Community psychiatric nursing and the depressed elderly: a case for using cognitive therapy

Abstract

This paper examines whether the literature suggests that Beck's cognitive therapy is a treatment helpful to depressed elderly people, and highlights the issues and adaptations which are considered in its use with this client group. Evidence from outcome studies and case studies is presented which does suggest that it is helpful. A number of issues are raised which require certain special sensitivities on the part of the therapist. Evidence is discussed which suggests that certain adaptations to style and content of therapy may be needed for it to be maximally effective. It is argued that the use of cognitive therapy by community psychiatric nurses (CPNs) could contribute to making the service to depressed elderly people more comprehensive.

Cognitive therapy for depression in the elderly

“…Rather, a more concrete, problem-solving approach was more helpful, where practical situations were brought into the group and greater weight was placed on action and goal-setting. Emphasis on homework and use of role plays have also been recommended for similar reasons (Hughes, 1991). The use of idiomatic labels for complex concepts, for example 'crystal balling' and 'loopy conclusions' for some thinking errors, has been valuable in improving the patient's absorption of new material (Tanner and Ball, 1989).…”

Community psychiatric nursing and depression in elderly people

“…The present wnter has reviewed the bterature on the use of Beck's cogmhve therapy with the depressed elderly (Hughes 1991) It is conduded that it does appear to be a helpful mtervention, but that a number of adaptations both to style and content of therapy may be needed for it to be maximally effective It is argued that CPNs should consider the use of such 'valued' mterventions with their depressed elderly dients Perbaps tben, a better prognosis for depression m many elderly people migbt be achieved by usmg psycbological tberapy, eitber alone or m combinahon witb tbe tradihonal pbysical treatments CPNs could offer psycbological tberapy to dients wbose medical responsibility remains witb tbe GP, or wbo are bemg treated by a psycbiatnst as an out-pahent Residual difficulhes wbcb migbt remain followmg m-patient treatment (and often do) migbt also be treated psycbologically by tbe CPN…”