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Chapter 4 - Cognitive Behavioral Therapy in Late Life

from Part 2 - Evidence-Based Psychotherapy in Later Life

Published online by Cambridge University Press:  09 January 2020

Rajesh R. Tampi
Affiliation:
Case Western Reserve University, Ohio
Brandon Yarns
Affiliation:
VA Greater Los Angeles Healthcare System
Kristina F. Zdanys
Affiliation:
University of Connecticut
Deena J. Tampi
Affiliation:
Diamond Healthcare Corporation
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Summary

This chapter introduces the research background and application of cognitive behavioral therapy (CBT) with older adults. First, an overview of the research literature is presented. Second, the theoretical framework underlying CBT is summarized with a focus on proposed agents of change. Third, research on patient selection, treatment modalities, and special topics is reviewed. Fourth, a session-by-session tutorial on the components of CBT from intake to treatment termination is provided. A case example is included along with several other cases to illustrate therapeutic techniques. Further readings, resources, and trainings are included at the end of the chapter.

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Publisher: Cambridge University Press
Print publication year: 2020

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References

Laidlaw, K, Thompson, LW, Dick-Siskin, L, Gallagher-Thompson, D. Cognitive behaviour therapy with older people. New York: John Wiley & Sons; 2003. p. xvi, 215.CrossRefGoogle Scholar
Laidlaw, K. An empirical review of cognitive therapy for late life depression: does research evidence suggest adaptations are necessary for cognitive therapy with older adults? Clin Psychol Psychother. 2001;8(1):114.Google Scholar
Karlin, BE. Cognitive behavioral therapy with older adults. In: Lauderdale, KHSS, editor. Cognitive behavior therapy with older adults: innovations across care settings. New York: Springer; 2011. p. 128.Google Scholar
Laidlaw, K, McAlpine, S. Cognitive behaviour therapy: how is it different with older people? J Ration Emot Cogn Behav Ther. 2008;26(4):250262.CrossRefGoogle Scholar
Beck, AT. Depression: clinical, experimental, and theoretical aspects. New York: Hoeber Medical Division, Harper & Row; 1967.Google Scholar
Lewinsohn, PM, Sullivan, JM, Grosscup, SJ. Changing reinforcing events: an approach to the treatment of depression. Psychotherapy: Theory, Research & Practice. 1980;17(3):322334.Google Scholar
Clark, DA, Beck, AT. Cognitive therapy of anxiety disorders: science and practice. New York: Guilford Press; 2010. p. ix, 628.Google Scholar
Wright, JH, Beck, AT. Cognitive therapy of depression: theory and practice. Psychiatric Services. 1983;34(12):11191127.Google Scholar
Gould, RL, Coulson, MC, Howard, RJ. Cognitive behavioral therapy for depression in older people: a meta‐analysis and meta‐regression of randomized controlled trials. Journal Am Geriatr Soc. 2012;60(10):18171830.Google Scholar
Pinquart, M, Duberstein, P, Lyness, J. Effects of psychotherapy and other behavioral interventions on clinically depressed older adults: a meta-analysis. Aging Ment Health. 2007;11(6):645657.Google Scholar
Peng, X, Huang, C, Chen, L, Lu, Z. Cognitive behavioural therapy and reminiscence techniques for the treatment of depression in the elderly: a systematic review. Journal of International Medical Research. 2009;37(4):975982.CrossRefGoogle ScholarPubMed
Wilson, K, Mottram, PG, Vassilas, C. Psychotherapeutic treatments for older depressed people. Cochrane database of systematic reviews. 2008(1): CD004853.Google Scholar
Gould, RL, Coulson, MC, Howard, RJ. Efficacy of cognitive behavioral therapy for anxiety disorders in older people: a meta‐analysis and meta‐regression of randomized controlled trials. J Am Geriatr Soc. 2012;60(2):218229.CrossRefGoogle ScholarPubMed
Hall, J, Kellett, S, Berrios, R, Bains, MK, Scott, S. Efficacy of cognitive behavioral therapy for generalized anxiety disorder in older adults: systematic review, meta-analysis, and meta-regression. American J of Geriatr Psychiatry. 2016;24(11):10631073.CrossRefGoogle ScholarPubMed
