ABSTRACT
Two hundred participants aged 65 and older recruited from 4 different family medicine clinics rated the acceptability of 3 different treatments for geriatric depression: (a) cognitive therapy (CT), (b) cognitive bibliotherapy (CB), and (c) antidepressant medication (AM). Results showed that the acceptability of the treatments is a function of the severity of the symptoms of the depressed patient to whom they would be applied. CT and CB were rated as more acceptable than AM when patient symptoms were mild to moderate. However, CT was more acceptable than both CB and AM when patient symptoms were described as severe. Acceptability ratings were not related to the raters' own depressive symptoms. The practical implications of these results are discussed.
Subject(s)
Antidepressive Agents/therapeutic use , Bibliotherapy , Cognitive Behavioral Therapy , Depressive Disorder/therapy , Patient Acceptance of Health Care , Aged , Antidepressive Agents/adverse effects , Depressive Disorder/psychology , Family Practice , Female , Geriatric Assessment , Humans , Male , Patient Care Team , Self CareABSTRACT
Many residents in long-term-care facilities demonstrate agitated behaviors. Research on behavioral approaches for reducing agitation in nursing home residents has been conducted during the past 25 years. This research is critically reviewed in this article and suggestions for future research are offered. Empirical evidence suggests that behavioral approaches are effective. Antecedent control strategies have been shown to reduce physically nonaggressive behaviors. Both aggressive and verbally agitated behaviors have been successfully treated by manipulating reinforcing consequences of these behaviors. Future research in this area needs to test behavioral treatments using randomized group designs, compare behavioral interventions to other treatments used alone or in combination, specify criteria for clinically significant improvement, diversify and ascertain the validity of assessment methods, and verify the maintenance of treatment effects over relatively long follow-up periods.
Subject(s)
Behavior Therapy/methods , Psychomotor Agitation/therapy , Social Behavior Disorders/therapy , Aged , Aggression , Behavior Therapy/standards , Geriatric Assessment , Geriatric Psychiatry/methods , Homes for the Aged/standards , Humans , Long-Term Care/methods , Long-Term Care/standards , Nursing Homes/standards , Outcome Assessment, Health Care/methods , Outcome Assessment, Health Care/standards , Reinforcement, Psychology , Research Design/standards , Verbal BehaviorABSTRACT
D.C. Mohr (1995) suggested that high deterioration rates may occur in self-directed treatments. The investigators examined data from 5 studies of self-administered treatment for depression and found in contrast much lower rates (9% vs. 19%) than those cited in Mohr's review. The negative response rates for the self-administered treatments compared favorably with the negative response rates in the therapist-administered treatments provided in the National Institute of Mental Health Treatment of Depression Collaborative Research Program. The findings indicate that it may be the manner in which participants are prepared for self-administered treatment that is critical.
