Cognitive Behavioral Therapy for Anxiety in Cognitively Intact Older Adults

2017 ◽  
Vol 31 (1) ◽  
pp. 57-71 ◽  
Author(s):  
Viviana M. Wuthrich
Keyword(s):  
Older Adults ◽  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Cognitive Changes ◽  
Negative Attitudes ◽  
Age Related ◽  
Physical Abilities ◽  
The Individual ◽  
Meta Analyses

This article discusses potential adaptations to cognitive behavioral therapy (CBT) needed when working with older adults. Although CBT has been demonstrated to be efficacious in older anxious populations in meta-analyses, more research is needed to better understand the efficacy of CBT for the individual anxiety disorders, for older adults aged 80 years and older, and the efficacy of individual CBT elements. Despite normal age-related reductions in cognitive and physical abilities, most research suggests that only minor adaptations to CBT, if any, are needed for older adults. More significant adaptations relate to therapist attitudes and beliefs rather than the pragmatic CBT delivery, for example, negative attitudes related to aging and the likely benefit of CBT. Despite normal age-related declines in some cognitive domains, research to date suggests that normal cognitive changes do not significantly impact on treatment outcomes over the course of CBT; a case example is presented.

Cognitive Behavioral Therapy

2017 ◽  
Author(s):  
Nancy P. Kropf ◽  
Sherry M. Cummings
Keyword(s):  
Older Adults ◽  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Practice Research ◽  
Evidence Based ◽  
Depression And Anxiety ◽  
Flexible Approach ◽  
Psychotherapeutic Interventions ◽  
Meta Analyses

In Chapter 4, “Cognitive Behavioral Therapy: Evidence-Based Practice,” research on the use of CBT with older adults is summarized and evaluated. Fifteen meta-analyses and systematic reviews published between 2000 and 2015 are presented. The most developed area of research on CBT effectiveness with older clients is on depression and anxiety outcomes. A smaller, but still substantial, literature focuses on outcomes of CBT for insomnia. While research on the effectiveness of CBT with older adults is not as encompassing as that for younger populations, it is, nonetheless, substantive and, thus far, more advanced than that of most other psychotherapeutic interventions used with older adults. Research suggests that CBT with older clients is as effective as other psychotherapeutic interventions, with superior results in decreasing the negative outcomes of anxiety. In administration, CBT is a flexible approach that has utility across a variety of settings and contexts.

361 Relative Effectiveness of Cognitive Behavioral Therapy and its Components in Improving Insomnia Symptoms in Older Adults

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A144-A144
Author(s):  
Kathleen O’Hora ◽  
Beatriz Hernandez ◽  
Laura Lazzeroni ◽  
Jamie Zeitzer ◽  
Leah Friedman ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Sleep Onset ◽  
Post Treatment ◽  
Cognitive Behavioral ◽  
Sleep Onset Latency ◽  
Significant Group ◽  
Time Interaction ◽  
Insomnia Symptoms

Abstract Introduction The prevalence of insomnia complaints in older adults is 30–48%, compared to 10–15% in the general population. Cognitive Behavioral Therapy for Insomnia (CBT-I) is a first-line, non-pharmacological sleep treatment for Insomnia. However, the relative impact of Behavioral (BT) and Cognitive (CT) components compared to that of CBT-I in older adults is unknown. Methods 128 older adults with insomnia were randomized to receive CBT-I, BT, or CT. Sleep diaries and the Insomnia Severity Index (ISI) were collected pre- and post-treatment and at a 6-month follow-up. We conducted split-plot linear mixed models with age and sex as covariates to assess within and between subject changes to test effects of group, time, and their interaction on ISI, sleep onset latency (SOL), wake after sleep onset (WASO), total sleep time (TST), time in bed (TIB), sleep efficiency (SE), and percent of treatment responders (ISI decrease>7) and remitters (ISI<8). Effect size (d) was calculated by dividing the difference between means by the root-mean-squared error of the mixed effects model. Results All treatments lead to a significant improvement across outcome measures at post-treatment (p’s<0.001) and 6-months (p’s<0.01), with the exception of TIB, response, and remission. For TIB, there was a significant Group x Time interaction (p<0.001): while all treatments significantly reduced TIB post-treatment relative to baseline, CBT-I (p<0.001,d=-2.26) and BT (p<0.001,d=-1.59) performed significantly better than CT (p=0.003, d=-0.68). In contrast, at 6-months CBT-I (p<0.001,d=-1.16) performed significantly better at reducing TIB than CT (p=0.195,d=-0.24) or BT (p=0.023,d=-0.61) relative to baseline. There was also a non-significant trend for a Group x Time interaction for remission status (p=0.062). Whereas, the percentage of remitters within all groups post-treatment did not differ from chance (p>0.234), at 6 months, the percentage of remitters was significantly higher than chance in CBT-I (73.63%,p=0.026) and BT (78.08%,p=0.012), but not CT (47.85%,p=0.826). There were no other significant time or interaction effects (all p>0.05). Conclusion CBT-I and its components are effective in improving subjective insomnia symptoms in older adults. Evidence suggests CBT-I may be superior to either CT or BT alone in improving TIB in older adults. Support (if any) NIMHR01MH101468; MIRECC at VAPAHCS

scholarly journals Cognitive Behavioral Therapy in Korean Tinnitus Patients

2021 ◽  
Vol 64 (11) ◽  
pp. 844-850
Author(s):  
Angela Yun Kim ◽  
Gi-Hwan Ryu ◽  
Hyunseok Choi ◽  
June Choi ◽  
Gi Jung Im ◽  
...  
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Randomized Clinical Trials ◽  
Behavioral Therapy ◽  
Automatic Thoughts ◽  
Cognitive Behavioral ◽  
Individual Counseling ◽  
Specific Scheme ◽  
Behavioral Therapies ◽  
Meta Analyses ◽  
Analogue Scales

