Acceptance and Commitment Therapy With Older Adults: Rationale and Considerations
Open accessAbstract
Older adults are the fastest growing segment of the population. With these changing demographics, mental health professionals will be seeing more older clients. Additionally, older adults are an underserved population in that most older adults in need of mental health services do not receive treatment. Thus, it is essential that treatments for mental and behavioral health problems are empirically supported with older adults and that mental health professionals are aware of the special needs of older adult populations. Acceptance and Commitment Therapy (ACT) is an emerging approach to the treatment of distress. The purpose of this article is to provide a rationale for using ACT with older adults based on gerontological theory and research. We also review research on ACT-related processes in later life. We present a case example of an older man with depression and anxiety whom we treated with ACT. Finally, we describe treatment recommendations and important adaptations that need to be considered when using ACT with older adults and discuss important areas for future research. © 2011.
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Claims the paper makes
9 of 61 cited sources checked · 5 supported · 0 flagged · accuracy not yet measured
- Premisecitation
Evidence on cognitive behavioral treatment effectiveness is mixed for some older subgroups, such as depressed medically ill homebound older adults.
“However, studies have produced mixed findings on their effectiveness with some subpopulations, such as depressed, medically ill homebound older adults (Ayalon, Fialova, Arean, & Onder, 2010; Gellis & Bruce, 2010).”
Quote in the paperSubstantial claim1 of 2 sources checked- cites Ayalon, Fialova, Arean, & Onder, 2010 source
- cites Gellis & Bruce, 2010 source
The Discussion (page unavailable in our copy) reports mixed results across outcomes: problem-solving therapy reduced depressive symptoms in homebound older adults with cardiovascular disease, but did not significantly improve anxiety or physical functioning. It does not report mixed findings across studies on effectiveness for depression in this subgroup; instead, it says a previous home-care trial found a similar improvement in depressive symptoms. (LLM, conf=0.79)
Experimental — accuracy not yet measured
- Premisecitation
Very little research has tested ACT in older adults, with only one pilot study to date.
“The research examining the effectiveness of ACT with older adults is extremely limited. To date, only one pilot study has been conducted to examine the effectiveness of ACT with older adults (Wetherell et al., 2011).”
Quote in the paperSubstantial claim1 of 1 sources checked- cites Wetherell et al., 2011 source
The Discussion describes this as a pilot study of ACT for older adults with generalized anxiety disorder, and the Method > Procedure says it was intended to prepare for a larger trial. The paper supports identifying this study as a pilot, but it does not establish that it was the only pilot study of ACT with older adults to date. The indexed passages provide no page numbers. (LLM, conf=0.84)
Experimental — accuracy not yet measured
- Premisecitation
In chronically ill, functionally impaired older adults, anxiety and depressive symptoms commonly co-occur with a correlation of 0.71.
“Other research suggests that in chronically ill, functionally impaired older adults, anxiety and depressive symptoms commonly co-occur (r = 0.71; Petkus et al., 2010).”
Quote in the paperSubstantial claim1 of 1 sources checked- cites Petkus et al., 2010 source
- Premisecitation
Prior research indicates that older adults frequently have difficulty recognizing symptoms of anxiety and depression.
“As described previously, research suggests that older adults are often not good at identifying symptoms of anxiety and depression (Gum et al., 2009; Wetherell, Petkus et al., 2009).”
Quote in the paperSubstantial claim1 of 2 sources checked - Findingcitation
In the authors' pilot study, older adults treated with ACT may have had lower attrition than those treated with CBT.
“A recently completed pilot study by our group suggests that attrition rates may be lower among older adults treated with ACT when compared to those who received CBT (Wetherell et al., 2011).”
Quote in the paperSubstantial claim1 of 1 sources checked- cites Wetherell et al., 2011 source
- Interpretationcitation
For older adults in therapy, becoming more aware of thoughts and emotions can be especially hard.
“Increasing awareness of thoughts and emotions may be particularly difficult with older adult clients.”
