Cognitive behaviour therapy for generalized anxiety disorder: Is CBT equally efficacious in adults of working age and older adults?

Abstract

The current meta-analysis compared the efficacy of CBT for GAD between adults of working age and older people. In addition, we conducted a qualitative content analysis of treatment protocols used in studies with older clients to explore potential factors that may enhance treatment outcomes with this particular client group. Applying the inclusion criteria resulted in the identification of 15 studies with 22 comparisons between CBT and control groups (770 patients). When examining overall effect sizes for CBT for GAD between older people and adults of working age there were no statistically significant differences in outcome. However, overall effect size of CBT for GAD was moderate for older people (g=0.55, 95% CI 0.22-0.88) and large for adults of working age (g=0.94, 95% CI 0.52-1.36), suggesting that there is still room for improvement in CBT with older people. The main difference in outcome between CBT for GAD between the two age groups was related to methodological quality in that no older people studies used an intention-to-treat design. The content analysis demonstrated that studies with older clients were conducted according to robust CBT protocols but did not take account of gerontological evidence to make them more age-appropriate.

Supervisee Attachment, Cognitive Distortions, and Difficulty With Corrective Feedback

“…Cognitive therapy was developed by Beck and others under the premise that changing the way a person thinks about an event or a situation can change the way the person feels about it, and that this change can lead to more effective and rational decision‐making. This theoretical orientation and its associated clinical interventions have emerged as the dominant force in psychotherapy research, with empirical support across a variety of populations and presenting issues (e.g., Karlin et al, 2012; Kishita & Laidlaw, 2017; Waite, McManus, & Shafran, 2012). Exploration of the helpfulness or utility of automatic thoughts and beliefs (i.e., cognitive distortions) can help reframe the way people understand and decode their environment (Beck, 2005; Hays, 2009).…”

Metacognitive therapy versus cognitive–behavioural therapy in adults with generalised anxiety disorder

“… 3 There are eight meta-analyses of randomised controlled trials of GAD in adults 4 – 11 and two in older adults. 12 , 13 Most published trials have tested the effects of different drugs, different types of cognitive–behavioural therapy (CBT) or treatments using relaxation therapies. Only two meta-analyses have a broader approach and assess all psychological treatments, 7 , 11 and only one includes both CBT and pharmacotherapy, predominantly benzodiazepines.…”

Association between anxious symptoms and sleeping medication use among US older adults

“…Several studies have highlighted the effectiveness of cognitive behavioral therapy (CBT) for treating insomnia (Bush et al , 2012) and anxiety (Kishita and Laidlaw, 2017). CBT aims to identify and challenge dysfunctional thoughts related to sleep and its impact on function (Morin, 1993; Zdanys and Steffens, 2015).…”