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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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