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Abstract

At least four academic clinical trials have demonstrated the utility of cognitive behavior therapy (CBT) for older adults with generalized anxiety disorder (GAD). These data may not generalize, however, to more heterogeneous and functionally impaired patients and the medical settings in which they typically receive care. A recent pilot project suggested the potential benefits of a new version of CBT for GAD among older patients in primary care. The manual developed and tested in this pilot project is presented here. Treatment components include motivation and education, relaxation skills, cognitive therapy, problem-solving-skills training, exposure exercises, and sleep-management-skills training. Procedures are designed to be administered flexibly to maximize attentionto individualpatient needs. Examples of session summaries, patient handouts, and homework forms are provided.

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References

Barlow, D. H., & Cerny, J. A. (1988). Psychological treatment of panic. New York: Guilford.

Bernstein, D. A., & Borkovec, T. D. (1973). Progressive relaxation training. Champaign, IL: Research.

Blazer, D., George, L. K., & Hughes, D. (1991). The epidemiology of anxiety disorders: An age comparison. In C. Salzman & B. D. Lebowitz (Eds.), Anxiety in the elderly: Treatment and research (pp. 17-30). New York: Springer.

Borkovec, T. D., & Costello, E. (1993). Efficacy of applied relaxation and cognitive behavioral therapy in the treatment of generalized anxiety disorder. Journal of Consulting and Clinical Psychology, 61, 611-619.

Brown, T. A., O’Leary, T. A., & Barlow, D. H. (2001). Generalized anxiety disorder. In D. H. Barlow (Ed.), Clinical hand book of psychological disorders (3rd ed.). New York: Guilford.

Craske, M. G., Barlow, D. H., & O’Leary, T. (1992). Mastery of your anxiety and worry. Albany, NY: Graywind.

Diefenbach, G. J., Hopko, D. R., Feigon, S., Stanley, M. A., Novy, D. M., Beck, J. G., et al. (200e). Minor GAD: Characteristics of subsyndromal GAD in older patients. Behavior Research and Therapy, 41, 481-487.

Gallagher-Thomas, D., & Osgood, N. J. (1997). Suicide in later life. Behavior Therapy, 28, 23-41.

Gorenstein, E. E., Papp, L. A., Kleber, M. S., Mohlman, J., de Jesus, M., & Gorman, J. M. (2003). Cognitive-behavioral therapy for management of anxiety and medication in taper in older adults. Manuscript under review.

10.

Gorenstein, E. E., Papp, L. A., & Kleber, M. S. (1999b). Cognitive behavioral treatment of anxiety in later life. Cognitive and Behavioral Practice, 6, 305-320.

11.

Kogan, J. N., Edelstein, B. A., and McKee, D. R. (2000). Assessment of anxiety in older adults: Current status. Journal of Anxiety Disorders, 14, 109-132.

12.

Meichenbaum, D. (1988). Stress innoculation training. Elmsford, NY: Pergamon.

13.

Mohlman, J., Gorenstein, E. E., Kleber, M., de Jesus, M., Gorman, J. M., & Papp, J. A. (2003). Standard and enhanced cognitive behavior therapy for late-life generalized anxiety disorder: Two pilot investigations. American Journal of Geriatric Psychiatry, 11, 24-32.

14.

Morin, C. M., Colecchi, C., Stone, J., Sood, R., & Brink, D. (1999). Behavioral and pharmacological therapies for late-life insomnia: A randomized controlled trial. Journal of the American Medical Association, 281, 991-999.

15.

Pearson, J. L. (1998). Research in late-life anxiety: Summary of a National Institute of Mental Health workshop on late-life anxiety. Psychopharmacology Bulletin, 34, 127-138.

16.

Stanley, M. A., & Beck, J. G. (2000). Anxiety disorders. Clinical Psychology Review, 20, 731-754.

17.

Stanley, M. A., Beck, J. G., & Glassco, J. D. (1996). Treatment of generalized anxiety in older adults: A preliminary comparison of cognitive-behavioral and supportive approaches. Behavior Therapy, 27, 565-581.

18.

Stanley, M. A., Beck, J. G., Novy, D. M., Averill, P. M., Swann, A. C., Diefenbach, G. J., et al. (2003a). Cognitive behavioral treatment of late-life generalized anxiety disorder. Journal of Consulting and Clinical Psychology, 71, 309-319.

19.

Stanley, M. A., Hopko, D. R., Diefenbach, G. J., Bourland, S. L., Rodriguez, H., & Wagener, P. (2003b). Cognitive behaviortherapy for late-life generalized anxiety disorder in primarycare (CBT-GAD/PC): Preliminary findings. American Journal of Geriatric Psychiatry, 11, 92-96.

20.

Wetherell, J. L., Gatz, M., & Craske, M. G. (2003). Treatment of generalized anxiety disorder in older adults. Journal of Consulting and Clinical Psychology.

Cognitive Behavioral Treatment for Older Adults with Generalized Anxiety Disorder

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