Characteristics and effectiveness of cognitive behavioral therapy for older adults living in residential care: a systematic review

Article

Chan, Phoebe, Bhar, Sunil, Davison, Tanya E., Doyle, Colleen, Knight, Bob G., Koder, Deborah, Laidlaw, Ken, Pachana, Nancy, Wells, Yvonne and Wuthrich, Viviana M.. 2021. "Characteristics and effectiveness of cognitive behavioral therapy for older adults living in residential care: a systematic review." Aging and Mental Health. 25 (2), pp. 187-205. https://doi.org/10.1080/13607863.2019.1686457
Article Title

Characteristics and effectiveness of cognitive behavioral therapy for older adults living in residential care: a systematic review

ERA Journal ID39992
Article CategoryArticle
AuthorsChan, Phoebe (Author), Bhar, Sunil (Author), Davison, Tanya E. (Author), Doyle, Colleen (Author), Knight, Bob G. (Author), Koder, Deborah (Author), Laidlaw, Ken (Author), Pachana, Nancy (Author), Wells, Yvonne (Author) and Wuthrich, Viviana M. (Author)
Journal TitleAging and Mental Health
Journal Citation25 (2), pp. 187-205
Number of Pages20
Year2021
Place of PublicationUnited Kingdom
ISSN1360-7863
1364-6915
Digital Object Identifier (DOI)https://doi.org/10.1080/13607863.2019.1686457
Web Address (URL)https://www.tandfonline.com/doi/full/10.1080/13607863.2019.1686457
Abstract

Objectives: Cognitive behavioral therapy (CBT) for depression and anxiety for older adults living in residential aged care facilities (RACFs) needs to accommodate the care needs of residents and the circumstances of RACFs. This systematic review examines the delivery and content characteristics of these interventions, in relation to participant satisfaction, staff appraisal, uptake rate, attrition rate, and treatment effectiveness. Such a review could provide important information for the development of future CBT-based interventions.

Method: Studies that examined the application of CBT for depression or anxiety in RACFs were identified by systematically searching a number of relevant databases. Reference lists of all included studies were examined, and citation searches on the Web of Science were conducted. Two independent reviewers were involved in screening articles and in extracting data and assessing methodological quality of the selected studies.

Results: Across the 18 studies included in this review, the most common therapeutic strategy was pleasant activities scheduling. Studies varied on treatment duration (2–24 weeks), number of sessions (6–24), and length of sessions (10–120 min). Residents and staff members were satisfied with the CBT interventions. The average uptake rate was 72.9%. The average attrition rate was 19.9%. Statistically significant results were reported in 8 of the 12 randomized controlled trials (RCTs). In these eight RCTs, CBT was characterized by psychoeducation, behavioral activation, and problem-solving techniques; further, the therapists in six of these studies had training in psychology.

Conclusion: CBT interventions for depression and anxiety are acceptable to RACF residents and judged positively by staff members. Effective studies differed from non-effective studies on content and training characteristics, but not on other delivery features.

Keywordscognitive behavioral therapy; residential aged care; characteristics;systematic review; depression; anxiety
ANZSRC Field of Research 2020320210. Geriatrics and gerontology
520399. Clinical and health psychology not elsewhere classified
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Byline AffiliationsSwinburne University of Technology
University of Melbourne
School of Psychology and Counselling
University of Exeter, United Kingdom
University of Queensland
Macquarie University
Institution of OriginUniversity of Southern Queensland
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