scholarly journals Psychotherapies with older people: an overview

2004 ◽  
Vol 10 (5) ◽  
pp. 371-377 ◽  
Author(s):  
Jason Hepple
Keyword(s):  
Older People ◽  
Behavioural Therapy ◽  
Interpersonal Therapy ◽  
Younger Adults ◽  
Cognitive Behavioural ◽  
Old Age Psychiatry ◽  
Analytic Therapy ◽  
The Uk ◽  
Psychiatric Problems ◽  
Cognitive Analytic Therapy

Psychotherapies with older people have been slow to develop, both theoretically and operationally, in the UK. This is due to ageism and the predominance of models of psychological development relevant to children and younger adults. Despite this, many have applied their practice and skills to psychological work in old age psychiatry, countering the dominance of the ‘organic’ model. An evidence and practice base exists to suggest that cognitive–behavioural therapy, interpersonal therapy, cognitive analytic therapy, psychodynamic and systemic approaches can help in a range of psychiatric problems in older people, including affective disorders, personality disorders and dementia. The inclusion of older people in existing psychotherapy services and the development of networks of practitioners whose support and supervision are encouraged are likely to be positive ways forward.

Cognitive behavioural therapy with older adults: enthusiasm without the evidence?

2009 ◽  
Vol 2 (2) ◽  
pp. 75-82 ◽  
Author(s):  
Philip Wilkinson
Keyword(s):  
Older People ◽  
Methodological Quality ◽  
Evidence Base ◽  
Behavioural Therapy ◽  
Younger Adults ◽  
Behavioural Interventions ◽  
Management Interventions ◽  
Cognitive Behavioural ◽  
Cognitive Behavioural Interventions ◽  
Robust Evidence

AbstractCognitive behavioural interventions specifically for older people have been described and researched for the last 30 years. However, despite a robust evidence base to support the use of CBT in the treatment of mental disorders in younger adults, trials with older people have generally been of poor methodological quality. Therefore, the potential of CBT to improve the outcome of late-life mental illness has not yet been adequately tested and demonstrated. The priorities, if this is to happen, are to develop standardized, reproducible CBT interventions and to evaluate these in large trials alongside medication or as part of case-management interventions.

scholarly journals Using an integrative, Cognitive Analytic Therapy (CAT) approach to treat intimate partner violence risk

2017 ◽  
Vol 9 (2) ◽  
pp. 128-140
Author(s):  
Ruth J. Tully ◽  
Alex Barrow
Keyword(s):  
Intimate Partner Violence ◽  
Partner Violence ◽  
Psychological Intervention ◽  
Behavioural Therapy ◽  
Intimate Partner ◽  
Content Type ◽  
Analytic Therapy ◽  
The Uk ◽  
Cognitive Analytic Therapy

Purpose There is limited research on Cognitive Analytic Therapy (CAT) in forensic contexts; this case study therefore significantly contributes to the knowledge base. The purpose of this paper is to present the assessment and treatment of an adult male offender with a diagnosis of schizophrenia. The client’s offence involved intimate partner violence and was committed at a time of acute psychiatric relapse. Design/methodology/approach In total, 12 sessions of cognitive behavioural therapy and CAT informed treatment were individually designed to meet the needs of the client, delivered in an in-patient setting in the UK. The client’s progress was assessed using psychometric, observational, and narrative/descriptive methods. Findings Psychometric evidence was limited by distorted responding. However, narrative/descriptive assessment indicated that progress had been made in some areas. Recommendations for further treatment were made. Practical implications In total, 12 sessions did not meet all of the client’s needs. The use of CAT as a model that his team could use in understanding his violence was conducive to risk management. Overall, insight gained through CAT-based psychological intervention contributed to risk reduction. Originality/value This case study demonstrates the applicability of CAT to forensic settings.

Integrating Approaches to Psychotherapy in Psychosis

2005 ◽  
Vol 39 (11-12) ◽  
pp. 972-981 ◽  
Author(s):  
Frank Margison
Keyword(s):  
Critical Analysis ◽  
Evidence Base ◽  
Integrated Treatment ◽  
Interpersonal Therapy ◽  
Psychological Treatments ◽  
Cognitive Behavioural ◽  
Working Together ◽  
Analytic Therapy ◽  
Cognitive Analytic Therapy ◽  
Different Levels

Objective: The evidence base for specific psychological treatments for psychosis is now well established, but many practitioners see themselves as integrationist in approach. The basic tenets of integration are explored with an emphasis on understanding how different levels of need can be conceptualized and then used to ‘adapt’ a treatment to meet those needs in an individual. The needs are then incorporated into an integrated treatment formulation. Method: The evidence base is strongest for cognitive behavioural and family approaches, but the present paper summarizes concepts from two specific models of therapy that are intrinsically integrational in their approach: cognitive analytic therapy and psychodynamic interpersonal therapy. Results: Both approaches show aspects of integration. However, following this approach to integration to its limit would ultimately lead to one undifferentiated therapy. Conclusions: Both approaches share a common set of values of developing specific ways of increasing collaboration and working together, and these values are shown to underpin adaptive ways of working with psychosis, but further critical analysis of the development of integrative models is needed.