Hendriks, G, Oude Voshaar, R, Keijsers, G, Hoogduin, C, Van Balkom, A. Cognitive‐behavioural therapy for late‐life anxiety disorders: a systematic review and meta‐analysis. Acta Psychiatr Scand. 2008;117(6):403411.CrossRefGoogle ScholarPubMed
Granholm, E, McQuaid, JR, McClure, FS, et al. Randomized controlled trial of cognitive behavioral social skills training for older people with schizophrenia: 12-month follow-up. J Clin Psychiatry. 2007;68(5):730737.Google Scholar
Mueser, KT, Deavers, F, Penn, DL, Cassisi, JE. Psychosocial treatments for schizophrenia. Annual review of clinical psychology. 2013;9:465497.Google Scholar
Reiser, R, Reddy, S, Parkins, MM, Thompson, LW, Gallagher-Thompson, D. Psychosocial treatment of bipolar disorder in older adults. Cognitive Behavior Therapy with Older Adults. 2011:65.Google Scholar
Swartz, HA, Swanson, J. Psychotherapy for bipolar disorder in adults: a review of the evidence. Focus. 2014;12(3):251266.CrossRefGoogle ScholarPubMed
Miklowitz, DJ, Otto, MW, Frank, E, et al. Psychosocial treatments for bipolar depression: a 1-year randomized trial from the Systematic Treatment Enhancement Program. Arch Gen Psychiatry. 2007;64(4):419426.Google Scholar
Clapp, JD, Beck, JG. Treatment of PTSD in older adults: do cognitive-behavioral interventions remain viable? Cogn Behav Pract. 2012;19(1):126135.Google Scholar
Cook, JM, McCarthy, E, Thorp, SR. Older adults with PTSD: brief state of research and evidence-based psychotherapy case illustration. Am J Geriatr Psychiatry. 2017;25(5):522530.Google Scholar
Thorp, SR, Stein, MB, Jeste, DV, Patterson, TL, Wetherell, JL. Prolonged exposure therapy for older veterans with posttraumatic stress disorder: a pilot study. Am J Geriatr Psychiatry. 2012;20(3):276280.Google Scholar
McCurry, SM, Logsdon, RG, Teri, L, Vitiello, MV. Evidence-based psychological treatments for insomnia in older adults. Psychol Aging. 2007;22(1):18.Google Scholar
Montgomery, P, Dennis, JA. Cognitive behavioural interventions for sleep problems in adults aged 60+. Cochrane database of systematic reviews. 2003(1).Google Scholar
Irwin, MR, Cole, JC, Nicassio, PM. Comparative meta-analysis of behavioral interventions for insomnia and their efficacy in middle-aged adults and in older adults 55+ years of age. Health Psychology. 2006;25(1):3.Google Scholar
Bélanger, L, LeBlanc, M, Morin, CM. Cognitive behavioral therapy for insomnia in older adults. Cognitive and Behavioral Practice. 2012;19(1):101115.Google Scholar
Ehde, DM, Dillworth, TM, Turner, JA. Cognitive-behavioral therapy for individuals with chronic pain: efficacy, innovations, and directions for research. American Psychologist. 2014;69(2):153.Google Scholar
Lunde, L-H, Nordhus, IH, Pallesen, S. The effectiveness of cognitive and behavioural treatment of chronic pain in the elderly: a quantitative review. J Clin Psychol Medical Settings. 2009;16(3):254262.Google Scholar
Nicholas, MK, Asghari, A, Blyth, FM, et al. Self-management intervention for chronic pain in older adults: a randomised controlled trial. PAIN. 2013;154(6):824835.Google Scholar
Hummel, SB, Van Lankveld, JJ, Oldenburg, HS, et al. Efficacy of internet-based cognitive behavioral therapy in improving sexual functioning of breast cancer survivors: results of a randomized controlled trial. J Clin Oncol. 2017;35(12):13281340.CrossRefGoogle ScholarPubMed
Kunik, M, Veazey, C, Cully, J, et al. COPD education and cognitive behavioral therapy group treatment for clinically significant symptoms of depression and anxiety in COPD patients: a randomized controlled trial. Psychological Medicine. 2008;38(3):385396.CrossRefGoogle ScholarPubMed
Wetherell, JL, Gatz, M, Craske, MG. Treatment of generalized anxiety disorder in older adults. J Consult Clin Psychol. 2003;71(1):31.Google Scholar
Wuthrich, V, Rapee, R, Kangas, M, Perini, S. Randomized controlled trial of group cognitive behavioral therapy compared to a discussion group for co-morbid anxiety and depression in older adults. Psychological Medicine. 2016;46(4):785795.Google Scholar
