Cognitive Behavior Therapy With Mindfulness and Acceptance Skills for the Treatment of Older Adults

Abstract

Cognitive behavior therapy (CBT) is a psychotherapy approach for the treatment of depression in older adult populations. This article discusses an extension of CBT to include mindfulness and acceptance skills for the treatment of depression in older adults with comorbid medical illness. Findings support that a brief intervention of 12 weeks was effective in producing a clinically significant change in depression and quality of life at the completion of therapy and at follow-up. This suggests that mindfulness and acceptance skills in addition to CBT skills may be an effective intervention for the treatment of depression of older adults with chronic medical illnesses.

Keywords

cognitive behavior therapy mindfulness acceptance older adult depression

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References

Arean

P. A.

Raue

P. J.

Sirey

J. A.

Snowden

(2012). Implementing evidence-based psychotherapies in settings serving older adults: Challenges and solutions. Psychiatry Services, 63, 605-607.

Beck

A. T.

(1979). Cognitive therapy and emotional disorders. New York, NY: Meridian.

Beck

J. S.

(1995). Cognitive therapy: Basics and beyond. New York, NY: Guilford Press.

Bennett

Wells

(2010). Metacognition, memory disorganization, and rumination in posttraumatic stress symptoms. Journal of Anxiety Disorders, 24, 318-325.

Blazer

(2002). Depression in later life. New York, NY: Springer.

Davis

D. M.

Hayes

J. A.

(2011). What are the benefits of mindfulness? A practice review of psychotherapy related research. Psychotherapy, 48, 198-208.

Fiske

Wetherell

J. L.

Gatz

(2009). Depression in older adults. Annual Review of Clinical Psychology, 5, 363-389.

Folstein

M. F.

Folstein

S. E.

McHugh

P. R.

(1975). “Mini-mental state”: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189-198.

Fortin

Bravo

Hudon

Lapointe

Almirall

Dubois

M.-F.

Vanasse

(2006). Relationship between multimorbidity and health-related quality of patients in primary care. Quality of Life Research, 15, 83-91.

10.

Foulk

M. A.

Ingersoll-Dayton

Kavanagh

Robinson

Kales

H. C.

(2014). Mindfulness-based cognitive therapy with older adults: An exploratory study. Journal of Gerontological Social Work, 57, 498-520.

11.

Gregg

J. A.

Hayes

S. C.

Glenn-Lawson

J. L.

(2007). Improving diabetes self-management through acceptance, mindfulness, and values: A randomized controlled trial. Journal of Consulting and Clinical Psychology, 75, 336-343.

12.

Hamilton

(1960). A rating scale for depression. Journal of Neurology, Neurosurgery & Psychiatry, 23, 56-62.

13.

Hayes

S. C.

Strosahl

K. D.

Wilson

K. G.

(2003). Acceptance and commitment therapy: An experiential approach to behavior change. New York, NY: Guilford Press.

14.

Hofmann

S. G.

Asmundson

G. J.

(2008). Acceptance and mindfulness-based therapy: New wave or old hat? Clinical Psychology Review, 28, 1-16.

15.

Huss

D. B.

Baer

R. A.

(2007). Acceptance and change: The integration of mindfulness based cognitive therapy into ongoing dialectical behavior theory in a case of borderline personality disorder with depression. Clinical Case Studies, 6, 17-33.

16.

Kabat-Zinn

(1990). Full catastrophe living: Using the wisdom of your body and mind to face stress, pain and illness. New York, NY: Delacorte.

17.

Kahl

K. G.

Winter

Schweiger

(2012). The third wave of cognitive behavioural therapies: What is new and what is effective? Current Opinion in Psychiatry, 25, 522-528.

18.

Lunde

L. H.

Nordhus

I. H.

(2009). Combining acceptance and commitment therapy and cognitive behavioral therapy for the treatment of chronic pain in older adults. Clinical Case Studies, 8, 296-308.

19.

Lynch

T. R.

Cheavens

J. S.

Cukrowicz

K. C.

Thorp

S. R.

Bronner

Beyer

(2007). Treatment of older adults with co-morbid personality disorder and depression: A dialectical behavior therapy approach. International Journal of Geriatric Psychiatry, 22, 131-143.

20.

