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Group psychotherapy for older adults with generalised anxiety disorder is an under-researched area.
This report describes a mixed method evaluation of the acceptability and feasibility of an Overcoming Worry Group.
The Overcoming Worry Group was a novel adaptation of a cognitive behavioural therapy protocol targeting intolerance-of-uncertainty for generalised anxiety disorder, tailored for delivery to older adults in a group setting (n = 13).
The adapted protocol was found to be acceptable and feasible, and treatment outcomes observed were encouraging.
This proof-of-concept study provides evidence for an Overcoming Worry Group as an acceptable and feasible group treatment for older adults with generalised anxiety disorder.
Background: Despite the prevalence of co-morbid anxiety and depression in older adults, evaluation of suitable clinical models is rare. Aims: This study tested the acceptability and effectiveness of a transdiagnostic approach to treating co-morbid anxiety and depression in an older adults in a routine clinical setting. Method: In an A/B single case experimental design, a patient completed five daily ideographic measures of anxiety and depression across baseline and treatment and the HADS at five time points over time, including 3-month follow-up. The 8-session treatment was transdiagnostic CBT informed by the Unified Protocol. Results: All sessions were attended. Significant baseline-treatment improvements were found for daily structure, mood, confidence and worry, with large associated effect sizes. The HADS showed that the patient met recovery criteria by the end of treatment, with some evidence of anxious relapse at follow-up. Conclusion: Transdiagnostic CBT offers promise as a treatment approach to mixed anxiety and depression in older adults. The model needs to be further tested using more rigorous and suitably powered methodologies.
In this study a visual screening procedure and a forced arm training procedure were compared within an alternating treatments design in terms of their effects in reducing self-injury in an intellectually disabled boy. Visual screening was found to be clearly the superior procedure, producing a marked decrease in the rate of self-injury. Subsequent experimental phases combined visual screening first with toy play training and then with contingent social interaction. Further marked decreases in self-injury occurred, which remained in evidence at a four month follow-up. Generalisation data were obtained from both morning and afternoon sessions. Collateral behaviour change was monitored in both treatment and generalisation sessions, generally indicating increases in neutral behaviours and reductions in self-stimulatory behaviours accompanying reductions in self-injury. Implications of these results for examining the wider physical and social contexts in which self-injury occurs were noted.
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