Cognitive Behavior Therapy with Older Adults - Springer Publishing

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Cognitive Behavioral Therapy
With Older Adults
Bradley E. Karlin
C
ognitive behavioral therapy (CBT) is a brief, structured psychotherapy
that focuses on the key roles that cognitions and behaviors
have in the onset and maintenance of mental illness. CBT has been
shown to be effective in treating a wide range of mental disorders,
including depression, anxiety, bipolar disorder, substance use disorders,
eating disorders, insomnia, and personality disorders (e.g., Butler,
Chapman, Forman, & Beck, 2006). In addition, recent research has also
shown CBT to be efficacious in treating symptoms of schizophrenia
(Beck & Rector, 2005), with additional research currently underway.
CBT has also been shown to be at least as efficacious as medication for
moderate-to-severe major depression (e.g., DeRubeis et al., 2005). For
many patients, a combination of CBT and medication has shown to be
more effective than either treatment alone (e.g., DeRubeis et al.). CBT
has also been shown to have enduring effects that often far outlast the
completion of treatment (e.g., Hollon, Stewart, & Strunk, 2006).
Over the last several decades, there has been significant research
examining the efficacy of CBT with older adults, specifically. This
research has consistently shown that CBT is efficacious with older individuals.
Much of this research has focused on the use of CBT for treating
depression in older adults (e.g., Pinquart & Sörensen, 2001; Scogin,
Welsh, Hanson, Stump, & Coates, 2005), although there has been
increasing research in recent years documenting the efficacy of CBT for
the treatment of late-life anxiety (Barrowclough et al., 2001; Stanley et
al., 2003), insomnia, and pain (Morin, Colecchi, Stone, Sood, & Brink,
1999; Vitiello, Rybarczyk, Von Korff, & Stepanski, 2009). In general,
older adults can benefit from CBT to approximately the same degree as
younger adults. Specific adaptations to the therapy strategies and process
can maximize treatment gains with older clients, although the core
ingredients of CBT remain the same when working with older adults.
This chapter provides an overview of CBT, i dentifying the theoretical
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