Category: Aging and Older Adults

Symposium

Symposium 22 - CBT in Older Adults: Treatment Targets and Modified Strategies

Friday, November 17
10:15 AM - 11:45 AM
Location: Cobalt 502, Level 5, Cobalt Level

Keywords: Aging / Older Adults | Treatment-CBT | Treatment Development
Presentation Type: Symposium

People are living longer and the number of older adults worldwide is on the rise. The United Nations estimates there are now 700 million people aged 60 years and over. By 2050 that figure will rise to over 2 billion. Mental disorders are prevalent in later life, approximately 20% of older adults meeting criteria for a mental disorder over the prior year (Karel, Gatz, & Smyer, 2012). In line with ABCT’s focus on diverse populations for this year’s conference, our symposium addresses advances in behavioral and cognitive therapies for older adults.


Estimates indicate that only 25% of older adults who need treatment receive psychotherapy (Wei et al., 2005). One contributor to this disparity is older adults are less likely to seek treatment in mental health clinics, but present instead to primary care or to community agencies. To reach older adults, behavioral and cognitive therapies must be suitable for delivery in these settings where many providers may not be mental health professionals. Thus, an issue is the amount of training and skill required for effective treatment delivery. Ideally, treatments will be relatively simple and straightforward. Dr. Raue will present on a behavior therapy called Engage that is designed to: address needs of older adults, target neurobiological mechanisms in depression, and match the skill set of community based clinicians.


 Many older adults do not have access to a CBT provider due to issues such as mobility problems that limit travel outside the home. Alternate means of delivering behavioral and cognitive therapies can increase accessibility for older adults. Dr. Gould will present on a RCT of a guided self-help behavior therapy protocol delivered via DVD and phone for older adults with anxiety disorders. This delivery modality has the potential to reach many older adults who otherwise might not receive treatment.


 Behavioral and cognitive therapies are efficacious in reducing suicide ideation and preventing suicide attempts in younger adults and youth (e.g., Dialectical Behavior Therapy and Cognitive Therapy). However, the vast majority of older adults die on their first attempt. Treatments such as DBT and CT that target older adults with suicidal thinking or a previous attempt will be too late for most older adults at risk. Upstream therapies that target risk factors for the development of suicide ideation should be tested. Our remaining presentations address modified treatment targets for older adults at risk – reasons for living and social isolation—that may prevent the development of suicide ideation.  Ms. Lutz will present on an evaluation of the Reasons for Living Scale for Older Adults that has been revised to make it suitable for use in clinical practice. Dr. Van Orden will present on an adaptation of Engage that seeks to help older adults who are isolated to increase social engagement.


 Dr. Wetherell, an expert in behavioral and cognitive therapies for older adults, will integrate the presentations with regards to this year’s conference theme. She will discuss how the research presented in this symposium will contribute to our understanding of ways to broaden the efficacy and effectiveness of behavioral and cognitive therapies for the treatment of mental health problems in later life. 

Learning Objectives:

Kimberly Van Orden

University of Rochester School of Medicine

Presentation(s):

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Jarred V. Gallegos

Graduate Research Assistant
West Virginia University

Presentation(s):

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    Julie Wetherell

    VA San Diego Healthcare System

    Presentation(s):

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      Kimberly Van Orden

      University of Rochester School of Medicine

      Presentation(s):

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      Patrick Raue

      Professor
      University of Washington

      Presentation(s):

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      Christine Gould

      VA Palo Alto Health Care System/Stanford

      Presentation(s):

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      Julie Lutz

      West Virginia University

      Presentation(s):

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