Characteristics of Cognitive Behavioral Therapy for Older Adults Living in Residential Care: Protocol for a Systematic Review

Background: The prevalence rates of depressive and anxiety disorders are high in residential aged care settings. Older adults in such settings might be prone to these disorders because of losses associated with transitioning to residential care, uncertainty about the future, as well as a decline in personal autonomy, health, and cognition. Cognitive behavioral therapy (CBT) is efficacious in treating late-life depression and anxiety. However, there remains a dearth of studies examining CBT in residential settings compared with community settings. Typically, older adults living in residential settings have higher care needs than those living in the community. To date, no systematic reviews have been conducted on the content and the delivery characteristics of CBT for older adults living in residential aged care settings. Objective: The objective of this paper is to describe the systematic review protocol on the characteristics of CBT for depression and/or anxiety for older adults living in residential aged care settings. Methods: This protocol was developed in compliance with the recommendations of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). Studies that fulfill the inclusion criteria will be identified by systematically searching relevant electronic databases, reference lists, and citation indexes. In addition, the PRISMA flowchart will be used to record the selection process. A pilot-tested data collection form will be used to extract and record data from the included studies. Two reviewers will be involved in screening the titles and abstracts of retrieved records, screening the full text of potentially relevant reports, and extracting data. Then, the delivery and content characteristics of different CBT programs of the included studies, where available, will be summarized in a table. Furthermore, the Downs and Black checklist will be used to assess the methodological quality of the included studies. Results: Systematic searches will commence in May 2018, and data extraction is expected to commence in July 2018. Data analyses and writing will happen in October 2018. Conclusions: In this section, the limitations of the systematic review will be outlined. Clinical implications for treating late-life depression and/or anxiety, and implications for residential care facilities will be discussed

A survey of Australian psychologists in aged care: the relationship between training, attitudes and professional practice with older clients\ud

The proportion of Australian adults aged over 65 years is due to increase over the next\ud 20 years with corresponding increases in mental illness. A growing demand for clinical\ud psychology services to older adults is expected yet overseas surveys indicate a low rate\ud of specializing in working with the over-65 age group. The status of geropsychology in\ud Australia is examined through exploratory analysis of survey data from a practising\ud psychologist sample and from a post-graduate psychology trainee sample. Six published\ud studies are reported that examine the relationship among training, personal contact and\ud attitudes, and the relative contributions of these three factors to decisions on working\ud with older adults among Australian psychologists. Pilot research highlights the\ud importance of interest in working with older clients and additional training external to\ud formal degree courses in discriminating between those psychologists who specialised in\ud aged care compared to generalist practitioners. A national survey of psychologists\ud identifies clinical exposure to older adults while training and negative expectations of\ud subjective ageing as additional factors predicting specialist category membership. Low\ud rates of professional involvement with older clients in general highlight the\ud corresponding dearth of psychologists specialising in aged care service provision, a\ud finding congruent with overseas research. The positive influence of clinical contact, as\ud opposed to the absence of predictive ability for personal contact, is also emphasized in a\ud survey of post-graduate psychology students. Professional attitudes, such as confidence\ud and interest in working with older adults, are other predictors of interest in working\ud with older clients among students. The use of the Reactions to Ageing Questionnaire in several analyses also highlights the importance of affect in influencing behaviour, with\ud professional attitudes predicting personal attitudes towards ageing, as opposed to\ud personal contact or formal training. The final study underscores the role of contextual\ud relevance, with training contributing to more variance in interest in working with older\ud adults among trainees, as compared to practitioners whose professional interest was\ud influenced more by attitudes. The contact hypothesis is not confirmed in this research in\ud either the student or the practitioner samples. Strategies to promote the field of clinical\ud geropsychology across a variety of settings, ranging from training to clinical service\ud delivery are discussed

The availability of psychological services for aged care residents in Australia: a survey of facility staff

Objective: Rates of depression and anxiety are high among older adults in residential aged care facilities (RACFs). This study examined the extent to which psychological services are made available to facility residents in Australia, and investigated barriers to accessing such services. Method: The sample consisted of 90 senior staff from a random sample of RACFs. Participants completed self-report questionnaires regarding their perspectives on the availability of psychological services and potential barriers to access psychological services. Results: Access to psychological services was poor. Psychologists were employed at a rate only one third that of other providers of mental health services. Residents were rarely referred to psychologists or to psychological treatments. The most important barriers to access, as perceived by participants, were the low availability of psychologists specialising in treating older adults, lack of government funding for such access, and limited staff training in detecting depression and anxiety. Conclusion: Access to psychologists and psychological services remains poor in Australian residential aged care settings. Such access may be improved by developing a workforce of clinical geropsychologists, improving funding mechanisms for residents to access psychological services, and addressing staff knowledge about depression and anxiety

Characteristics of Cognitive Behavioral Therapy for Older Adults Living in Residential Care: Protocol for a Systematic Review (Preprint)

