Module 4: Thinking Tools

This chapter describes the fourth module of CBT for late-life depression, which explores thinking tools. The first section focuses on teaching clients to identify unhelpful thoughts using a thought diary. Clients then practice challenging unhelpful thoughts and using an expanded 6-column unhelpful thought diary (UTD). Some clients may need to address underlying core beliefs or “schemas” in order to effectively challenge negative thoughts. A section on overthinking is also included for clients who have problems with excessive worrying.

Age-Related Issues That Affect CBT

Specific client groups often require specific procedural changes to ensure that the CBT model is applied optimally to facilitate improvement in the client’s level of adjustment and quality of life. This is particularly the case for older individuals, who often undergo numerous social, psychological, and physical health changes that are less evident in quantity and quality in other client groups seeking therapy. This chapter addresses age-related issues that the therapist should keep in mind when using CBT with older clients.

Assessment of Older Adults

Assessment of cognitive, emotional, and functional status is recommended prior to beginning CBT with an older client. This provides a clearer understanding of the client’s main problems and enables the therapist to determine whether or not the client is a suitable candidate for CBT. This chapter outlines preparation for assessment, the CBT model for older adults, assessment of alcohol or other substance abuse, depression and anxiety, suicide ideation, medical history, and social support.

Introductory Information for Therapists

This chapter presents introductory information for therapists on this cognitive-behavioral therapy (CBT) program for depression in late life, including diagnostic criteria for depression, development of this treatment program and evidence base, recommendations for program implementation, the CBT model of depression in the elderly, risks and benefits of the treatment program, alternative treatments, and an online of the treatment program itself.

Module 6: Communication Tools

This chapter outlines the sixth module of CBT for late-life depression, which covers communication tools, including the communication continuum (passive, aggressive, and effective/assertive communication styles), effective communication in conflicted situations, role playing activities, and techniques to improve interpersonal effectiveness, such as ‘I’ statements, compromise, repetition, and techniques for developing new relationships.

Module 2: Identifying Target Complaints and Setting Goals

This chapter describes the second module of CBT for late-life depression, which focuses on the identification of target complaints and setting goals. It includes a review of home practice, before identifying and prioritizing target complaints, translating target complaints into goals, progress towards goals, and home practice exercises.

Module 7: Termination

This chapter describes the seventh module of CBT for late-life depression, which covers termination and the therapy ending processes. It includes scheduling the therapy conclusion process, maintenance of achievements, review of skills learned, planning for future stressful situations, and warning signs.

Module 5: Feeling Tools

This chapter discusses fifth module of CBT for late-life depression, which explores feeling tools, including the importance of relaxation, awareness of anxiety, keeping a tension diary, relaxation training, as well as imagery as a tool to challenge negative thoughts and stress management, and the management of frustration and anger.

Module 3: Doing Tools

This chapter describes the third module of CBT for late-life depression, which focuses on activity tools, including behavioral activation, activity monitoring, activity scheduling, the importance of pleasant activities, the California Older Person’s Pleasant Events Schedule (COPPES), and graphing the relationship between pleasant events and mood, as well as problem-solving steps and techniques.

Module 1: Introduction to Cognitive-Behavioral Therapy

This chapter outlines the first module of CBT for late-life depression, including an introduction to CBT. It discusses client history and complaint assessment using the Beck Depression Inventory-II (BDI-II), presentation of the CBT approach, the A-B-C model, downward spiral, expectations of CBT and the importance of home practice, as well as case conceptualization.