Quote in the paperSubstantial claim1 of 2 sources checked- cites Gum et al., 2009 source
- cites Wetherell, Petkus et al., 2009 source
The Discussion reports that older adults were less accurate than younger adults at classifying emotional symptoms such as sadness, worry, and fear. But the Methods specify that participants classified listed symptoms, not their own experiences; the paper does not test whether older adult therapy clients have difficulty becoming aware of their thoughts and emotions. (LLM, conf=0.86)
Experimental — accuracy not yet measured
- Findingown data
Switching Joe's treatment from problem-solving to ACT helped his depression and anxiety.
“The change in approach from problem-solving to ACT was beneficial in treating Joe's depression and anxiety.”
Quote in the paperNot a substantial claim - Findingown data
Joe's Beck Depression Inventory score fell from 31 before treatment to 18 afterward, a 42% improvement.
“His Beck Depression Inventory score decreased from 31 at the beginning of treatment to 18 at post-treatment, a 42% improvement.”
Quote in the paperNot a substantial claim - Premisecitation
ACT is an emerging evidence-based treatment for emotional distress.
“Acceptance and Commitment Therapy (ACT) is an emerging evidenced-based approach to the treatment of emotional distress (Hayes, Strosahl, & Wilson, 1999).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Hayes, Strosahl, & Wilson, 1999
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Premisecitation
Problem-solving therapy and related treatments work for depression in community-dwelling and primary care older adults.
“Studies have shown that these types of treatments, including problem-solving therapy, are effective in treating depression in older adults in the community and primary care (Bell & D'Zurilla, 2009).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Bell & D'Zurilla, 2009 source
- Premisenone given
Most studies of psychosocial treatment effectiveness in older adults have tested cognitive behavioral approaches.
“To date, most research examining the effectiveness of psychosocial treatments with older adults have examined cognitive behavioral approaches.”
Quote in the paperSubstantial claim - Premisecitation
Avoiding distressing internal experiences is linked with greater distress in older adults.
“Experiential avoidance of distressing internal experiences appears to be associated with greater distress in older adulthood.”
Quote in the paperSubstantial claim- The authors state this as an assumption: Psychological inflexibility is a primary feature of psychopathology in the ACT model.
- Premisecitation
Cognitive behavioral therapy may be less than optimal for anxiety in later life.
“CBT approaches may also be suboptimal in the treatment of anxiety in later life (Wetherell, Ruberg, & Petkus, 2010; Thorp et al., 2009).”
Quote in the paperSubstantial claim0 of 2 sources checked- cites Wetherell, Ruberg, & Petkus, 2010
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites Thorp et al., 2009 source
- Premisecitation
Using thought suppression to cope with unwanted thoughts is associated with a lower sense of meaning in life among community-dwelling older adults.
“Engaging in thought suppression as a mechanism to cope with unwanted thoughts has been associated with less subjective sense of meaning in life in community-dwelling older adults (Krause, 2007).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Krause, 2007 source
- The authors state this as an assumption: Psychological inflexibility is a primary feature of psychopathology in the ACT model.
- Premisecitation
Apart from dementia, mental and behavioral health disorder rates decline in later life.
“With the exception of dementia, the rates of mental and behavioral health disorders decrease in older adulthood (Smyer & Qualls, 1999).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Smyer & Qualls, 1999
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Premisecitation
Most older adults who need mental health treatment do not receive it.
“Older adults are an underserved population; the majority of older adults in need of mental health treatment do not receive care (Swartz et al., 1998; Wang et al., 2005).”
Quote in the paperSubstantial claim0 of 2 sources checked - Premisecitation
The ACT model's core psychopathology processes continue to operate in older adulthood.
“Research has suggested that the core processes related to psychopathology in the ACT model persist into older adulthood.”
Quote in the paperSubstantial claim- The authors state this as an assumption: Psychological inflexibility is a primary feature of psychopathology in the ACT model.
- Premisenone given
Older adults with chronic illness and functional impairment, including homebound and nursing home residents, are at greater risk for mood or anxiety disorders.
“However, certain subpopulations of older adults who face chronic illness and functional impairment, such as homebound and nursing home-dwelling older adults, are at increased risk for mood or anxiety disorders.”
Quote in the paperSubstantial claim- Rests on an assumption: Older adults with chronic illness and functional impairment, including those who are homebound or live in nursing homes, have a higher risk of mood or anxiety disorders.