BACKGROUND The prevalence rates of depressive and anxiety disorders are high in residential aged care settings. Older adults in such settings might be prone to these disorders because of losses associated with transitioning to residential care, uncertainty about the future, as well as a decline in personal autonomy, health, and cognition. Cognitive behavioral therapy (CBT) is efficacious in treating late-life depression and anxiety. However, there remains a dearth of studies examining CBT in residential settings compared with community settings. Typically, older adults living in residential settings have higher care needs than those living in the community. To date, no systematic reviews have been conducted on the content and the delivery characteristics of CBT for older adults living in residential aged care settings. OBJECTIVE The objective of this paper is to describe the systematic review protocol on the characteristics of CBT for depression and/or anxiety for older adults living in residential aged care settings. METHODS This protocol was developed in compliance with the recommendations of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). Studies that fulfill the inclusion criteria will be identified by systematically searching relevant electronic databases, reference lists, and citation indexes. In addition, the PRISMA flowchart will be used to record the selection process. A pilot-tested data collection form will be used to extract and record data from the included studies. Two reviewers will be involved in screening the titles and abstracts of retrieved records, screening the full text of potentially relevant reports, and extracting data. Then, the delivery and content characteristics of different CBT programs of the included studies, where available, will be summarized in a table. Furthermore, the Downs and Black checklist will be used to assess the methodological quality of the included studies. RESULTS Systematic searches will commence in May 2018, and data extraction is expected to commence in July 2018. Data analyses and writing will happen in October 2018. CONCLUSIONS In this section, the limitations of the systematic review will be outlined. Clinical implications for treating late-life depression and/or anxiety, and implications for residential care facilities will be discussed. CLINICALTRIAL PROSPERO 42017080113; https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=80113 (Archived by WebCite at http://www.webcitation.org/70dV4Qf54) REGISTERED REPORT IDENTIFIER RR1-10.2196/9902 </sec

The Availability of Psychological Services for Aged Care Residents in Australia: A Survey of Facility Staff

Objective: rates of depression and anxiety are high among older adults in residential aged care facilities (RACFs). This study examined the extent to which psychological services are made available to facility residents in Australia, and investigated barriers to accessing such services. Method: the sample consisted of 90 senior staff from a random sample of RACFs. Participants completed self-report questionnaires regarding their perspectives on the availability of psychological services and potential barriers to access psychological services. Results: access to psychological services was poor. Psychologists were employed at a rate only one third that of other providers of mental health services. Residents were rarely referred to psychologists or to psychological treatments. The most important barriers to access, as perceived by participants, were the low availability of psychologists specialising in treating older adults, lack of government funding for such access, and limited staff training in detecting depression and anxiety. Conclusion: access to psychologists and psychological services remains poor in Australian residential aged care settings. Such access may be improved by developing a workforce of clinical geropsychologists, improving funding mechanisms for residents to access psychological services, and addressing staff knowledge about depression and anxiety

Characteristics of Cognitive Behavioral Therapy for Older Adults Living in Residential Care: Protocol for a Systematic Review

Background: The prevalence rates of depressive and anxiety disorders are high in residential aged care settings. Older adults in such settings might be prone to these disorders because of losses associated with transitioning to residential care, uncertainty about the future, as well as a decline in personal autonomy, health, and cognition. Cognitive behavioral therapy (CBT) is efficacious in treating late-life depression and anxiety. However, there remains a dearth of studies examining CBT in residential settings compared with community settings. Typically, older adults living in residential settings have higher care needs than those living in the community. To date, no systematic reviews have been conducted on the content and the delivery characteristics of CBT for older adults living in residential aged care settings. Objective: The objective of this paper is to describe the systematic review protocol on the characteristics of CBT for depression and/or anxiety for older adults living in residential aged care settings. Methods: This protocol was developed in compliance with the recommendations of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). Studies that fulfill the inclusion criteria will be identified by systematically searching relevant electronic databases, reference lists, and citation indexes. In addition, the PRISMA flowchart will be used to record the selection process. A pilot-tested data collection form will be used to extract and record data from the included studies. Two reviewers will be involved in screening the titles and abstracts of retrieved records, screening the full text of potentially relevant reports, and extracting data. Then, the delivery and content characteristics of different CBT programs of the included studies, where available, will be summarized in a table. Furthermore, the Downs and Black checklist will be used to assess the methodological quality of the included studies. Results: Systematic searches will commence in May 2018, and data extraction is expected to commence in July 2018. Data analyses and writing will happen in October 2018. Conclusions: In this section, the limitations of the systematic review will be outlined. Clinical implications for treating late-life depression and/or anxiety, and implications for residential care facilities will be discussed

Characteristics of cognitive behavioral therapy for older adults living in residential care: Protocol for a systematic review

Background: The prevalence rates of depressive and anxiety disorders are high in residential aged care settings. Older adults in such settings might be prone to these disorders because of losses associated with transitioning to residential care, uncertainty about the future, as well as a decline in personal autonomy, health, and cognition. Cognitive behavioral therapy (CBT) is efficacious in treating late-life depression and anxiety. However, there remains a dearth of studies examining CBT in residential settings compared with community settings. Typically, older adults living in residential settings have higher care needs than those living in the community. To date, no systematic reviews have been conducted on the content and the delivery characteristics of CBT for older adults living in residential aged care settings. Objective: The objective of this paper is to describe the systematic review protocol on the characteristics of CBT for depression and/or anxiety for older adults living in residential aged care settings. Methods: This protocol was developed in compliance with the recommendations of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). Studies that fulfill the inclusion criteria will be identified by systematically searching relevant electronic databases, reference lists, and citation indexes. In addition, the PRISMA flowchart will be used to record the selection process. A pilot-tested data collection form will be used to extract and record data from the included studies. Two reviewers will be involved in screening the titles and abstracts of retrieved records, screening the full text of potentially relevant reports, and extracting data. Then, the delivery and content characteristics of different CBT programs of the included studies, where available, will be summarized in a table. Furthermore, the Downs and Black checklist will be used to assess the methodological quality of the included studies. Results: Systematic searches will commence in May 2018, and data extraction is expected to commence in July 2018. Data analyses and writing will happen in October 2018. Conclusions: In this section, the limitations of the systematic review will be outlined. Clinical implications for treating late-life depression and/or anxiety, and implications for residential care facilities will be discussed