A pilot trial of psychological therapy groups for the very old in residential care: Clinical and logistical issues

Abstract

Background: This study sought to evaluate the clinical effectiveness and practical viability of groups loosely based on cognitive behaviour therapy (CBT) principles for older frail residents of an aged-care facility with anxiety and/or depressive symptoms.Methods: Six residents (mean age 88 years) participated in 8 weekly sessions of group psychotherapy. All had multiple physical comorbidities and loss of physical independence; one participant had a diagnosis of dementia.

A feasibility study of group‐based cognitive behaviour therapy for older adults in residential care

“…The challenges reported by Blair and Bird () around goal setting and homework completion persisted in the current study. It is possible that the poorly defined goals and lack of engagement in homework tasks are related to the subclinical nature of the sample.…”

“…The authors discussed many logistical, process, and content issues related to running therapy groups with very old people in residential care and provided recommendations for recruitment, group process and content. Whilst standard CBT content was appropriate, Blair and Bird () recommend including topics on pain, sleep, loss/grief and worry about adult children. In terms of process, they recommend small groups of no more than five, a group name with positive connotations, timing of 2 hrs with a 1‐hr break, standardised measures specifically developed for older people and with fewer choices than the Beck Depression Inventory II (BDI‐II), and flexibility in discussing issues specific to living in residential aged care.…”

<p>The Influence of Nonpharmacological Complex Therapy Conducted at a Community Day-Care Center on Cognitive function and Mood in Older Adults</p>

“…An evaluation of the effects of nonpharmacological interventions (similar to the one that was implemented at the CD-CC) on the mental health status of elderly persons represents an important field of investigations for many researchers worldwide. 21,22 A review of research on the impact of physical activity on mental and somatic status of elderly adults has indicated that the physical activity can be an alternative to pharmacological therapy for depressive disorders, and thus, it can affect the reduction of costs related to medical care for older persons. [23][24][25] Furthermore, regular physical exercises, physical therapy, and respiratory exercises cause the reduction of depressive symptoms, mental disorders, and anxiety states.…”

Characteristics of Cognitive Behavioral Therapy for Older Adults Living in Residential Care: Protocol for a Systematic Review

“…In addition, they found that the effect of psychotherapies was comparable to that reported in pharmacotherapy trials with depressed older adults. Despite a lack of systematic reviews specifically examining CBT in residential care settings, studies such as those conducted by Anderson et al [ 15 ] and by Blair and Bird [ 16 ] found that CBT was effective and feasible for reducing depressive symptoms in older adults living in residential care.…”

“…Such a systematic review is essential because it provides crucial information for the development of future CBT-based programs for residents in aged care. As highlighted by Kishita and Laidlaw [ 20 ] and Blair and Bird [ 16 ], identifying components of CBT programs that are specific to this population (eg, logistical issues such as how to approach residents, group size, timing, and duration of sessions) could help enhance treatment accessibility, acceptability, and outcomes. Moreover, by identifying the content of such protocols, that is, the strategies and techniques used to assist residents, clinicians may be better prepared to address the concerns of older adults living in residential aged care settings.…”