- Premisecitation
Cognitive behavioral treatments have limited effectiveness for older adults with generalized anxiety disorder.
“Cognitive behavioral treatments have limited effectiveness in older adults suffering from GAD (Thorp et al., 2009).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Thorp et al., 2009 source
- Premisecitation
Older adults with depression often report losing interest but deny feeling depressed.
“Depressed older adults commonly present with complaints about loss of interest and deny depressed mood (Gallo & Rabins, 1999).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Gallo & Rabins, 1999
- Interpretationreasoning
If goals that have become impossible are not replaced by feasible goals aligned with the person's values, that person may lose touch with a deeply held value.
“If these unattainable goals are not replaced with attainable goals that are in accordance with values, the individual may lose contact with a deeply held life value.”
Quote in the paperSubstantial claim - Interpretationreasoning
A person can lose touch with important life values after major life changes, including retirement or disability caused by chronic illness.
“Losing contact with one's life values may occur following important significant life events such as retirement or new functional impairments that arise from a chronic illness.”
Quote in the paperSubstantial claim - Premisecitation
Older adults were less accurate than younger adults at labeling symptoms as depression, anxiety, both, or neither.
“Older adults in another study were less accurate than younger people in classifying a list of symptoms as depression, anxiety, both, or neither (Wetherell et al., 2009).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Wetherell et al., 2009
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Interpretationreasoning
Chronic illness can create functional limitations that make a person's existing goals physically impossible to pursue.
“Additionally, new functional impairments that stem from chronic illnesses may render current goals physically unattainable.”
Quote in the paperSubstantial claim - Premisecitation
Substance abuse problems are often misdiagnosed or missed in older adults.
“Additionally, it is important to assess for substance abuse as an internal control strategy as these problems are commonly misdiagnosed or undetected in older adults (Loukissa, 2007).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Loukissa, 2007 source
- Interpretationreasoning
Older adults may be less likely to understand or engage in treatment aimed at reducing anxiety and depression because they are less familiar with these conditions.
“Because older adults are less familiar with depression and anxiety, they may be less likely to understand the purpose of or engage in a treatment whose goal is to decrease anxiety and depression.”
Quote in the paperSubstantial claim - Interpretationreasoning
Because ACT is transdiagnostic, it may make assessing and treating anxiety and depression more efficient.
“The transdiagnostic nature of ACT may make the assessment and treatment of anxiety and depression more efficient.”
Quote in the paperSubstantial claim- The authors state this as an assumption: Psychological inflexibility is a primary feature of psychopathology in the ACT model.
- Interpretationreasoning
An ACT treatment model may be effective for older adults.
“This suggests that an ACT model of treatment would be potentially effective with this population.”
Quote in the paperSubstantial claim- The authors state this as an assumption: Psychological inflexibility is a primary feature of psychopathology in the ACT model.
- Premisecitation
Older adults' worries generally focus on health changes or possible developmental losses.
“Additionally, the worry content of older adults generally tends to center around changes in health or possible developmental losses (Diefenbach, Tolin, Gilliam, & Meunier, 2008).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Diefenbach, Tolin, Gilliam, & Meunier, 2008 source
- Interpretationreasoning
Theories of adult development and successful aging suggest ACT may be useful for older adults.
“Theories of adult development and successful aging suggest that an ACT approach to treatment could be useful for older adults.”
Quote in the paperSubstantial claim- The authors state this as an assumption: Psychological inflexibility is a primary feature of psychopathology in the ACT model.
- Interpretationreasoning
Patients who restrict activities more than their physical disability requires and attribute all restriction to health are likely fused with a damaged conceptualized self.
“Patients who limit their activities beyond what is imposed by physical disability, while attributing these limitations solely to health, are likely fusing with this damaged conceptualized self.”
Quote in the paperSubstantial claim- The authors state this as an assumption: Psychological inflexibility is a primary feature of psychopathology in the ACT model.
- Interpretationreasoning
ACT may be especially helpful for older adults because it can build on their strengths.
“Given this research, an ACT intervention may be especially beneficial as it may draw upon the strengths of older individuals.”
