Cognitive-Behavioral Therapy With Culturally Diverse Older Adults.

2007 ◽  
pp. 179-197 ◽  
Author(s):  
Angela W. Lau ◽  
Lisa M. Kinoshita
Keyword(s):  
Older Adults ◽  
Cognitive Behavioral Therapy ◽  
Culturally Diverse ◽  
Behavioral Therapy ◽  
Cognitive Behavioral

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

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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