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Pretherapy Training for Group Cognitive Therapy with Depressed Older Adults

Published online by Cambridge University Press:  29 November 2010

David Latour
Affiliation:
University of Ottawa
Philippe Cappeliez
Affiliation:
University of Ottawa

Abstract

This study was devised to determine the effectiveness of a pretherapy training procedure in enhancing group cognitive therapy for depressed older adults. Twenty-nine subjects were randomly assigned to a pretherapy training condition or an attention-placebo control condition. Subjects were 65 years of age or older, had a score of 14 or higher on the Beck Depression Inventory or on the Geriatric Depression Scale, and had no previous experience in psychotherapy. The pretherapy training procedure was based on Bandura's social cognitive theory and included verbal persuasion, vicarious experience, and performance accomplishment. The pretherapy training improved knowledge about psychotherapy and promoted the development of a problem-oriented focus in therapy. However it was unsuccessful in significantly reducing dropouts, increasing attendance, modifying role expectancies in the expected direction, and differentially affecting the outcome of cognitive therapy. For the experimental and control conditions taken together, 53.7 per cent of the subjects demonstrated clinically significant improvement at the end of therapy. Implications for research and clinical practice are discussed.

Résumé

Cette étude portait sur l'utilité d'une procédure de préparation à la thérapie cognitive en groupe pour des personnes âgées souffrant de dépression. Vingt-neuf sujets furent assignés aléatoirement soit à une condition de préthérapie expérimentale, soit à une condition contrôle. Les sujets âgés de 65 ans ou plus présentaient un score d'au moins 14 au Questionnaire de Dépression de Beck ou à l'Échelle de Dépression Gériatrique, et Us n'avaient jamais eu d'expérience de la psychothérapie. La procédure de préthérapie fut élaborée à partir de la théorie socio-cognitive de Bandura et elle impliquait la persuasion verbale, l'expérience vicariante, ainsi que l'accomplissement de comportements. La préthérapie a amélioré la connaissance des sujets concernant la psychothérapie et elle a favorisé le développement d'une attitude centrée sur le problème pendant la thérapie. Toutefois le taux des abandons, la fidélité de la participation aux sessions, les attentes de rôle, et l'issue de la thérapie cognitive n'ont pas été influencés de manière significative par la préthérapie. Prenant en considération l'ensemble des sujets des deux conditions, 53.7 pour cent des sujets ont manifesté une amélioration cliniquement significative à la fin de l'intervention. Les implications pour la recherche et la pratique clinique font l'objet de la discussion.

