This paper discusses the treatment of depression in older adults (over age 65) using cognitive therapy techniques first developed by Beck and colleagues. The focus of this paper concerns whether modifications of CBT are required in order to ensure maximal efficacy and discusses what modifications may be suitable by advocating conceptual and theoretical reasons for their adoption. Some important contextual factors may need to be taken account of when working with older people such as dealing with expectancies about lifespan, the likelihood of chronic physical illness and longevity and chronicity of the personal history of problems. It is our contention that much more has been written about outcome in CBT with older people than has been written about psychotherapy process issues. This paper aims to address this perceived gap in the literature.
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Baltes, P. B. (1991). The many faces of human ageing: Toward a psychological culture of old age. Psychological Medicine, 21, 837–854.
Baltes, P. B., & Smith, J. (2002). New frontiers in the future of aging: From successful ageing of the young old to the dilemmas of the fourth age. Paper presented at the Valencia Forum, Researchers, Educators and Providers contribution to the Second World Assembly on Ageing Valencia, Spain.
Boerner, K., & Jopp, D. A. (2007). Improvement/maintenance and reorientation as central features of coping with major life change and loss: Contributions of three major life-span theories. Human Development, 50, 171–195.
Carstensen, L., Isaacowitz, D., & Charles, S. T. (1999). Taking time seriously: A theory of socioemotional selectivity. American Psychologist, 54, 165–181.
Carstensen, L., & Lockenhoff, C. A. (2003). Aging, emotion, and evolution: The bigger picture. Annals of the New York Academy of Sciences, 1000, 152–179.
Carstensen, L., & Mikels, J. A. (2005). At the intersection of emotion and cognition: Aging and the positivity effect. Current Directions in Psychological Science, 14, 117–121.
Charlesworth, G., & Greenfield, S. (2004). Overcoming barriers to collaborative conceptualization in cognitive therapy with older adults. Behavioural and Cognitive Psychotherapy, 32, 411–422.
Cuijpers, P., van Straten, A., & Smit, F. (2006). Psychological treatment of late life depression: A meta-analysis of randomized controlled trials. International Journal of Geriatric Psychiatry, 21, 1139–1149.
Engels, G. I., & Verney, M. (1997). Efficacy of nonmedical treatments of depression in elders: A quantitative analysis. Journal of Clinical Geropsychology, 3, 17–35.
Frazer, C. J., Christensen, H., & Griffiths, K. M. (2005). Effectiveness of treatments for depression in older people. Medical Journal of Australia, 182, 627–632.
Freund, A. M. (2006). Age-differential motivation consequences of optimization versus compensation focus in younger and older adults. Psychology and Aging, 21, 240–252.
Freund, A. M., & Baltes, P. B. (1998). Selection, optimization, and compensation as strategies of life management: Correlations with subjective indicators of successful aging. Psychology and Aging, 13, 531–543.
Gallagher-Thompson, D., & Coon, D. W. (2007). Evidence based psychological treatments for distress in family caregivers of older adults. Psychology and Aging, 22, 37–51.
Gallagher-Thompson, D., & Steffen, A. (1994). Comparative effects of cognitive-behavioral and brief psychodynamic psychotherapies for depressed family caregivers. Journal of Consulting and Clinical Psychology, 62, 543–549.
Gatz, M. (2007). Commentary on evidence-based psychological treatments for older adults. Psychology and Aging, 22, 52–55.
Grant, R. W., & Casey, D. A. (1995). Adapting cognitive behavioral therapy for the frail elderly. International Psychogeriatrics, 7, 561–571.
Jopp, D. A., & Smith, J. (2006). Resources and life-management strategies as determinants of successful aging: On the protective effect of selection, optimization, and compensation. Psychology and Aging, 21, 253–265.
Knight, B. G. (2004). Psychotherapy with older adults (3rd ed.). Thousand Oaks: Sage Publications.
Koder, D. A., Brodaty, H., & Anstey, K. J. (1996). Cognitive therapy for depression in the elderly. International Journal of Geriatric Psychiatry, 11, 97–107.
Krishnan, K. R. K., Delong, M., Kraemer, H., Carney, R., Speigel, D., Gordon, C., et al. (2002). Comorbidity of depression with other medical diseases in the elderly. Biological Psychiatry, 52, 559–588.