Cognitive behavioral therapy, first introduced by Beck in the 1950s to treat depression by integrating cognitive and behavioral therapies, is now an established psychotherapy technique used to treat insomnia, chronic pain, and anxiety. Currently, cognitive behavioral therapy is widely used to treat tinnitus in European countries, and the efficacy and safety of the treatment have been proven through randomized clinical trials and meta-analyses. Although interest in cognitive behavioral therapy for tinnitus is increasing in Korea, there are limited reports. Because many studies so far have targeted patients in Western countries, it is difficult to apply the same to domestic patients due to cultural and linguistic differences, the absence of standardized guidelines, and limitations in clinic hours. We experienced various cases in which tinnitus was effectively treated simultaneously with pharmacotherapy and cognitive behavioral therapy, so here we report an introduction to the program along with a literature review. Cognitive behavioral therapy was performed as a 4-week program in our hospital, and progress was evaluated through Visual Analogue Scales (VAS) and tinnitus handicap inventory (THI). After each weekly 20-minute individual counseling session, a take-home writing task was given to the patient. The main goal was to guide the patient to discover and correct automatic thoughts related to their tinnitus symptoms. This paper aimed to introduce a specific scheme on how to perform cognitive behavioral therapy for domestic tinnitus patients.

scholarly journals Meta-analysis and Meta-regression of Cognitive Behavioral Therapy for Psychosis (CBTp) Across Time: The Effectiveness of CBTp has Improved for Delusions

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Katarzyna Sitko ◽  
Bridgette M Bewick ◽  
David Owens ◽  
Ciara Masterson
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Negative Symptoms ◽  
Behavioral Therapy ◽  
Meta Analysis ◽  
Cognitive Behavioral ◽  
Psychotic Symptoms ◽  
Positive Symptoms ◽  
Medium Effects ◽  
Treatment As Usual ◽  
Meta Analyses

Abstract Published research shows small-to-medium effects of Cognitive Behavioral Therapy for Psychosis (CBTp) on reducing psychotic symptoms. Given the on-going development of CBTp interventions, the aim of this systematic review is to examine whether the effectiveness of CBTp has changed across time. MEDLINE, EMBASE, PsycINFO, and CENTRAL were searched for randomized controlled trials examining CBTp interventions targeting positive and/or negative symptoms vs treatment as usual. Four meta-analyses were carried out to examine the effectiveness of CBTp for: positive symptoms; delusions; hallucinations; and negative symptoms. Four meta-regressions examined whether the effectiveness of CBTp changed across time for these groups of symptoms. A total of 28 studies (n = 2698) yielded a pooled g of −0.24 (95% confidence interval [CI] −0.32, −0.16, P < .001) favoring CBTp for positive symptoms, with nonsignificant heterogeneity (Q = 26.87, P = .47; I2 =0%); 13 studies (n = 890) yielded a pooled g of −0.36 (95% CI −0.59, −0.13, P = .002) for delusions, with substantial heterogeneity (Q = 31.99, P = .001; I2 =62%); 16 studies (n = 849) yielded a pooled g of −0.26 (95% CI −0.42, −0.11, P < .001) for hallucinations, with nonsignificant heterogeneity (Q = 18.10, P = .26; I2 =17%); 19 studies (n = 1761) yielded a pooled g of −0.22 (95% CI −0.33, −0.12, P < .001) for negative symptoms, with nonsignificant heterogeneity (Q = 20.32, P = .32, I2 =11%). Meta-regressions indicated a significant effect of year on the effectiveness of CBTp only for delusions (F[1, 11] = 5.99, P = .032; R2 = 0.594); methodological quality did not effect this finding. Findings indicate small-to-medium effects of CBTp for psychotic symptoms, with increasing effectiveness across time for delusions.

Cognitive Behavioral Therapy

2017 ◽  
Author(s):  
Nancy P. Kropf ◽  
Sherry M. Cummings
Keyword(s):  
Older Adults ◽  
Cognitive Behavioral Therapy ◽  
Behavioral Treatment ◽  
Cognitive Distortions ◽  
Behavioral Therapy ◽  
Theory And Practice ◽  
Cognitive Behavioral ◽  
Cognitive Behavioral Treatment ◽  
Behavioral Strategies ◽  
Term Care

Chapter 3, “Cognitive Behavioral Therapy: Theory and Practice,” presents the history, examines the theoretical underpinnings, and explains the essential skills and techniques of cognitive behavioral therapy (CBT). Theoretical principles, such as cognitive distortions, underlying assumptions and schema, and their presentation in older adults, are discussed. The treatment approach of CBT is outlined, including the nature of the therapeutic relationship, changing cognitions, behavioral strategies, the use of homework in treatment, and special considerations and adaptations for practice with older clients. Various contexts and settings where CBT is implemented are summarized, such as individual and group settings within community-based, acute-care, and long-term-care facilities. The chapter ends with the case example of cognitive behavioral treatment with an older female caregiver, which highlights and illustrates CBT practice with older adults.

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