Zijlstra, GR, Van Haastregt, JC, Ambergen, T, et al. Effects of a multicomponent cognitive behavioral group intervention on fear of falling and activity avoidance in community‐dwelling older adults: results of a randomized controlled trial. J Am Geriatr Soc. 2009;57(11):20202028.Google Scholar
Dear, BF, Zou, JB, Ali, S, et al. Clinical and cost-effectiveness of therapist-guided internet-delivered cognitive behavior therapy for older adults with symptoms of anxiety: a randomized controlled trial. Behavior Therapy. 2015;46(2):206217.Google Scholar
O’moore, KA, Newby, JM, Andrews, G, et al. Internet cognitive–behavioral therapy for depression in older adults with knee osteoarthritis: a randomized controlled trial. Arthritis Care & Research. 2018;70(1):6170.Google Scholar
Spek, V, Cuijpers, P, Nyklíček, I, et al. One-year follow-up results of a randomized controlled clinical trial on internet-based cognitive behavioural therapy for subthreshold depression in people over 50 years. Psychological Medicine. 2008;38(5):635639.Google Scholar
Titov, N, Dear, BF, Ali, S, et al. Clinical and cost-effectiveness of therapist-guided internet-delivered cognitive behavior therapy for older adults with symptoms of depression: a randomized controlled trial. Behavior Therapy. 2015;46(2):193205.Google Scholar
Lichstein, KL, Scogin, F, Thomas, SJ, et al. Telehealth cognitive behavior therapy for co‐occurring insomnia and depression symptoms in older adults. J Clin Psychol. 2013;69(10):10561065.Google Scholar
Rybarczyk, B, Lopez, M, Schelble, K, Stepanski, E. Home-based video CBT for comorbid geriatric insomnia: a pilot study using secondary data analyses. Behav Sleep Med. 2005;3(3):158175.Google Scholar
Brenes, GA, Danhauer, SC, Lyles, MF, Hogan, PE, Miller, ME. Telephone-delivered cognitive behavioral therapy and telephone-delivered nondirective supportive therapy for rural older adults with generalized anxiety disorder: a randomized clinical trial. JAMA Psychiatry. 2015;72(10):10121020.Google Scholar
Hyer, L, Yeager, CA, Hilton, N, Sacks, A. Group, individual, and staff therapy: an efficient and effective cognitive behavioral therapy in long-term care. Am J Alzheimers Dis Other Demen. 2009;23(6):528539.Google Scholar
Cully, JA, Stanley, MA, Petersen, NJ, et al. Delivery of brief cognitive behavioral therapy for medically ill patients in primary care: a pragmatic randomized clinical trial. J Gen Intern Med. 2017;32(9):10141024.Google Scholar
Holvast, F, Massoudi, B, Voshaar, RCO, Verhaak, PF. Non-pharmacological treatment for depressed older patients in primary care: a systematic review and meta-analysis. PloS One. 2017;12(9):e0184666.Google Scholar
DiNapoli, EA, Pierpaoli, CM, Shah, A, Yang, X, Scogin, F. Effects of home-delivered cognitive behavioral therapy (CBT) for depression on anxiety symptoms among rural, ethnically diverse older adults. Clinical Gerontologist. 2017;40(3):181190.Google Scholar
Cully, JA, Stanley, MA, Deswal, A, et al. Cognitive-behavioral therapy for chronic cardiopulmonary conditions: preliminary outcomes from an open trial. Primary Care Companion to the Journal of Clinical Psychiatry. 2010;12(4).Google Scholar
Freedland, KE, Carney, RM, Rich, MW, Steinmeyer, BC, Rubin, EH. Cognitive behavior therapy for depression and self-care in heart failure patients: a randomized clinical trial. JAMA Intern Med. 2015;175(11):17731782.Google Scholar
Jeyanantham, K, Kotecha, D, Thanki, D, Dekker, R, Lane, DA. Effects of cognitive behavioural therapy for depression in heart failure patients: a systematic review and meta-analysis. Heart Failure Rev. 2017;22(6):731741.Google Scholar
Calleo, JS, Amspoker, AB, Sarwar, AI, et al. A pilot study of a cognitive-behavioral treatment for anxiety and depression in patients with Parkinson disease. J Geriatr Psychiatry Neurol. 2015;28(3):210217.Google Scholar
Egan, SJ, Laidlaw, K, Starkstein, S. Cognitive behaviour therapy for depression and anxiety in Parkinson’s disease. J Parkinsons Dis. 2015;5(3):443451.Google Scholar