Laidlaw, K. (2006). Cognitive Behavior Therapy with Older Adults. In S. Quall & B. G. Knight (Eds.), Psychotherapy with older adults. New York: John Wiley & Sons Inc.
Laidlaw, K., & Baikie, E. (2007). Psychotherapy & demographic change. Nordic Journal of Psychology, 59, 45–58.
Laidlaw, K., Power, M. J., Schmidt, S., & the WHOQOL Group. (2006). The attitudes to ageing questionnaire (AAQ): Development and psychometric properties. International Journal of Geriatric Psychiatry, 21, 1–13.
Laidlaw, K., Thompson, L. W., Dick-Siskin, L., & Gallagher-Thompson, D. (2003). Cognitive behaviour therapy with older people. Chichester: John Wiley & Sons Ltd.
Laidlaw, K., Thompson, L. W., & Gallagher-Thompson, D. (2004). Comprehensive conceptualization of cognitive behaviour therapy for late life depression. Behavioural and Cognitive Psychotherapy, 32, 389–399.
Landreville, P., Landry, J., Baillargeon, L., Guerette, A., & Matteau, E. (2001). Older adults’ acceptance of psychological and pharmacological treatments for depression. Journal of Gerontology; Psychological Sciences, 50B, P285–P291.
Martin, D. J., Garske, J. P., & Davis, M. K. (2000). Relation of the therapeutic alliance with outcome and other variables: A meta-analytic review. Journal of Consulting and Clinical Psychology, 68, 438–450.
Morris, R. G., & Morris, L. W. (1991). Cognitive and behavioural approaches with the depressed elderly. International Journal of Geriatric Psychiatry, 6, 407–413.
Overholser, J. C., & Silverman, E. J. (1998). Cognitive-behavioral treatment of depression part VIII: Developing and utilizing the therapeutic relationship. Journal of Contemporary Psychotherapy, 28, 199–214.
Pinquart, M., Duberstein, P. R., & Lyness, J. M. (2006). Treatments for later-life depressive conditions: A meta-analytic comparison of pharmacotherapy and psychotherapy. American Journal of Psychiatry, 163, 1493–1501.
Pinquart, M., & Sorensen, S. (2001). How effective are psychotherapeutic and other psychosocial interventions with older adults? A meta-analysis. Journal of Mental Health and Aging, 7, 207–243.
Pinquart, M., & Sorensen, S. (2006). Gender differences in caregiver experiences: An updated meta-analysis. Journal of Gerontology: Psychological Sciences, 61B, P33–P45.
Qualls, S. H., Segal, D., Norman, S., Neiderhe, G., & Gallagher-Thompson, D. (2002). Psychologists in practice with older adults: Current patterns, sources of training and need for further education. Professional Psychology: Research and Practice, 33, 435–442.
Safran, J., & Segal, Z. (1996). Interpersonal process in cognitive therapy. New Jersey: Jason Aronson, Inc.
Satre, D., Knight, B. G., & David, S. (2006). Cognitive behavioural interventions with older adults: Integrating clinical and gerontological research. Professional Psychology: Research and Practice, 37, 489–498.
Scogin, F., Welsh, D., Hanson, A., Stump, J., & Coates, A. (2005). Evidence-based psychotherapies for depression in older adults. Psychology Science and Practice, 12, 222–237.
Steuer, J. L., & Hammen, C. L. (1983). Cognitive-behavioral group therapy for the depressed elderly: Issues and adaptations. Cognitive Therapy & Research, 7, 285–296.
United Nations. (2007). World population prospects: The 2006 revision. New York: Population Division, Department of Economic and Social Affairs.
Valbak, K. (2004). Suitability for psychoanalytic psychotherapy: A review. Acta-Psychiatrica-Scandinavica, 109(3), 64–178.
Zeiss, A. M., & Steffen, A. (1996). Treatment issues with elderly clients. Cognitive & Behavioral Practice, 3, 371–389.
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Laidlaw, K., McAlpine, S. Cognitive Behaviour Therapy: How is it Different with Older People?. J Rat-Emo Cognitive-Behav Ther 26, 250–262 (2008). https://doi.org/10.1007/s10942-008-0085-6
- Cognitive behaviour therapy
- Late life depression
- Psychotherapy process issues
- Successful ageing
- Gerontology and geropychology