Cognitive Behavioral Therapy for Late-Life Depression Intervention Summary

Cognitive Behavioral Therapy (CBT) for Late-Life Depression is an active, directive, time-limited, and structured 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.

Descriptive Information

Areas of Interest Mental health treatment
Outcomes Review Date: December 2006
1: Symptoms of depression
2: Diagnosis of depression
3: Life satisfaction
4: Coping strategies and involvement in pleasurable activities
5: Severity of other psychiatric symptoms
Outcome Categories Mental health
Quality of life
Social functioning
Ages 55+ (Older adult)
Genders Male
Female
Races/Ethnicities Black or African American
Hispanic or Latino
White
Settings Outpatient
School
Geographic Locations Urban
Suburban
Implementation History The CBT for Late-Life Depression basic protocol (or variations of this protocol) has been in use for about 25 years in the United States. CBT has been used in Scotland in a randomized clinical trial using a modification of the protocol. Since 1980, the developer has trained more than 50 psychologists, psychiatrists, social workers, and nurse specialists in using the protocol, most of whom have assumed clinical positions in their settings. Many clinical centers have used the protocol or parts of it, and five have been evaluated for outcomes (three under the developer's supervision). About 700 patients and more than 1,000 caregivers have participated in the program through Stanford University's Older Adult and Family Center over the past two decades. Modifications of the protocol are being used to treat special populations, such as family caregivers in a group format.
NIH Funding/CER Studies Partially/fully funded by National Institutes of Health: Yes
Evaluated in comparative effectiveness research studies: Yes
Adaptations The developers have treated individuals from numerous ethnic-minority groups in their training and research programs using the original protocols with successful outcomes. Adaptations have been developed for use with special populations such as family caregivers, Hispanic Americans, Asian Americans, African Americans, and Persians. A male-specific adaptation has also been developed. Translations and back-translations of the manuals and instruments for evaluation have been made available in Spanish and Chinese. Randomized trials have shown the effectiveness of this intervention among Latinos, Chinese, and African Americans.
Adverse Effects No adverse effects, concerns, or unintended consequences were identified by the developer.
IOM Prevention Categories IOM prevention categories are not applicable.