Cognitive and behavioural approaches with the depressed elderly

✍ Scribed by Robin G. Morris; Lorna W. Morris

• Book ID: 102845930
• Publisher: John Wiley and Sons
• Year: 1991
• Tongue: English
• Weight: 694 KB
• Volume: 6
• Category: Article
• ISSN: 0885-6230
• DOI: 10.1002/gps.930060612

✦ Synopsis

Considerable progress has been made in the psychological treatment of depression and it is a matter of debate as to whether psychological therapies can be more effective than pharmacotherapy in the long run (Dobson, 1989; Williams, 1984).

Recently, there has been a growing recognition that psychological approaches developed with younger adults can be successfully adapted for use with older people (Gatz et al., 1985; Knight, 1986; Thompson et al., 1987).

There is still the legacy of Freud's view that elderly people lack the plasticity or flexibility to engage in therapy (Butler and Lewis, 1982). These changes do occur in the elderly but it is now recognized that they do not necessarily compromise the therapeutic process. For example, a reduction in the speed of information processing is not a barrier to communication if the therapist reduces the conversational flow of each session, with a greater latency between patient speech and therapist speech. Indeed, elderly people often have more time in between sessions to process what has been covered, perhaps accounting for the impression that progress can be just as rapid even if individual sessions 'feel' slower (Knight, 1986).

Differing cultural experiences over time can also be confused with developmental changes, with the result that therapists make wrong assumptions about patients' capacity for change. This refers not just to differing attitudes and values held by elderly people, but beliefs about illness and the therapeutic process. An elderly patient may not be familiar with 'talking therapy' and be expecting physical treat-