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The use of CBT in dementia care: a rationale for Communication and Interaction Therapy (CAIT) and therapeutic lies

Published online by Cambridge University Press:  07 May 2015

Ian A. James
Ian A. James*
Affiliation:
Northumberland Tyne and Wear NHS Foundation Trust & Northumbria University Akenside Unit, Campus for Ageing and Vitality, Newcastle upon Tyne, UK
*
*Address for correspondence: Dr I. A. James, Northumberland Tyne and Wear NHS Foundation Trust & Northumbria University, Akenside Unit, Campus for Ageing and Vitality, Westgate Rd, Newcastle upon Tyne, NE4 6BE (email: Ianandrew.james@ntw.nhs.uk)
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Abstract

At the very beginning of our lives we have similar needs, but as we get older the ways of maintaining our wellbeing will vary greatly. Quite simply, we get more different and complex as we age! Hence, attempts to both meet older people's needs and treat their psychological difficulties often require comprehensive assessments and biopsychosocial formulations. It is relevant to note that many of the latter formulations are informed by CBT theory, even when dealing with people presenting with dementia and challenging behaviour. Despite the conceptual complexities, there is increasing evidence to suggest that the most effective interventions for this ‘challenging’ population are basic communication strategies. This paper outlines the key principles of effective communication under the heading of Communication and Interaction Therapy (CAIT). The concepts underpinning CAIT are illustrated via a number of case studies of people living in 24-hour care. It will be argued that an implication of this approach is the judicious use of therapeutic lies, but only as a last resort.

Keywords

Alzheimerdeceptiondialoguetherapy
Type
Review
Information
the Cognitive Behaviour Therapist , Volume 8 , 2015 , e10
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2015 

