese clinical setting. The results of this study might encourage more Asian nurses to provide CBT as a part of their nursing practice. Further controlled trials that address the limitations of this study are required.

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“…Older adults’ positive therapy engagement experiences have been found to be associated with the perceived benefits provided by psychological therapies that have specific working mechanisms (Camacho et al., 2018; Choi et al., 2013; Dakin & Areán, 2013; Nance, 2012; Simmonds et al., 2013; Williams et al., 2018). Older adults thought that self‐help groups were beneficial because the groups provided opportunities to interact with other older adults with depression (Stark et al., 2018).…”

Section: Resultsmentioning

confidence: 99%

Barriers and facilitators of engagement in psychological therapies among older adults with depression: A systematic review and thematic synthesis

Liu

Gellatly

2020

Psychiatric Ment Health Nurs

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Accessible summary What is known on the subject? The utilization rate of psychological therapies is low in older adults with depression. The barriers and facilitators to engaging in psychological therapies experienced by older adults with depression are unclear. What does the paper add to existing knowledge? Personal suitability for therapy engagement, practical abilities, personal therapy preferences, and familiarity with psychological therapies are associated with psychological therapy engagement. Psychological therapists can also impact psychological therapy engagement among older adults with depression. What are the implications for practice? Proving the effectiveness and suitability of chosen psychological therapies is important for improving therapy engagement. Strategies for handling functional impairments among older adults with depression are necessary for engaging this population in psychological therapies. Although in‐home psychological therapies are accessible, barriers to handling the technologies used for delivering the therapies should be addressed. More methods of accessing information about psychological therapies should be available to older adults in order for them to increase their knowledge on the topic. Psychological therapists should have positive attitudes and the competence to treat depression in older adults. Abstract Introduction Although psychological therapies are preferred by older adults, the utilization rate of these therapies is significantly low in older adults with depression. Understanding the barriers and facilitators to engaging in psychological therapies experienced by older adults is important for improving utilization rates. Aim This review aimed to explore the barriers and facilitators to engaging in psychological therapies experienced by older adults with depression. Methods A systematic review of qualitative studies on psychological therapy engagement among older adults with depression. Relevant published studies and grey literature were searched. The Critical Appraisal Skills Programme tool was used to assess the quality of the included studies. The results of the included studies were synthesized using thematic synthesis. Results Personal suitability for therapy engagement, practical abilities, personal therapy preferences and familiarity with psychological therapies was associated with therapy engagement. Therapists’ competencies also affected therapy engagement. Discussion Older adult's personal health status and requirements for psychological therapy should be considered. Implications for practice Mental health practitioners should consider whether specific psychological therapies are beneficial and acceptable for older adults. Improvements are needed in older adult's familiarity with psychological therapies and the ability of therapists to address the mental problems of older adults.

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Pains, Joys, and Secrets: Nurse-Led Group Therapy for Older Adults with Depression

Cited by 13 publications

References 22 publications

Group psychoeducative cognitive-behaviour therapy for mixed anxiety and depression with older adults

Group psychoeducative cognitive-behaviour therapy for mixed anxiety and depression with older adults

Nurse-led group cognitive behavioral therapy for major depressive disorder among adults in Japan: A preliminary single-group study

Barriers and facilitators of engagement in psychological therapies among older adults with depression: A systematic review and thematic synthesis

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