Contextual Adult Life Span Theory for Adapting Psychotherapy with Older Adults

Introduction Bipolar disorder is a severe and chronic mental health problem that persists into older adulthood. The number of people living with this condition is set to rise as the UK experiences a rapid ageing of its population. To date, there has been very little research or service development with respect to psychological therapies for this group of people. Methods and analysis A parallel two-arm randomised controlled trial comparing a 14-session, 6-month Recovery-focused Cognitive-Behavioural Therapy for Older Adults with bipolar disorder (RfCBT-OA) plus treatment as usual (TAU) versus TAU alone. Participants will be recruited in the North-West of England via primary and secondary mental health services and through self-referral. The primary objective of the study is to evaluate the feasibility and acceptability of RfCBT-OA; therefore, a formal power calculation is not appropriate. It has been estimated that randomising 25 participants per group will be sufficient to be able to reliably determine the primary feasibility outcomes (eg, recruitment and retention rates), in line with recommendations for sample sizes for feasibility/pilot trials. Participants in both arms will complete assessments at baseline and then every 3 months, over the 12-month follow-up period. We will gain an estimate of the likely effect size of RfCBT-OA on a range of clinical outcomes and estimate parameters needed to determine the appropriate sample size for a definitive, larger trial to evaluate the effectiveness and cost-effectiveness of RfCBT-OA. Data analysis is discussed further in the Analysis section in the main paper. Ethics and dissemination This protocol was approved by the UK National Health Service (NHS) Ethics Committee process (REC ref: 15/NW/0330). The findings of the trial will be disseminated through peer-reviewed journals, national and international conference presentations and local, participating NHS trusts

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“…These correspond with the current literature on adapting psychological therapies for older adults. 33 34 …”

Section: Methodsmentioning

confidence: 99%

Feasibility randomised controlled trial of Recovery-focused Cognitive Behavioural Therapy for Older Adults with bipolar disorder (RfCBT-OA): study protocol

et al. 2016

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“…To understand unexpected encounters like the one described, novice researchers might consider using a guided approach to reflexive practice; we suggest applying the Contextual Adult Life Span Theory for Adapting Psychotherapy (CALTAP) model developed by Knight and Poon (2008). Devised for clinical therapy encounters, CALTAP encourages therapists to consider how cohort, socio-cultural context, maturity, and specific challenges affect therapy.…”

Section: Understanding One's Positionalitymentioning

confidence: 99%

Looking Back to Move Forward: The Value of Reflexive Journaling for Novice Researchers

Meyer

Willis

2018

Journal of Gerontological Social Work

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For novice qualitative researchers, each encounter in the field yields a ream of questions and uncertainties. While fieldwork has inherent ambiguities for all researchers, novice researchers have less experience on which to draw to assess their interactions with participants. Adding to this uncertainty, gerontological fieldwork is frequently imbued by age-and cohortrelated nuances, characteristics which new researchers often do not share with participants. It is also not uncommon for new researchers to work primarily alone on projects, such as dissertations and theses. Mentors and academic advisors can help examine research encounters, however advice may be most constructive following engagement in reflexive exercises. We discuss the benefits of using reflexive journaling to assist with answering the many questions generated while conducting qualitative interviews during a study with family carers. Advisors might consider encouraging the use of reflexive journaling to help novices grow as researchers.

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“…Experts have specifically discussed that established therapeutic approaches ought to be amended to fit older adults’ developmental stage and relevant needs (Kennedy & Tannenbaum, 2000; Knight & Poon, 2008; Molilnari et al, 2003). The majority of these age-related adjustments to psychotherapeutic approaches have been based on theories of aging and relevant research on older adulthood in general rather than clinical data (Knight & McCallum, 2011).…”

Section: Older Adults In Therapymentioning

confidence: 99%

Are Older Adults Unique? Examining Presenting Issues and Changes in Therapy Across the Life Span

et al. 2018

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With the urgent need to increase and improve mental health care of the growing population of older adults in the United States, clinical research is warranted to further the knowledge and improve the relevant training for mental health professionals working with older adults. This study drew from two diverse clinical samples of adults ages 18 years to 80 years to examine whether and how initial clinical presentations and changes over time in individual, family-of-origin, and relational measures differed across the life span. Results indicated a variety of linear and curvilinear associations between individual, family-of-origin, and relational measures at intake and age, with some moderation by gender. There were no significant results between the amount of change on those measures and age, indicating that older adults may change in similar fashion to middle-aged and younger adults in psychotherapy. Relevant clinical implications are provided.

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Contextual Adult Life Span Theory for Adapting Psychotherapy with Older Adults

Cited by 33 publications

References 34 publications

Feasibility randomised controlled trial of Recovery-focused Cognitive Behavioural Therapy for Older Adults with bipolar disorder (RfCBT-OA): study protocol

Feasibility randomised controlled trial of Recovery-focused Cognitive Behavioural Therapy for Older Adults with bipolar disorder (RfCBT-OA): study protocol

Looking Back to Move Forward: The Value of Reflexive Journaling for Novice Researchers

Are Older Adults Unique? Examining Presenting Issues and Changes in Therapy Across the Life Span

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