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References

All-Party Parliamentary Group on Dementia (2008). Always a last resort: inquiry into the prescription of antipsychotic drugs to people with dementia living in care homes (www.Alzheimers.org.uk). Accessed 15 June 2008.Google Scholar
Banerjee, S (2009). The Use of Antipsychotic Medication for People with Dementia: Time for Action. London: DoH.Google Scholar
Beck, AT (1976). Cognitive Therapy and the Emotional Disorders. New York: International University Press.Google Scholar
Blackburn, IM, James, IA, Milne, DL, Baker, C, Standart, S, Garland, A, Reichelt, F (2001). The revised cognitive therapy scale (CTS-R): psychometric properties. Behavioural and Cognitive Psychotherapy 29, 431–447.CrossRefGoogle Scholar
Brechin, D, Murphy, G, James, I, Codner, J (2013). Alternatives to antipsychotic medication: psychological approaches in managing psychological and behavioural distress in people with dementia. British Psychological Society Publications (www.bps.org.uk).Google Scholar
Culley, H, Barber, R, Hope, A, James, IA (2013). Therapeutic lying in dementia care. Nursing Standard 28, 35–39.CrossRefGoogle ScholarPubMed
Craven-Staines, S, Dexter-Smith, S, Li, C (2010). Integrating psychological formulations into older people's services – three years on (Part 3): staff perception of formulation meetings. PSIGE Newsletter 112, 16–22.Google Scholar
Day, A, James, I, Meyer, T, Lee, D (2011). Do people with dementia find lies and deception in dementia care acceptable. Ageing and Mental Health 15, 822–829.CrossRefGoogle ScholarPubMed
Dexter-Smith, S (2007). Integrating psychological formulations into inpatient services. PSIGE Newsletter 97, 38–42.Google Scholar
Dexter-Smith, S (2010). Integrating psychological formulations into older people's services-three years on (Part 1): three years on. PSIGE Newsletter 112, 8–11.Google Scholar
Dexter-Smith, S, Hopper, S, Sharpe, P (2010). Integrating psychological formulations into older people's services: Evaluation of the formulation training programme. PSIGE Newsletter 112, 8–11.Google Scholar
Eggenberger, E, Heimerl, K, Bennett, M (2013). Communication skills training in dementia care: a systematic review of effectiveness, training content, and didactic methods in different care settings. International Psychogeriatrics. 25, 345–358.CrossRefGoogle Scholar
Elvish, R, James, IA, Milne, D (2010). Lying in dementia care: an example of a culture that deceives in people's best interests. Aging and Mental Health 14, 255–262.CrossRefGoogle ScholarPubMed
Fossey, J, James, IA (2007). Evidence-based Approaches for Improving Dementia Care in Care Homes. London: Alzheimer's Society.Google Scholar
Fossey, J, Ballard, C, Juszczak, E, James, I, Alder, N, Jacoby, R, Howard, R (2006). Effect of enhanced psychosocial care on antipsychotic use in nursing home residents with severe dementia: cluster randomised trial. British Medical Journal 332, 756–758.CrossRefGoogle ScholarPubMed
James, IA (2010). Cognitive Behaviour Therapy for People With and Without Dementia. London: Jessica Kingsley.Google Scholar
James, IA (2011). Understanding Behaviour in Dementia that Challenges: A Guide to Assessment and Dementia. London: Jessica Kingsley.Google Scholar
James, IA, Barton, S (2004). Changing core beliefs: the use of continua. Behaviour and Cognitive Psychotherapy 32, 431–442.Google Scholar
James, IA, Fossey, J (2013). Non-pharmacological intervention in care homes. In: Oxford Textbook of Old Age Psychiatry (ed. Jacoby, R., Oppenheimer, C., Dening, T. and Thomas, A.), pp. 269–281. Oxford: Oxford University Press.Google Scholar
James, IA, Hope, A (2013). Relevance of emotions and beliefs in the treatment of behaviours that challenge in dementia patients. Neurodegenerative Disease Management 3, 575–588.Google Scholar
James, IA, Kendell, K, Reichelt, FK (1999). Conceptualisations of self-worth in older people. Behavioural and Cognitive Psychotherapy 27, 285–290.CrossRefGoogle Scholar
James, IA, Milne, D, Morse, R (2008). Micro-skills of clinical supervision: scaffolding skills. Journal of Cognitive Psychotherapy 22, 29–36.CrossRefGoogle Scholar
James, IA, Powell, I, Smith, T, Fairbairn, A (2003). Lying to residents: can the truth sometimes be unhelpful for people with dementia? Psychology Special Interest Group for Older People (PSIGE) Newsletter 82, 26–28.Google Scholar
James, IA, Wood-Mitchell, A, Waterworth, AM, Mackenzie, L, Cunningham, J (2006). Lying to people with dementia: developing ethical guidelines for care settings. International Journal of Geriatric Psychiatry 21, 800–801.CrossRefGoogle ScholarPubMed
Jones, G, Burns, A (1992). Reminiscing disorientation theory. In: Care-giving in Dementia, Research and Applications (ed. Jones, G. M. M. and Miesen, B. M. L.), pp. 57–76. London/New York: Routledge.Google Scholar
Levinson, SC (2003). Space in Language and Cognition. Cambridge: Cambridge University Press.Google Scholar
Levy-Storms, L (2008). Therapeutic communication training in long-term care institutions: recommendations for future research. Patient Education and Counselling 73, 8–21.CrossRefGoogle ScholarPubMed
Mackenzie, L, James, I (2010). Can lies be considered forms of person-centred communication? Northern Dementia Conference. Newcastle, September 2010 (details available from second author).Google Scholar
Marriott, A, Donaldson, C, Tarrier, N, Burns, A (2000). Effectiveness of cognitive-behavioural family intervention in reducing the burden of care in carers of patients with Alzheimer's disease. British Journal of Psychiatry 176, 557–562.Google Scholar
Safran, JD, Segal, ZV (1990). Interpersonal Processes in Cognitive Therapy. New York: Basic Books.Google Scholar
Spector, A, Thorgrimsen, L, Woods, B, Orrell, M (2006). Making a Difference: An Evidence-based Group Programme to Offer Cognitive Stimulation Therapy (CST) to People with Dementia. London: Hawker Publications.Google Scholar
Woods, B, Spector, A, Jones, C, Orrell, M, Davies, S (2005). Reminiscence therapy for dementia. Cochrane Database of Systematic Reviews. Art. no. CD001120. Issue 2. Chichester: John Wiley.Google Scholar
Wood-Mitchell, A, James, IA, Waterworth, A, Swann, A (2008). Factors influencing the prescribing of medications by old age psychiatrists for behavioural and psychological symptoms of dementia: a qualitative study. Age and Ageing 3, 1–6.Google Scholar
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