Adapting CBT

Question 1

What interview schedule can you use when working with families?

Answer 1

Darlington Family Interview Schedule

Question 2

What needs to be considered when assessing whether someone is suitable for CBT?

Answer 2

Can they link emotions and events?

Can they link beliefs with this?

Question 3

What needs to be emphasised when doing cognitive therapy with people with learning disabilities?

Answer 3

Psychoeducation in emotional recognition and language

Question 4

What kinds of things are most useful to ask people with learning disabilities?

Answer 4

Immediate and concrete
Present or recent past
Short and simple
Definite right/wrong

Question 5

What are maturity factors in CBT?

Answer 5

Natural changes that occur with age.

Question 6

What are the Specific Challenge Factors for older adults in CBT?

Answer 6

Illness, social isolation, bereavement etc.

Question 7

Name four factors that can contribute to your understanding of an older person.

Answer 7

Cohort
Specific challenge
Context
Maturity

Question 8

What are the key findings from Laidlaw et al. (2003)?

Answer 8

Evidence for CBT in older adults is stronger than for other forms of therapy
Individual therapy is better than group for older adults
Psychotherapy seems as effective as medication
There is very little literature studying the outcomes on the older-old.

Question 9

What did Laidlaw et al. (2003) address?

Answer 9

The effectiveness of CBT with older adults.

Question 10

Who studied the effectiveness of CBT with older adults?

Answer 10

Laidlaw et al. (2003)

Question 11

Who outlines the challenges of psychotherapy with older adults?

Answer 11

Laidlaw and Pachana (2009)

Question 12

What are the 6 extra factors added to formulation for older adults by Laidlaw et al. (2003)?

Answer 12

Compensatory Strategies
Cohort Beliefs
Role Investment
Health Status
Socio-cultural context
Inter-generational links

Question 13

What is the best approach to formulating with older adults?

Answer 13

Concrete and staged ‘mini’-formulations to socialise

Question 14

What adaptations may be helpful to intervention when working with older adults?

Answer 14

Increased emphasis on rapport and relationship building
Increased emphasis on socialisation to therapy and psycho-education
Including others can often be useful (e.g. co-therapists)
Greater attention to behavioural and interpersonal factors in formulation

Question 15

What kinds of cognitive strategies are most helpful when working with older adults?

Answer 15

‘Re-activating’ positive coping strategies
More emphasis on the ‘usefulness’ and meaning of NATs
Aware of internalised ageism
Realistic goals

Question 16

Instead of looking for evidence, what should we address in older adults?

Answer 16

Reflecting on the effect/impact of thinking in a certain way
Reflecting on helpfulness of thought/response
Look at the motivation to continue to respond in this way

Question 17

What procedural modifications need to be made for older adults?

Answer 17

Tackling cognitive changes
Tackling sensory impairment
Awareness of physical health
Consider therapy setting and format
Be aware of verbosity from the client

Question 18

What might be a helpful and important technique in CBT for older adults?

Answer 18

Life review