Cognitive behavioural therapy

Cognitive behaviour therapy (CBT) is a dominant psychological treatment in the management of a range of psychiatric disorders and is increasingly being refined to suit the needs of older adults. This chapter summarizes the theory and practice of CBT, and emphasizes assessment, formulation, and adaptation of treatment with older patients. It describes in detail management of depressive disorder, anxiety disorders and dementia caregiver distress and includes relevant case examples. It also covers problem-solving therapy and behavioural activation. The chapter also describes mindfulness-based cognitive therapy (MBCT), which has potential benefits in the treatment of older adults, and it reviews applications with older people. It outlines newer applications, including treatment of psychological symptoms associated with physical illness, psychosis, and memory impairment. Finally, it describes how the evidence base for CBT-based interventions with older adults is limited and reviews the extent of the current evidence.