Pilot evaluation of a group stabilisation intervention for refugees and asylum seekers with PTSD

2021 ◽  
pp. 1-6
Author(s):  
Mary Griggs ◽  
Cheng Liu ◽  
Kate Cooper
Keyword(s):  
Repeated Measures ◽  
Asylum Seekers ◽  
Preliminary Evidence ◽  
Behavioural Therapy ◽  
Post Traumatic Stress ◽  
Group Setting ◽  
Post Intervention ◽  
Treatment Delivery ◽  
Cognitive Behavioural ◽  
The Uk

Abstract Background: Post-traumatic stress disorder (PTSD) is commonly experienced by asylum seekers and refugees (ASR). Evidence supports the use of cognitive behavioural therapy-based treatments, but not in group format for this population. However, group-based treatments are frequently used as a first-line intervention in the UK. Aims: This study investigated the feasibility of delivering a group-based, manualised stabilisation course specifically developed for ASR. The second aim was to evaluate the use of routine outcome measures (ROMs) to capture psychological change in this population. Method: Eighty-two participants from 22 countries attended the 8-session Moving On After Trauma (MOAT) group-based stabilisation treatment. PHQ-9, GAD-7, IES-R and idiosyncratic outcomes were administered pre- and post-intervention. Results: Seventy-one per cent of participants (n = 58) attended five or more of the treatment sessions. While completion rates of the ROMs were poor – measures were completed at pre- and post-intervention for 46% participants (n = 38) – a repeated-measures MANOVA indicated significant improvements in depression (p = .001, ηp2 = .262), anxiety (p = .000, ηp2 = .390), PTSD (p = .001, ηp2 = .393) and idiosyncratic measures (p = .000, ηp2 = .593) following the intervention. Conclusions: Preliminary evidence indicates that ASR who attended a low-intensity, group-based stabilisation group for PTSD experienced lower mental health scores post-group, although the lack of a comparison group means these results should be interpreted with caution. There are significant challenges in administering ROMs to individuals who speak many different languages, in a group setting. Nonetheless, groups have benefits including efficiency of treatment delivery which should also be considered.

Cognitive behavioural therapy and third wave approaches for anxiety and related disorders in older people

2021 ◽  
Author(s):  
Gert-Jan Hendriks ◽  
Willeke H van Zelst ◽  
Anton J van Balkom ◽  
Eleonora Uphoff ◽  
Lindsay Robertson ◽  
...  
Keyword(s):  
Older People ◽  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Third Wave ◽  
Cognitive Behavioural

scholarly journals Cognitive–behavioural therapy with older people

2007 ◽  
Vol 13 (2) ◽  
pp. 111-118 ◽  
Author(s):  
Ceri Evans
Keyword(s):  
Older People ◽  
Effective Treatment ◽  
Psychiatric Disorders ◽  
Cognitive Behavioural Therapy ◽  
Historical Context ◽  
Behavioural Therapy ◽  
Age Group ◽  
The Core ◽  
Cognitive Behavioural ◽  
The Individual

Cognitive–behavioural therapy (CBT) is an effective treatment for a number of psychiatric disorders in adults of all ages. With the proportion of the population aged 65 or over increasing steadily, it is important to be aware of how the CBT needs of this age group can be best met. This article provides an overview of CBT and the historical context of using it with older people. Although an understanding of the individual, irrespective of age, is at the core of CBT, potential modifications to the procedure and content aimed at optimising its effectiveness for older people are discussed.

scholarly journals What we know, what we do not know, and where are we heading? Efficacy and acceptability of psychological interventions for depression

2015 ◽  
Vol 25 (4) ◽  
pp. 301-308 ◽  
Author(s):  
N. Solomonov ◽  
J. P. Barber
Keyword(s):  
Randomized Clinical Trials ◽  
Behavioural Therapy ◽  
Drop Out ◽  
Interpersonal Therapy ◽  
Problem Solving Therapy ◽  
Cognitive Behavioural ◽  
Treatment Of Depression ◽  
Personalised Treatment ◽  
Meta Analyses ◽  
And Control

In the past several decades, increasing evidence supports the efficacy of psychotherapies for depression. The vast majority of findings from meta-analyses, randomized clinical trials (RCTs) and naturalistic studies have demonstrated that well-established psychotherapies (behavioural activation, problem-solving therapy, psychodynamic therapy, cognitive-behavioural therapy, interpersonal therapy and emotion-focused therapy) are superior to no-treatment and control conditions, and are in most cases equally effective in treating depression. However, despite this abundant support for psychotherapies, studies have also consistently shown high drop-out rates, high percentages of non-respondent patients who experience treatment failures, and mixed findings regarding the enduring effects of psychotherapy. Thus, there is a need to develop more personalised treatment models tailored to patients’ needs. A new integrative sequential stepwise approach to the treatment of depression is suggested.

