Langsam has supervised and supported trainees, interns, and licensed staff in her various roles across 18 years and continues to consult with agencies and train supervisors.
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She holds a master's degree in clinical psychology from John F. Summing Up: Recommended. Graduate students, faculty, and professionals. Libraries Unlimited. Need Help? Try our Search Tips. Award Winner. Reviewed Content. Sale Title. Available for Course Adoption. See all 9 reviews. Customers who bought this item also bought. Adult Psychopathology and Diagnosis. Deborah C. Family Therapy: Concepts and Methods 11th Edition.
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Aging and Mental Health, 2nd Edition
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ComiXology Thousands of Digital Comics. DPReview Digital Photography. East Dane Designer Men's Fashion. Shopbop Designer Fashion Brands. Few researchers have considered psychotherapy as a preventive intervention compared to treatment, however, several studies show promising results see Lee et al.
Below, we discuss a few recent efforts predominantly focusing on cognitive behavioral therapy and problem-solving therapy. The course was modified to provide relevant examples and pleasant events that would be appropriate for older adults in nursing homes. Participants were assisted, where needed, to write in their treatment manuals and to get to the sessions. Scores on the Geriatric Depression Scale a thirty-item questionnaire in which participants are asked to answer yes or no questions in reference to how they felt over the past week Yesavage et al.
However, the intervention group did not differ significantly from the control group on two other depression symptom scales The Center for Epidemiologic Studies Depression Scale and Dysfunctional Attitudes Scale for Medically Ill Elders Koenig et al. Problem-solving therapy is a behavioral approach that aims to reduce depression by targeting inaccurate problem appraisals and teaching skills to solve these problems adaptively.
Rovner and colleagues Rovner et al. At two months, the experimental group had half the incidence rate of depression compared to the control group The researchers did not find differences in incidence at six months; however, activities were better maintained in the experimental group. This intervention may be effective in older adults with other chronic diseases where both depression and disability are common.
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Taken together, with findings from Robinson and colleagues problem-solving therapy and escitalopram comparison, results suggest that problem-solving therapy provided over only a few weeks may have long-term effects in preventing depression, particularly in individuals with a medical comorbidity. Internet-based Interventions. In a three-group randomized control trial, Spek et al. Participants were adults ages 50 and older, with sub-threshold symptoms of depression. While both interventions had a large improvement effect size, the differences between the Coping with Depression course group and the wait-list control were negligible.
While 62 percent of individuals in the Internet cognitive-behavioral intervention were below the threshold indicator for depression on the Beck Depression Inventory a self-report scale that measures symptoms of depression Beck, Steer, and Brown, , only 45 percent of the Coping with Depression course and 38 percent of the wait-list participants were below threshold one year following initiation of treatment.
This reflects the natural course of improvement over time as well as the potential efficacy and desirability of Internet-based interventions. Stepped Care. Stepped-care interventions start with no intervention but progress to more involved interventions if an individual is not improving. If significant symptoms lasted after an initial three months, participants were randomized to either a usual care control group or cognitive-behavioral therapy bibliotherapy a self-help book version of the Coping with Depression course intervention.
A nurse first visited to provide information about anxiety and depression and basic advice on coping skills. If participants were still symptomatic three months later, they would progress to a seven-session problem-solving therapy. Finally, symptomatic participants at three months later would be referred to their primary care physician for antidepressant treatment.
The twelve-month incidence of anxiety and depressive disorders was 0.
Handbook of Mental Health and Aging - 2nd Edition
Sleep Problems Prevention. Sleep disturbance and mood are strongly associated, and as circadian rhythms and sleep patterns change with age, these associations are pivotal in older adults Buysse, Targeting the treatment of late-life insomnia, Germain and colleagues conducted a Brief Behavioral Treatment of Insomnia intervention, including one forty-five minute session and a short booster session two weeks later.
The Brief Behavioral Treatment includes education about sleep regulation, what influences sleep, and behaviors that can inhibit or promote sleep. In particular, participants were asked to follow four instructions for the four-week intervention: spend only the amount of time in bed one expects to sleep; wake up at the same time each day; only go to bed when sleepy; and get out of bed if not sleeping. Other prevention programs, such as psychosocial or exercise interventions, are less standardized than pharmacotherapy and psychotherapy interventions, yet have an opportunity to address specific risk factors in a way that may be more tolerable and less stigmatizing to older adults.
These programs provide some promising efforts that may be replicated, modified, or incorporated in a multifaceted way in indicated or selected randomized control trials. We consider some recent and promising examples see Forsman, Schierenbeck, and Wahlbeck, , for further review. Pot et al.
Both the intervention and control groups declined in anxiety, so there was not a significant between-group change-effect. While physical exercise long has been associated with improvements in mood, few interventions have focused on prevention and promotion, as opposed to treatment of clinical disorders. Baker et al. Since depressive symptoms were already low, there were no significant differences between treatment and control groups, but participants who had more depressive symptoms at baseline improved most. Rosenberg et al.
Anxiety scores declined across the intervention, but not significantly. These studies highlight the opportunity, yet also the paucity and lack of development, in prevention studies. Many of the described prevention studies only discussed improvement in symptoms or a comparison between an intervention and control group over time.
When symptoms are low or absent, however, the goal cannot be to reduce depression or anxiety, but rather to demonstrate reduced risk or lower incidence of new disorder over time. The above studies provide an overview of the potential for prevention and also challenges and limitations of this work. Pharmacotherapy has shown efficacy in preventing the recurrence of depression, yet antidepressants and benzodiazepines are associated with a number of negative side effects for older adults.
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Psychotherapy has been shown to reduce the incidence of depressive and anxiety disorders; but therapy sessions are lengthy and may require older adults to travel to a therapist.