Marchand

W. R.

(2012). Mindfulness-based stress reduction, mindfulness-based cognitive therapy, and Zen meditation for depression, anxiety, pain, and psychological distress. Journal of Psychiatric Practice, 18, 233-252.

21.

Marquett

R. M.

Thompson

L. W.

Reiser

R. P.

Holland

J. M.

O’Hara

R. M.

Kesler

S. R.

Thompson

D. G.

(2013). Psychosocial predictors of treatment response to cognitive–behavior therapy for late-life depression: An exploratory study. Aging & Mental Health, 17, 830-838.

22.

Maxfield

Segal

D. L.

(2008). Psychotherapy in nontraditional settings: A case of in-home cognitive–behavioral therapy with a depressed older adult. Clinical Case Studies, 7, 154-166.

23.

McVeigh

Mostashari

Thorpe

L. E.

(2005). Serious psychological distress among persons with diabetes—New York City, 2003. Journal of the American Medical Association, 293, 419-420. (Reprinted from Morbidity and Mortality Weekly Report, 53, 1089-1092, 2004)

24.

Morone

N. E.

Greco

C. M.

Weiner

D. K.

(2008). Mindfulness meditation for the treatment of chronic low back pain in older adults: A randomized controlled pilot study. Pain, 134, 210-319.

25.

Pinquart

Duberstein

P. R.

Lyness

J. M.

(2007). Effects of psychotherapy and other behavioral interventions on clinically depressed older adults: A meta-analysis. Aging & Mental Health, 11, 645-657.

26.

Roemer

Orsillo

(2009). Mindfulness and acceptance based therapies in practice. New York, NY: Guilford Press.

27.

Segal

Z. V.

Williams

J. M. G.

Teasdale

J. D.

(2002). Mindfulness-based cognitive therapy for depression: A new approach to preventing relapse. New York, NY: Guilford Press.

28.

Segal

Z. V.

Williams

J. M. G.

Teasdale

J. D.

(2013). Mindfulness-based cognitive therapy for depression (2nd ed.). New York, NY: Guilford Press.

29.

Serfaty

M. A.

Haworth

Blanchard

Buszewicz

Murad

King

(2009). Clinical effectiveness of individual cognitive behavioral therapy for depressed older people in primary care: A randomized controlled trial. Archives of General Psychiatry, 66, 1332-1340.

30.

Shih

Hootman

J. M.

Strine

T. W.

Chapman

D. P.

Brady

T. J.

(2006). Serious psychological distress in U.S. adults with arthritis. Journal of General Internal Medicine, 21, 1160-1166.

31.

Sirey

J. A.

Franklin

A. J.

McKenzie

S. E.

Ghosh

Raue

P. J.

(2014). Race, stigma, and mental health referrals among clients of aging services who screened positive for depression. Psychiatry Services, 65, 537-540.

32.

Smith

(2004). Clinical use of mindfulness training for older adults. Behavioural and Cognitive Psychotherapy, 32, 423-430.

33.

Spitzer

R. L.

Gibbon

Williams

J. B.

(1995). Structured Clinical Interview for Axis I DSM-IV Disorders (SCID). Washington, DC: American Psychiatric Association.

34.

Strine

T. W.

Hootman

J. M.

Okoro

C. A.

Balluz

Moriarty

D. G.

Owens

Mokdad

(2004). Frequent mental distress status among adults with arthritis age 45 years and older, 2001. Arthritis & Rheumatism, 51, 533-537.

35.

van Ravesteijn

HJ.

Suijkerbuijk

YB.

Langbroek

JA.

Muskens

Lucassen

PL.

van Weel

Wester

Speckens

AE.

(2014). Mindfulness-based cognitive therapy (MBCT) for patients with medically unexplained symptoms: process of change. J Psychosom Res. 77, 27-33.

36.

Veehof

M. M.

Oskam

M. J.

Schreurs

K. M.

Bohlmeijer

E. T.

(2011). Acceptance-based interventions for the treatment of chronic pain: A systematic review and meta-analysis. Pain, 152, 533-542.

37.

Zautra

A. J.

Davis

M. C.

Reich

J. W.

Sturgeon

J. A.

Arewasikporn

Tennen

(2012). Phone-based interventions with automated mindfulness and mastery messages improve the daily functioning for depressed middle-aged community residents. Journal of Psychotherapy Integration, 22, 206-228.