Broomfield, NM, Laidlaw, K, Hickabottom, E, et al. Post‐stroke depression: the case for augmented, individually tailored cognitive behavioural therapy. Clinical Psychology and Psychotherapy. 2011;18(3):202217.Google Scholar
Kneebone, II. A framework to support cognitive behavior therapy for emotional disorder after stroke. Cogn Behav Pract. 2016;23(1):99109.Google Scholar
Scogin, F, Morthland, M, Kaufman, A, et al. Improving quality of life in diverse rural older adults: a randomized trial of a psychological treatment. Psychol Aging. 2007;22(4):657.CrossRefGoogle ScholarPubMed
Stanley, MA, Wilson, N, Shrestha, S, et al. Calmer Life: a culturally tailored intervention for anxiety in underserved older adults. American J Geriatr Psychiatry. 2016;24(8):648658.CrossRefGoogle ScholarPubMed
Kraus, CA, Seignourel, P, Balasubramanyam, V, et al. Cognitive-behavioral treatment for anxiety in patients with dementia: two case studies. J Psychiatr Pract. 2008;14(3):186.Google Scholar
Orgeta, V, Qazi, A, Spector, A, Orrell, M. Psychological treatments for depression and anxiety in dementia and mild cognitive impairment: systematic review and meta-analysis. BJPsych. 2015;207(4):293298.Google Scholar
Snow, AL, Powers, D, Liles, D. Cognitive-behavioral therapy for long-term care patients with dementia. Geropsychological Interventions in Long-Term Care. 2006:265–283.Google Scholar
Spector, A, Charlesworth, G, King, M, et al. Cognitive-behavioural therapy for anxiety in dementia: pilot randomised controlled trial. BJPsych. 2015;206(6):509516.Google Scholar
Stanley, MA, Calleo, J, Bush, AL, et al. The Peaceful Mind program: a pilot test of a cognitive-behavioral therapy-based intervention for anxious patients with Dementia. Am J Geriatr Psychiatry. 2013;21(7):696708.Google Scholar
Teri, L, Gallagher-Thompson, D. Cognitive-behavioral interventions for treatment of depression in Alzheimer’s patients. Gerontologist. 1991;31(3):413416.Google Scholar
Hundt, NE, Amspoker, AB, Kraus-Schuman, C, et al. Predictors of CBT outcome in older adults with GAD. J Anxiety Disord. 2014;28(8):845850.Google Scholar
Wetherell, JL, Hopko, DR, Diefenbach, GJ, et al. Cognitive-behavioral therapy for late-life generalized anxiety disorder: Who gets better? Behavior Therapy. 2005;36(2):147156.Google Scholar
Kishita, N, Laidlaw, K. Cognitive behaviour therapy for generalized anxiety disorder: is CBT equally efficacious in adults of working age and older adults? Clin Psychol Rev. 2017;52:124136.CrossRefGoogle ScholarPubMed
Conti, EC, Barrera, TL, Amspoker, AB, et al. Predictors of outcomes for older adults participating in Calmer Life, a culturally tailored intervention for anxiety. Clinical Gerontol. 2017;40(3):172180.Google Scholar
Marquett, RM, Thompson, LW, Reiser, RP, et al. Psychosocial predictors of treatment response to cognitive-behavior therapy for late-life depression: an exploratory study. Aging Ment Health. 2013;17(7):830838.Google Scholar
Mohlman, J, Gorenstein, EE, Kleber, M, et al. Standard and enhanced cognitive-behavior therapy for late-life generalized anxiety disorder: two pilot investigations. Am J Geriatr Psychiatry. 2003;11(1):2432.Google Scholar
Kazantzis, N, Pachana, NA, Secker, DL. Cognitive behavioral therapy for older adults: practical guidelines for the use of homework assignments. Cogn Behav Pract. 2003;10(4):324332.Google Scholar
Kroenke, K, Spitzer, RL, Williams, JB, Löwe, B. The patient health questionnaire somatic, anxiety, and depressive symptom scales: a systematic review. Gen Hosp Psychiatry. 2010;32(4):345359.Google Scholar
Yesavage, JA, Sheikh, JI. 9/Geriatric depression scale (GDS) recent evidence and development of a shorter version. Clinical Gerontologist. 1986;5(1–2):165173.Google Scholar
Pachana, NA, Byrne, GJ, Siddle, H, et al. Development and validation of the Geriatric Anxiety Inventory. Int Psychogeriatr. 2007;19(1):103114.Google Scholar
Covin, R, Dozois, DJ, Ogniewicz, A, Seeds, PM. Measuring cognitive errors: Initial development of the Cognitive Distortions Scale (CDS). Int J Cogn Ther. 2011;4(3):297322.Google Scholar