Quote in the paperSubstantial claim- The authors state this as an assumption: Psychological inflexibility is a primary feature of psychopathology in the ACT model.
- Interpretationreasoning
When retirees cannot adopt new behavior goals that fit their values, they may become disconnected from those core values.
“Thus, if the client is unable to transition to new behavioral goals consistent with these values following retirement, he or she may experience disconnection with core values.”
Quote in the paperSubstantial claim - Premisecitation
Avoidance may mediate the link between past trauma and greater distress later in life.
“Engaging in avoidance may mediate the association between past trauma exposure and increased distress later in life (Dulin & Passmore, 2010).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Dulin & Passmore, 2010 source
- The authors state this as an assumption: Psychological inflexibility is a primary feature of psychopathology in the ACT model.
- Premisecitation
Negative views about aging can become a negative self-stereotype.
“Attitudes about aging are important, and having negative opinions about growing older can develop into a negative self-stereotype (Levy, 2003).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Levy, 2003 source
- Interpretationreasoning
Accepting unchangeable declines and then identifying attainable goals is adaptive and beneficial according to the successful aging model.
“Thus, this model of successful aging suggests that accepting declines that are unchangeable followed by identifying goals that are still attainable is adaptive and beneficial.”
Quote in the paperSubstantial claim - Interpretationreasoning
An acceptance approach focused on remaining resources may be more helpful than trying to change thoughts about loss or disability.
“An acceptance approach in which individuals learn to focus on their remaining resources may be more beneficial than an approach in which they are encouraged to modify their thinking about loss or disablement.”
Quote in the paperSubstantial claim- The authors state this as an assumption: Psychological inflexibility is a primary feature of psychopathology in the ACT model.
- Premisecitation
Letting go of unsuitable commitments or goals and replacing them with more feasible ones is associated with better emotional well-being.
“Additionally, disengaging from inappropriate commitments or goals and replacing them with more feasible goals is associated with better emotional well-being (Wrosch, Dunne, Scheier, & Schulz, 2006; Wrosch, Scheier, Miller, Schulz, & Carver, 2003).”
Quote in the paperSubstantial claim0 of 2 sources checked - Premisecitation
Older adults, especially older white men, have the highest suicide rate of any population segment.
“Older adults, particularly older white males, have the highest suicide rate of any segment of the population (Smyer & Qualls, 1999).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Smyer & Qualls, 1999
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Premisecitation
Among functionally impaired, chronically ill homebound older adults, thought suppression is associated with somatic, depressive, and anxiety symptoms after controlling for physical illness, functional impairment, and cognition.
“In functionally impaired, chronically ill homebound older adults, after controlling for physical illness, functional impairment, and cognitive functioning, engaging in thought suppression was associated with somatic, depressive, and anxiety symptoms (Petkus, Gum, & Wetherell, manuscript under review).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Petkus, Gum, & Wetherell, manuscript under review
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- The authors state this as an assumption: Psychological inflexibility is a primary feature of psychopathology in the ACT model.
- Premisecitation
Older adults who try hard to eliminate unsolvable problems have a higher risk of depression.
“Research supports this idea; older adults who actively engage in efforts to eliminate problems that cannot be solved are at increased risk for depression (Isaacowitz & Seligman, 2002).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Isaacowitz & Seligman, 2002 source
- Interpretationcitation
Experiential and behavioral avoidance worsen functioning in older adults.
“Taken together, these studies support the hypothesis that experiential and behavioral avoidance have an adverse effect on functioning in older adults.”
Quote in the paperSubstantial claim- The authors state this as an assumption: Psychological inflexibility is a primary feature of psychopathology in the ACT model.
- Interpretationreasoning
ACT may seem more credible to older adults because they are less aware of mental health issues.
“An ACT intervention may be more credible with older adults because of their lower levels of awareness of mental health issues.”
Quote in the paperSubstantial claim- The authors state this as an assumption: Psychological inflexibility is a primary feature of psychopathology in the ACT model.
- Premisecitation
Older adults often know less about behavioral and mental health problems than younger adults do.
