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Cognitive Behavioral Therapy for Late-Life Depression

An Evidence-Based Practice

Description

Cognitive Behavioral Therapy (CBT) for Late-Life Depression is an active, directive, time-limited, and stuctured problem-solving approach program that follows the conceptual model and treatment program developed by Aaron Beck and his colleagues. CBT for Late-Life Depression includes specific modifications for elderly depressed individuals who are being treated as outpatients. The intervention includes strategies to facilitate learning with this population, such as repeated presentation of information using different modalities, slower rates of presentation, and greater use of practice along with greater use of structure and modeling behavior. Patients are taught to identify, monitor, and ultimately challenge negative thoughts about themselves or their situations and develop more adaptive and flexible thoughts. Where appropriate, emphasis is also placed on teaching patients to monitor and increase pleasant events in their daily lives using behavioral treatment procedures. The intervention consists of up to 20 50- to 60-minute sessions following a structured manual.

Goal / Mission

The goal of this program is to use cognitive behavioral therapy to treat depression in older adults.

Impact

Research has shown that behavioral cognitive therapy helped patients reduce their depression symptoms, and maintained this improvement at 1-year follow-up more effectively than other types of therapy. At 6-month follow-up, clients who completed CBT were less likely to meet criteria for diagnoses of depression than clients who completed treatment as usual.

Results / Accomplishments

Improvement of depression symptoms at 1-year follow-up was maintained more effectively by behavioral or cognitive therapy. At 6-month follow-up, clients who completed CBT were less likely to meet criteria for diagnoses of depression than clients who completed treatment as usual. Among older adults, measures of life satisfaction improved following treatment. Patients also improved in overall adjustment and coping after treatment. CBT produced improved environmental quality of life when applied to older adults with moderate depression (p < 0.03). Patients were also able to reduce their psychiatric symptoms other than depression after treatment with CBT.

About this Promising Practice

Organization(s)
Stanford University School of Medicine, Older Adult and Family Center
Primary Contact
Dolores Gallagher-Thompson, Ph.D., ABPP
(650) 721-1024
dolorest@stanford.edu
https://med.stanford.edu/oafc.html
Topics
Health / Mental Health & Mental Disorders
Health / Older Adults
Organization(s)
Stanford University School of Medicine, Older Adult and Family Center
Source
SAMHSA's National Registry of Evidence-Based Practices and Programs (NREPP)
Date of publication
Dec 2006
For more details
https://med.stanford.edu/oafc/projects.html
Target Audience
Adults, Older Adults

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An Evidence-Based Practice meets the following HCI criteria:

  1. The program description includes at a minimum: the sponsoring organization, program goals, program implementation steps, and outcomes that have demonstrated program success in achieving the program goal in one or more localities.
  2. The results from an evaluation of the program include quantitative measures showing improvement in the outcome(s) of interest after the implementation of the program (i.e. increase in smoking cessation, not just the delivery of a smoking cessation program). The outcome measure(s) is/are compared at relevant time periods before and after the intervention or program implementation. Alternatively, the evaluation study compares the outcome(s) between an intervention group and an appropriate control group.
  3. The study is of peer-review quality and presents numbers in a scientific manner; measurements of precision and reliability are included (e.g. confidence intervals, standard errors), results from statistical tests show a significant difference or change in the outcome measure(s), and relevant point estimates and p-values are presented. Note: if the results from an evaluation of a program are presented in a scientific manner and the outcome measure is improved compared to the baseline measurement or the control group but the difference is not statistically significant, the practice is classified as effective and not evidence-based.
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