Laidlaw, K, Thompson, LW, Gallagher-Thompson, D. Comprehensive conceptualization of cognitive behaviour therapy for late life depression. Behav Cogn Psychother. 2004;32(4):389399.CrossRefGoogle Scholar
Conti, E, Arnspiger, C, Uriate, J, Kraus-Schuman, C, Batiste, M. 2016. Retrieved from: www.mirecc.va.gov/VISN16/docs/Safety_Planning_for_Older_Adults_Manual.pdfGoogle Scholar
Beck, AT. Cognitive models of depression. J Cogn Psychother. 1987;1(1):537.Google Scholar
Wenzel, A, Dobson, KS, Hays, PA. Cognitive behavioral therapy techniques and strategies. American Psychological Association; 2016.Google Scholar
Neumann, PJ, Araki, SS, Gutterman, EM. The use of proxy respondents in studies of older adults: lessons, challenges, and opportunities. J Am Geriatr Soc. 2000;48(12):16461654.CrossRefGoogle ScholarPubMed
Wenzel, A. Innovations in cognitive behavioral therapy: strategic interventions for creative practice: New York: Routledge; 2017.Google Scholar
MacPhillamy, DJ, Lewinsohn, PM. The pleasant events schedule: studies on reliability, validity, and scale intercorrelation. J Consult Clin Psychol. 1982;50(3):363.Google Scholar
Rider, K, Gallagher-Thompson, D, Thompson, L. California older person’s pleasant events schedule: manual. 2004;14:2006. Retrieved from: http://med.stanford.edu/oafc/coppes.htmlGoogle Scholar
Nezu, AM, Nezu, CM, Lombardo, ER. Cognitive-behavioral case formulation and treatment design: a problem-solving approach: New York: Springer; 2004.Google Scholar
Overholser, JC. Guided discovery. J Contemp Psychother. 2013;43(2):7382.Google Scholar
Beck, AT, Rush, AJ, Shaw, Bf, Emery, G. Cognitive therapy of depression. New York: Guilford Press; 1979.Google Scholar
Beck, AT, Dozois, DJ. Cognitive therapy: current status and future directions. Annu Rev Med. 2011;62:397409.Google Scholar
Gallagher-Thompson, D, Thompson, LW. Treating late life depression: a cognitive-behavioral therapy approach, therapist guide. New York: Oxford University Press; 2009.Google Scholar
Hofmann, SG, Asmundson, GJ. Acceptance and mindfulness-based therapy: new wave or old hat? Clin Psychol Rev. 2008;28(1):116.Google Scholar
MacBeth, A, Gumley, A. Exploring compassion: a meta-analysis of the association between self-compassion and psychopathology. Clin Psychol Rev 2012;32(6):545552.CrossRefGoogle ScholarPubMed
Ruiz, FJ. A review of Acceptance and Commitment Therapy (ACT) empirical evidence: correlational, experimental psychopathology, component and outcome studies. International Journal of Psychology and Psychological Therapy. 2010;10(1).Google Scholar
Neff, KD, Kirkpatrick, KL, Rude, SS. Self-compassion and adaptive psychological functioning. J Res Pers. 2007;41(1):139154.Google Scholar
Bennett-Levy, J, Westbrook, D, Fennell, M, et al. Behavioural experiments: historical and conceptual underpinnings. Oxford Guide to Behavioural Experiments in Cognitive Therapy. 2004:1–20.Google Scholar
Rutter, J, Friedberg, R. Guidelines for the effective use of Socratic dialogue in cognitive therapy. Innovations in Clinical Practice: A Source Book. 1999;17:481490.Google Scholar
James, IA, Barton, S. Changing core beliefs with the continuum technique. Behav Cogn Psychother. 2004;32(4):431442.Google Scholar
Padesky, CA. Schema change processes in cognitive therapy. Clin Psychol Psychother. 1994;1(5):267278.Google Scholar
Burns, D. Feeling good: the new mood therapy. New York: William Morrow; 1980.Google Scholar
Dobson, D, Dobson, KS. Evidence-based practice of cognitive-behavioral therapy. New York: Guilford Press; 2018.Google Scholar
Bernstein, DA, Borkovec, TD, Hazlett-Stevens, H. New directions in progressive relaxation training: a guidebook for helping professionals. Westport, CT: Greenwood; 2000.Google Scholar
Feldman, G, Greeson, J, Senville, J. Differential effects of mindful breathing, progressive muscle relaxation, and loving-kindness meditation on decentering and negative reactions to repetitive thoughts. Behaviour Research and Therapy. 2010;48(10):10021011.Google Scholar

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