“Furthermore, evidence suggests that older adults are often less knowledgeable about behavioral and mental health problems than are younger people (Fisher & Goldney, 2003).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Fisher & Goldney, 2003 source
- Premisecitation
Thought suppression and avoidance coping are associated with more suicidal ideation in depressed older adults who also have personality disorders.
“Thought suppression and avoidance coping have been associated with increased suicidal ideation in depressed older adults with co-morbid personality disorders (Cukrowicz, Ekblad, Cheavens, Rosenthal, & Lynch, 2008).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Cukrowicz, Ekblad, Cheavens, Rosenthal, & Lynch, 2008 source
- The authors state this as an assumption: Psychological inflexibility is a primary feature of psychopathology in the ACT model.
- Interpretationreasoning
Being fused with a damaged conceptualized aged self may block behavioral change.
“Cognitive fusion with this damaged conceptualized aged self may create a barrier to behavioral change.”
Quote in the paperSubstantial claim- The authors state this as an assumption: Psychological inflexibility is a primary feature of psychopathology in the ACT model.
- Premisecitation
Older adults with negative beliefs about aging tend to have worse functional and mental health outcomes.
“Furthermore, older adults who have negative beliefs about aging tend to have worse functional and mental health outcomes in older adulthood (Nuevo et al., 2006).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Nuevo et al., 2006
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Premisecitation
Depressed older adults more often show a form of depression without sadness marked by severe anhedonia.
“Research has demonstrated that depressed older adults are more likely to present with “depression without sadness” that is characterized by severe anhedonia (Gallo & Rabins, 1999).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Gallo & Rabins, 1999
- Premisecitation
In one study, doing poorly on difficult cognitive tasks caused more distress in younger adults than in older adults.
“In one study, poor performance on challenging cognitive tasks led to more distress among younger adults than among older individuals, despite the fact that cognitive decline is a concern with particular relevance to older adults (Chow et al., 2007).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Chow et al., 2007 source
- Premisecitation
Older adults often do not report sadness; instead they complain of losing enjoyment in previously pleasurable activities.
“Commonly, older adults will not describe being sad; rather, their presenting complaint is that they just do not get any enjoyment out of the things they have enjoyed in the past.”
Quote in the paperSubstantial claim - Premisecitation
Thought suppression is associated with worse outcomes after depression treatment in older adults.
“Furthermore, engaging in thought suppression has been associated with poorer outcomes in older adults following treatment for depression (Rosenthal, Cheavens, Compton, Thorp, & Lynch, 2005).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Rosenthal, Cheavens, Compton, Thorp, & Lynch, 2005 source
- The authors state this as an assumption: Psychological inflexibility is a primary feature of psychopathology in the ACT model.
- Interpretationreasoning
CBT that challenges the validity of older adults' worries may not help because those worries may not be unrealistic even if excessive and maladaptive.
“A CBT approach that challenges the validity of these thoughts may not be beneficial with older adults because these worries, while excessive and maladaptive, may not be unrealistic.”
Quote in the paperSubstantial claim - Premisecitation
Many older adults miss out on adequate mental health care because of obstacles such as functional impairment and disability.
“Due to barriers experienced by this population such as functional impairment and disability, many do not receive adequate mental health services (Gum et al., 2010).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Gum et al., 2010 source
- Premisecitation
Older patients with generalized anxiety disorder often describe their experience in unusual personal terms instead of calling it worry or anxiety.
“Instead of identifying what they are experiencing as “worry” or “anxiety,” it is not uncommon for older GAD patients to describe the process in idiosyncratic terms (Wetherell, Ruberg, & Petkus, 2010).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Wetherell, Ruberg, & Petkus, 2010
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Premisecitation
Older adults with anxiety disorders may struggle to put their symptoms into words.
“Additionally, older adults suffering from anxiety disorders may have difficulty describing their symptoms.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Wetherell, Ruberg, & Petkus, 2010
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Interpretationnone given
The case for using ACT with older adults rests on gerontological theory and research that mostly studied people without depression or anxiety disorders.
“It should be acknowledged that the appropriateness of ACT for older adults is based in gerontological theory and research largely conducted with individuals who do not have depressive or anxiety disorders.”
Quote in the paperSubstantial claim - Interpretationreasoning
Theories about adult development and aging give strong support for the possible usefulness of ACT with older adults.