Type
Articles
Copyright
Copyright © Canadian Association on Gerontology 1994

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References

Bandura, A. (1977). Social learning theory. Englewood Cliffs, NJ: Prentice-Hall.Google Scholar
Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Englewood Cliffs, NJ: Prentice-Hall.Google Scholar
Beck, A.T., Steer, R.A., & Garbin, M.G. (1988). Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation. Clinical Psychology Review, 8, 77100.CrossRefGoogle Scholar
Beck, A.T., Ward, C.H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 5363.CrossRefGoogle ScholarPubMed
Berzins, J.I. (1971). Revision of the psychotherapy expectancy questionnaire. Unpublished manuscript, University of Kentucky, Department of Psychology, Lexington, KY.Google Scholar
Beutler, L.E., Scogin, F., Kirkish, P., Schretlen, D., Corbishley, A., Hamblin, D., Meredith, K., Potter, R., Bamford, C.R., & Levenson, A.I. (1987). Group cognitive therapy and Alprazolam in the treatment of depression in older adults. Journal of Consulting and Clinical Psychology, 55, 550556.CrossRefGoogle ScholarPubMed
DeRubeis, R.J., & Feeley, M. (1990). Determinants of change in cognitive therapy for depression. Cognitive Therapy and Research, 14, 469482.CrossRefGoogle Scholar
Ernst, C, Vanderzyl, S., & Salinger, R. (1981). Preparation of psychiatric inpatients for group therapy. Journal o f Psychiatric Nursing, 19, 2833.Google ScholarPubMed
Folstein, M., Folstein, S., & McHugh, P. (1975). “Mini-Mental State” — A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189198.CrossRefGoogle ScholarPubMed
Gallagher, D. (1981). Behavioral group therapy with elderly depressives: An experimental study. In Upper, D. & Ross, S. (Eds.), Behavioral Group Therapy (Vol. 3, pp. 187219). Champaign, IL: Research Press.Google Scholar
Gallagher, D.E., & Thompson, L.W. (1982). Treatment of major depressive disorder in older adult outpatients with brief psychotherapies. Psychotherapy: Theory, Research, and Practice, 19, 482490.CrossRefGoogle Scholar
Garrison, J.E. (1978). Written versus verbal preparation of patients for group psychotherapy. Psychotherapy: Theory, Research, and Practice, 15, 130134.CrossRefGoogle Scholar
Hamilton, M. (1967). Development of a rating scale for primary depressive illness. British Journal of Social and Clinical Psychology, 6, 278296.CrossRefGoogle ScholarPubMed
Hill, W.F. (1965). Hill Interaction Matrix. University of Southern California. Los Angeles: Youth Study Center.Google Scholar
Hoberman, H.M., Lewinsohn, P.M., & Tilson, M. (1988). Group treatment of depression: Individual predictors of outcome. Journal of Consulting and Clinical Psychology, 56, 393398.CrossRefGoogle ScholarPubMed
Jacobson, N.S., Follette, W.C., & Revenstorf, D. (1984). Psychotherapy outcome research: Methods for reporting variability and evaluating clinical significance. Behavior Therapy, 15, 336352.CrossRefGoogle Scholar
Kipper, D. (1986). Psychotherapy through clinical role playing. New York, NY: Brun-ner/Mazel Publishers.Google Scholar
Mayerson, N.H. (1984). Preparing clients for group therapy: A critical review and theoretical formulation. Clinical Psychology Review, 4, 191213.CrossRefGoogle Scholar
Piper, W.E., Montvila, R.M., & McGihon, A.L. (1979). Process analysis in therapy groups: A behavior sampling technique with many potential uses. In Upper, D. & Ross, S. (Eds.), Behavioral Group Therapy: An Annual Review. Champaign, IL: Research Press.Google Scholar
Piper, W.E., & Perrault, E.L. (1989). Pretherapy preparation for group members. International Journal of Group Psychotherapy, 39, 1734.CrossRefGoogle ScholarPubMed
Steuer, J.L., Mintz, J., Hammen, C.L., Hill, M.A., Jarvik, L.F., McCarley, T., Motoike, P., & Rosen, R. (1984). Cognitive-behavioral and psychodynamic group psychotherapy in treatment of geriatric depression. Journal of Consulting and Clinical Psychology, 52, 180189.CrossRefGoogle ScholarPubMed
Strupp, H.H., & Bloxom, A.L. (1973). Preparing lower-class patients for group psychotherapy: Development and evaluation of a role-induction film. Journal of Consulting and Clinical Psychology, 41, 373384.CrossRefGoogle Scholar
Thompson, L.W., & Gallagher, D. (1984). Efficacy of psychotherapy in the treatment of late-life depression. Advances in Behavior Research and Therapy, 6, 127139.CrossRefGoogle Scholar
Thompson, L.W., Gallagher, D., & Breckenridge, J. (1987). Comparative effectiveness of psychotherapies for depressed elders. Journal of Consulting and Clinical Psychology, 55, 385390.CrossRefGoogle ScholarPubMed
Yesavage, J.A., Brink, T.L., Rose, T.L., Lum, O., Huang, V., Adey, M., & Leirer, V.O. (1983). Development and validation of a geriatric depression scale: A preliminary report. Journal of Psychiatric Research, 17, 3739.CrossRefGoogle Scholar
Yost, E.B., Beutler, L.E., Corbishley, M.A., & Allender, J.R. (1986). Group cognitive therapy: A treatment approach for depressed older adults. Elmsford, NJ: Pergamon Press.Google Scholar
Zimmerman, M., Coryell, W., Corenthal, C., & Wilson, S. (1986). A self-report scale to diagnose major depressive disorder. Archives of General Psychiatry, 43, 10761081.CrossRefGoogle ScholarPubMed