The development of 'ageless' mental health services means that an increasing number of clinicians are now required to work with older people. Cognitive Behavioural Therapy is recognised by all recent meta-analyses as the most effective therapy, yet few clinicians are trained specifically in its usage with the elderly.This book is a detailed guide to using CBT with older people both with and without cognitive difficulties. Reviewing its use in different settings, it covers both conceptual and practical perspectives, and details everything from causes and initial assessment to case formulation and change techniques. Case studies in both depression and dementia are used to illustrate how CBT should work and how positive effects can manifest themselves.Suitable both for trainees and experienced therapists, this book will be essential for anybody using cognitive behavioural therapy in their work with older people, regardless of their clients' levels of cognitive ability.
Chapter 1. 1.1 Introduction. 1.2 Partitioning - parts 1 to 3. Part 1. Chapter 2. Patients' Presentations and How CBT Helps. 2.1 Introduction. 2.2 Nature of the mood disorders. 2.3 Nature of standard CBT. 2.4 Working with people in non-standard CBT formats. 2.5 Conclusion. Chapter 3. Adapting Therapy for Older People. 3.1 Introduction. 3.2 Two dimensional framework for categorising presentations. 3.3 Conclusion. Chapter 4. Cognitive Changes, Executive Functioning, Working Memory and Scripts: Their Relevance to Therapeutic Engagement. 4.1 Introduction. 4.2 Cognitive changes. 4.3 Executive functioning. 4.4 Working memory. 4.5 Actions of scripts. 4.6 Conclusion. Part 2. Chapter 5. Assessment. 5.1 Introduction. 5.2 Assessment protocol. 5.3 Cautions regarding the assessment process. 5.4 Measures. 5.5 Conclusion. Chapter 6. Case Formulation. 6.1 Introduction. 6.2 Nature of formulations. 6.3 Formulations with older people. 6.4 Review of formulation approaches used with older people. 6.5 Choice of formulation. 6.6 Cautions regarding use of formulations. 6.7 Conclusion. Chapter 7 Change Techniques. 7.1 Introduction. 7.2 Nature of change. 7.3 Change strategies. 7.4 Process issues associated with change techniques. 7.5 Modifying core beliefs. 7.6 Cognitive change with the continuum technique. 7.7 Conclusion. Part 3. Chapter 8 A Case Study in Depression: Mary. 8.1 Introduction. 8.2 Overview of the case. 8.3 Review of the work undertaken with Mary. 8.4 Conclusion. Chapter 9 Assessing and Developing Clinical Competence. 9.1 Introduction. 9.2 The Cognitive Therapy Scale-Revised. 9.3 Conclusion. Chapter 10. Use of Psychotherapy in the Treatment of Challenging Behaviours in Care Facilities: A Staff-Centred, Person-Focused Approach. 10.1 Introduction. 10.2 Description of the NCBS and its treatment philosophy. 10.3 Overview of the case. 10.4 Protocol of the Newcastle approach. 10.5 Process and structural features of the assessment phase. 10.6 Information Sharing Session (ISS) and goal-setting process. 10.7 Formulation. 10.8 Treatment and outcome. 10.9 Reflections. Chapter 11.Concluding Comments 11.1 Introduction. 11.2 Working with carers. 11.3 Alternative models to CBT in the treatment of depression. 11.4 IAPT: Provision of Mental Health Services for Older People. 11.5 Concluding comments and reflections. Appendix 1: Disorder-specific conceptual models. Appendix 2: A training manual for promoting therapeutic competence. References.
This is an immensely ambitious book aiming to encompass a vast body of material spanning the literature on cognitive behavioural therapy (CBT), neuropsychology of aging, and models of cognition and memory. This makes it quite complex, but a great deal of thought has been given to how it is structured to enable the reader to make their way through...the book sites itself quite firmly in current competency based educational practice and I think has clearly been written as the result of the author's extensive experience of supervising psychology trainees. It is a very structured text, in many ways modelling the processes of agenda setting, information gathering, formulation and so on that are explored in the text...the book has some very important points to make and makes them in a well-researched and evidenced way. I think one of the most useful is about the nature of normal cognitive aging and the risk of excluding older people from genetic therapy services because fo a failure to appreciate the interaction between cognition and therapeutic engagement...Another feature of the book that I liked was the very practical emphasis on the need to be effective - to measure what you're doing, make a judgement about whether it is likely to help, and take steps to ensure that change occurs. I think this emphasis on the progression from engagement to understanding to changing and the need to achieve action beyond a shared understanding will be particularly useful to inexperienced therapists...It is a very learned and well informed treatise with some important and quite novel things to say and it packs in a huge amount of information. Will it be a useful addition to the bookshelf? Certainly, especially if you want a pithy summary of the issues that are specific to therapy with older people or if you want to encourage people to think about dementia from a CBT framework.