Psychiatry

2018 ◽  
Author(s):  
Isabel McMullen
Keyword(s):  
Mental Health ◽  
Psychiatric Illness ◽  
Mental Health Problems ◽  
Ethical Issues ◽  
Behavioural Therapy ◽  
Outpatient Clinics ◽  
Personal Stories ◽  
Cognitive Behavioural ◽  
The Uk ◽  
State Examination

Mental health problems are estimated to affect one in four people each year in the UK, making mental illness one of the commonest presentations to GP surgeries, outpatient clinics, and Emergency Departments. Yet many doctors and medical students feel uncertain about how to approach patients with a psychiatric disorder. The key to becoming a good psychiatrist lies in the clinical interview. There are few physical signs or investigations that allow doctors to diagnose psychiatric illness, so a detailed history and mental state examination are important. As a psychiatrist, you are in the privileged position of having patients tell you their personal stories, and the skill is in listening attentively and asking relevant questions to help to clarify parts of the story. The best way to practise these techniques is to watch experienced clinicians at work and to interview patients yourself. Obviously diagnosis is important, so you need to be aware of the types of symptoms that fit with each type of disorder, as well as the medical conditions that may mimic psychiatric illness. Investigations may be necessary to rule out other diseases, and you need to be able to request these appropriately. Psychiatrists have access to a range of treatments—medical (e.g. antidepressants), psychological (e.g. cognitive behavioural therapy), and physical (e.g. electroconvulsive therapy)—and you need to know which ones to recommend. Most of these treatments are delivered in conjunction with the multidisciplinary team, so you should be clear about the roles of each team member. Finally, there is overlap between psychiatry and the law, which can raise interesting ethical issues. It is sometimes necessary to treat a person against their will, for the safety of that person or others, so you need to know about mental health law. Psychiatrists are also often requested to provide a second opinion in difficult capacity assessments.

Psychological and other non-pharmacological approaches

2019 ◽  
pp. 74-84
Author(s):  
Navneet Kapur ◽  
Robert Goldney
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Behaviour Therapy ◽  
Pharmacological Interventions ◽  
Interpersonal Therapy ◽  
Problem Solving Therapy ◽  
Cognitive Behavioural ◽  
Volunteer Organizations

This chapter discusses psychological and non-pharmacological interventions for suicidal behaviour in more detail. All people who present with suicidal thoughts and behaviour warrant some treatment, but the nature and intensity of this will depend on individual needs. Psychological treatments may include cognitive behavioural therapy, interpersonal therapy, problem-solving therapy, and mindfulness-based cognitive behavioural therapy. Dialectical behaviour therapy is specifically designed for those with a diagnosis of borderline personality disorder. Broader non-pharmacological approaches such as crisis centres, volunteer organizations, brief-contact interventions, and safety plans may be promising but require further research. Common therapeutic elements include a non-judgemental approach, empathy, respect, warmth, and genuineness.

scholarly journals Cognitive behavioural therapy for chronic fatigue and chronic fatigue syndrome: outcomes from a specialist clinic in the UK

2020 ◽  
Vol 113 (10) ◽  
pp. 394-402
Author(s):  
James Adamson ◽  
Sheila Ali ◽  
Alastair Santhouse ◽  
Simon Wessely ◽  
Trudie Chalder
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Cognitive Behavioural Therapy ◽  
Social Adjustment ◽  
Physical Functioning ◽  
Chronic Fatigue ◽  
Behavioural Therapy ◽  
Fatigue Syndrome ◽  
Cognitive Behavioural ◽  
The Uk

Objectives Cognitive behavioural therapy is commonly used to treat chronic fatigue syndrome and has been shown to be effective for reducing fatigue and improving physical functioning. Most of the evidence on the effectiveness of cognitive behavioural therapy for chronic fatigue syndrome is from randomised control trials, but there are only a few studies in naturalistic treatment settings. Our aim was to examine the effectiveness of cognitive behavioural therapy for chronic fatigue syndrome in a naturalistic setting and examine what factors, if any, predicted outcome. Design Using linear mixed effects analysis, we analysed patients' self-reported symptomology over the course of treatment and at three-month follow-up. Furthermore, we explored what baseline factors were associated with improvement at follow-up. Setting Data were available for 995 patients receiving cognitive behavioural therapy for chronic fatigue syndrome at an outpatient clinic in the UK. Participants Participants were referred consecutively to a specialist unit for chronic fatigue or chronic fatigue syndrome. Main outcome measures Patients were assessed throughout their treatment using self-report measures including the Chalder Fatigue Scale, 36-item Short Form Health Survey, Hospital Anxiety and Depression Scale and Global Improvement and Satisfaction. Results Patients’ fatigue, physical functioning and social adjustment scores significantly improved over the duration of treatment with medium to large effect sizes (|d| = 0.45–0.91). Furthermore, 85% of patients self-reported that they felt an improvement in their fatigue at follow-up and 90% were satisfied with their treatment. None of the regression models convincingly predicted improvement in outcomes with the best model being (R2 = 0.137). Conclusions Patients’ fatigue, physical functioning and social adjustment all significantly improved following cognitive behavioural therapy for chronic fatigue syndrome in a naturalistic outpatient setting. These findings support the growing evidence from previous randomised control trials and suggest that cognitive behavioural therapy could be an effective treatment in routine treatment settings.

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