“Theories of adult development and aging provide a strong rationale for the potential utility of an ACT-based intervention with older adults.”
- Also stated in: § Future directions and conclusion · boosted
“Gerontological research provides a strong rationale for the use of ACT with this population.”
Quote in the paperNot a substantial claim - Also stated in: § Future directions and conclusion · boosted
- Premisecitation
For older adults with anxiety disorders, trying to control experience by doing too many activities is a frequent form of avoidance.
“control by overengaging in activities, which is a common form of experiential avoidance among older adults with anxiety disorders (Wetherell et al., 2009).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Wetherell et al., 2009
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- May combine two claims. 26
- Classified as probably not a substantial claim. 22
May combine two claims.
PremisecitationNormal aging includes declines in processing speed, working memory, and attention.
“Cognitive changes such as decreased processing speed, working memory, and attention occur as part of the normal aging process (Schaie, 2005).”
Quote in the paperSubstantial claim1 of 1 sources checked- cites Schaie, 2005 source
In “LONGITUDINAL AGE CHANGES” (page unavailable), the paper reports negative age differences in perceptual speed, supporting the speed-related part of the claim. It measures verbal memory rather than working memory and does not report a decline in attention. Its discussion of normal and pathological aging also cautions against treating cognitive decline as an undifferentiated part of normal aging. (LLM, conf=0.86)
Experimental — accuracy not yet measured
May combine two claims.
PremisecitationAvoidance coping is associated with more depression and persistent anxiety.
“Additionally, using avoidance as a coping strategy is also associated with increased depression (Andrew & Dulin, 2007) and persistent anxiety (Ayers et al., 2010).”
Quote in the paperSubstantial claim1 of 2 sources checked- The authors state this as an assumption: Psychological inflexibility is a primary feature of psychopathology in the ACT model.
May combine two claims.
PremisecitationA pilot study found ACT to be feasible and acceptable and possibly effective for reducing depression and worry in older adults with generalized anxiety disorder.
“Results suggest that ACT is feasible, acceptable, and may be effective at reducing depression and worry.”
Quote in the paperSubstantial claim1 of 1 sources checked- cites Wetherell et al., 2011 source
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
FindingreasoningJoe built on small committed actions and became more active in looking for work.
“He then built off these simple committed actions and was more active in finding employment.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
FindingreasoningUsing a different defusion exercise, the passengers on the bus activity, helped Joe understand the concept better.
“To overcome this challenge, different cognitive defusion activities such as the passenger's on the bus activity was done which Joe was better able to understand.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
FindingcitationJoe reacted defensively and did not understand the point of the cognitive defusion exercise that involved quickly repeating the words 'ice cream' and 'worthless'.
“Joe became defensive and had difficulty understanding the purpose of the quickly repeat the word “ice cream” and “worthless” cognitive defusion exercise (Hayes & Smith, 2005, p. 71-72).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Hayes & Smith, 2005, p. 71-72
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Findingown dataJoe's ACT treatment had some difficulties, particularly with cognitive defusion and beginning committed action.
“Although ACT treatment was largely successful with Joe, some challenges existed during treatment. Specifically, the cognitive defusion and starting committed action were challenging.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Findingown dataJoe's early action goals, such as getting a job, were ambitious and mostly outside his control.
“He initially would come up with goals for action that were largely out of his control such as getting employment and ambitious.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingnone givenOne obstacle was that after breakfast Joe would feel unwell and then nap for the remainder of the morning.
“A barrier to these actions was that he would eat breakfast, feel lousy and then take a nap for the rest of the morning.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataBy the end of treatment, Joe was regularly doing things he valued, including applying for jobs and contacting his son more often.
“At the end of treatment he was actively engaging in valued behaviors such as applying for jobs and contacting his son with greater frequency.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Findingnone givenJoe first received a problem-solving approach for his depression, but his symptoms did not improve significantly.
“A problem-solving conceptualization and approach to treatment for his depression was initially tried, with no significant improvements in symptoms.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataAt first, Joe struggled to carry out committed actions.
“Additionally, Joe initially had difficulty carrying out his committed action.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingnone givenJoe found a job after the twelfth session.
