Teaching CT to Older Patients

CT is largely a learning-based therapy. Much of how we help patients overcome depression is through providing new information about their condition, helping them to learn new strategies for regulating their affect, to try different ways to interact with others, and to look at problems differently than before. Whereas older patients are very capable of learning new material, how they learn and the rate at which they learn is different than the pace and rate at which younger people learn; thus, the therapist must make an extra effort to ensure that older patients attend to, process, and encode the new information accurately. Although the degree to which older and younger patients differ in their learning abilities varies from patient to patient, it is nonetheless important that therapists working with older adults be equipped to handle potential learning challenges that can arise as people age.

The most common age-related neurocognitive changes that affect the process of CT are changes in information processing, language recall, processing speed, attentional resources, and working memory. Many older people have subtle changes in these processes; therefore, it is very hard to discern that they are processing information differently than when they were younger. However, depression imparts its own cognitive slowing; thus, these differences in processing may be more noticeable the more depressed the older adult is (Pearson, Teri, Reifler, & Raskind, 1989).

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