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Cognitive-Behavioral Theory: A Good Choice for Depression in Late Adulthood

Cognitive-behavioral theory would be an appropriate theory choice for a 60 year old female afflicted by depression.  Erford (2014) observed later adulthood (age 60 and above) is characterized by multiple losses: the death of loved ones, the decrease in income due to, retirement, and” the loss of abilities both cognitive and physical.” (p. 232).  Consequently, depression can occur within situations of loss. The lack of financial security in late adulthood can be a stressor especially for women. Hurst & Genest (1995) noted, “For example, there is a strong relationship between socioeconomic status (SES) and depression, and women are more apt to be of a lower socioeconomic status.(p.246.)  Kalodner (2011) pointed out conclusions from research, “indicate that cognitive therapy is as effective as medication in the treatment of depression, even in cases of severe depression.” (p. 207).

A woman in late adulthood suffering from depression would benefit from cognitive-behavioral therapy in meeting her goals in terms of reducing depressive symptoms. Cognitive-behavioral therapists place emphasis on developing a collaborative relationship with their clients, which in and of itself can be a powerful therapeutic intervention.( Kalodner, 2011.).  Depression often carries with it, an onslaught of negative thinking. Since part of the process of change in CBT focuses on changing the individual’s faulty belief systems (Kalodner, 2011), CBT would be helpful in treating depression and transforming negative thinking.   Kalodner (2011) pointed out, “Research has demonstrated that cognitive therapy does indeed change thoughts and that there are reductions in psychological disturbances.” (p. 200.).

Interventions  

A person suffering from depressive symptoms such as a woman in late adulthood may fall victim to cognitive distortions which may also exacerbate the depression. For example, she may feel the loss of her husband and financial security are the worst experiences of her life and begin to feel worthless as a result. This kind of thinking  may contain  elements referred to “all or nothing” thinking (p.202) which  can be damaging emotionally. Kalodner (2011) asserted, “All or nothing” thinking is characterized by assuming that things are either 100% perfect or absolutely terrible; there is no gray area.” ( p. 202).

Since cognitive-behavioral therapy attacks negative thinking in order to transform the client’s mindset, interventions such as thought-stopping and positive self- statements would be beneficial for a depressed woman in late adulthood in helping to readjust her thinking process. Kalodner (2011) noted, “Thought-stopping is a procedure designed to interfere with thoughts that run through the mind of the client and make it difficult to change behavior.” (p. 202).  The use of positive self- statements as a companion to thought-stopping can prove to be powerful towards the process of change. (Kalodner, 2011.).  Positive self- statements are similar to affirmations that clients make about themselves that point to their strengths. For example, repeating the words, “I am a joyful person” may over time be effectual in changing a client’s negative perception of themselves, and may help reduce depressive symptoms.  Kalodner (2011) asserted, “The important point is that what the clients tell themselves influences their thoughts, feelings, and behaviors.” (p. 202). Another aspect of positive self-statements, is that the therapist challenges the client to act in kind. (Kalodner, 2011).  Another intervention helpful in alleviating the client’s emotional distress and helping to alleviate some of the depression, is encapsulated in the empathetic relationship the therapist works to create with the client. Beck et al. (1979) (as cited in Kalodner, 2011) discussed “the importance of the relationship and included strategies for developing a therapeutic relationship in manuals.” (p. 198.).

A behavioral intervention that would also be helpful in treating a depressed woman in late adulthood would be positive reinforcement. Kalodner (2011) explained positive reinforcement “is a procedure in which some behavior is increased by following it with something rewarding.” (p. 201). For example, in a therapy session with a depressed woman, the therapist might use praise as the client explains how often she used thought-stopping that week to change her negative thinking.

References

Beck, A.T. (1979). Cognitive therapy and emotional disorders. New York, NY: International Universities Press.

Erford, B.T.(2014) Orientation to the counseling profession: Advocacy, ethics, and essential professional foundations(2nd ed.). Upper Saddle River, N.J.: Pearson Inc.

Hurst, S. A., & Genest, M. (1995). Cognitive-behavioural therapy with a feminist orientation: A perspective for therapy with depressed women. Canadian Psychology/Psychologie Canadienne, 36(3), 236-257. doi:10.1037/0708-5591.36.3.236

Kalodner, C.R . (2011).Cognitive-behavioral theories. In D. Capuzzi and D. Gross (Eds.). Counseling and psychotherapy: Theories and interventions. (pp.193- 213). Alexandria, VA: American Counseling Association.

Audrey ONeal: About Audrey Jackie O'Neal: Currently, O'Neal is a clinical therapist in training and completing a Masters of Science in Mental Health Counseling via Walden University. In her blog here at GR, she writes about issues related to mental health counseling. O'Neal was awarded a scholarship for the CUNY Graduate School of Journalism course" Entrepreneurial Journalism" from Tow-Knight Entrepreneurial Journalism Center. As a reporter O’Neal has been a regular contributor to the award-winning The Press of Atlantic City, and The New York Amsterdam News. Her stories and commentary both print and broadcast have appeared on NPR- 51% The Women’s Perspective, CBS Radio, Book Talk- Artists First Radio Network among others. “Organizations that have hired me to write feature stories point out my ability to filter through developments often going back months, connect with the parties involved (for the most part, located across the world), and produce a heartwarming and vivid story is impressive. My news stories have been published on various online platforms, most notably, on the Huffington Post. Clients say my writing talent has expanded and strengthened their voice in the community.” She holds an M.F.A. in Creative Writing from Sarah Lawrence College.
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