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Applying Cognitive-Behavioral Psychotherapy to the Chronically Ill Elderly: Treatment Issues and Case Illustration

Published online by Cambridge University Press:  07 January 2005

Bruce Rybarczyk ,
Dolores Gallagher-Thompson ,
John Rodman ,
Antonette Zeiss ,
Frank E. Gantz  and
Jerome Yesavage
Bruce Rybarczyk
Affiliation:
Department of Psychology and Social Sciences, Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois, U.S.A.
Dolores Gallagher-Thompson
Affiliation:
Counseling Psychology Program, Stanford University, Stanford, California, U.S.A.
John Rodman
Affiliation:
Older Adult Center, Division of Gerontology, Stanford University School of Medicine, California, U.S.A. Department of Psychiatry, St. Paul Ramsey Medical Center, St. Paul, Minnesota, U.S.A.
Antonette Zeiss
Affiliation:
Older Adult Center, Division of Gerontology, Stanford University School of Medicine, California, U.S.A.
Frank E. Gantz
Affiliation:
Older Adult Center, Division of Gerontology, Stanford University School of Medicine, California, U.S.A. Psychology Services, VA Medical Center, Salisbury, North Carolina, U.S.A.
Jerome Yesavage
Affiliation:
Older Adult Center, Division of Gerontology, Stanford University School of Medicine, California, U.S.A. Alzheimer's Disease Clinical Research Center, Palo Alto Veteran Affairs Medical Center, Palo Alto, California, U.S.A.
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Abstract

A large percentage of older adults must endure at least one chronic medical illness. Clinically significant depression and anxiety are common among these patients. Specific psychotherapy approaches as well as adaptations required to address the unique issues of this population have not been delineated in the literature. We outline a cognitive-behavioral therapy approach and discuss five treatment issues we have found to be important for this population. These issues include: (1) resolving practical barriers to participation; (2) accepting depression as a separate and reversible problem; (3) limiting excess disability; (4) counteracting the loss of important social roles and autonomy; and (5) challenging the perception of being a “burden.” A case study of a chronic obstructive pulmonary disease (COPD) patient with depression is presented and recommendations for future research are suggested.

Type
Clinical Practice and Service Development
Information
International Psychogeriatrics , Volume 4 , Issue 1 , June 1992 , pp. 127 - 140
Copyright
© 1992 Springer Publishing Company

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