“Joe obtained employment following session 12.”
Quote in the paperNot a substantial claimMay combine two claims.
PremisecitationWhen older adults receive treatment, it is usually medication-based even though many prefer counseling.
“If these individuals do receive treatment, it is typically pharmacological, despite the fact that many prefer counseling (Gum, Iser, & Petkus, 2010).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Gum, Iser, & Petkus, 2010 source
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationProjections indicate the older adult population will double by 2030 and make up about one fifth of the population.
“estimates suggest that the number of older adults will double by 2030, representing approximately 20 percent of the population (A Profile of Older Americans, 2009).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites A Profile of Older Americans, 2009
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
May combine two claims.
PremisecitationOlder adults' nonuse of mental health care is explained in part by not knowing about services, not perceiving a need, and stigma.
“Reasons why older adults do not receive treatment include lack of knowledge about mental health services, lack of perceived need for services (Klap, Unroe, & Unutzer, 2003), and stigma (Livingston & Boyd, 2010).”
Quote in the paperNot a substantial claim0 of 2 sources checkedProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationThe segment of the U.S. population growing fastest is adults aged 65 and older.
“Adults aged 65 and older are the fastest growing segment of the U.S. population.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites A Profile of Older Americans, 2009
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Probably not a substantial claim: may not pass S2 (checkable).
InterpretationreasoningReconnecting older clients with their values early in ACT may be especially beneficial.
“Thus, working towards reconnecting the client with his or her values at the onset of treatment may be most beneficial when doing ACT with older adults.”
Quote in the paperNot a substantial claim- The authors state this as an assumption: Psychological inflexibility is a primary feature of psychopathology in the ACT model.
May combine two claims.
PremisecitationAging may bring resilience through separating past feelings from current feelings, which could mean less cognitive fusion.
“Zautra and colleagues (2000) posit that aging is accompanied by resilience due to the ability to dissociate past feelings from current feelings, which could suggest lower levels of cognitive fusion.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Zautra and colleagues (2000)
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- The authors state this as an assumption: Psychological inflexibility is a primary feature of psychopathology in the ACT model.
May combine two claims.
PremisecitationGeneralized anxiety disorder is often chronic, beginning early in life and continuing into older age.
“First, GAD is often a chronic condition that arises early in life and persists into older age (Chou, 2009; Le Roux, Gatz, & Wetherell, 2005).”
Quote in the paperSubstantial claim0 of 2 sources checkedClassified as probably not a substantial claim. May combine two claims.
PremisecitationThe selective optimization with compensation model holds that people choose goals, direct resources to them, and seek the best means to reach them.
“The SOC model posits that throughout life, individuals select goals toward which to devote resources and seek the optimal means to achieve the selected goal.”
Quote in the paperSubstantial claim0 of 2 sources checkedProbably not a substantial claim: may not pass S3 (load-bearing), S4 (based).
Interpretationnone givenPeople whose adult lives centered on their careers may become strongly attached to the value of contributing to society through work.
“For example, clients who were extremely engaged in their career their entire adult life may strongly fuse with the value of making a contribution to society, which was manifested through work.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim.
Premisenone givenACT aims to help people live in line with their deeply held values.
“The goal of an ACT intervention is to live life in accordance to deeply held values.”
Quote in the paperSubstantial claim- The authors state this as an assumption: Psychological inflexibility is a primary feature of psychopathology in the ACT model.
May combine two claims.
PremisecitationIn a homebound older adult sample, only half of those with a depressive, substance use, or anxiety disorder and about a third of those with an adjustment disorder knew they had a problem.
“One study with homebound older adults found that only 50 percent of participants with a depressive, substance use, or anxiety disorder, and 35 percent with a current adjustment disorder, were aware that they were experiencing a problem (Gum et al., 2009).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Gum et al., 2009 source
May combine two claims.
PremisecitationIn older adulthood, the balance of gains and losses shifts toward more losses, some of which cannot be changed.
“Although gains still occur in older adulthood, the gain/loss dynamic shifts, such that this period is characterized by an increased proportion of losses, some of which are unchangeable.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Baltes, 1997 source
Classified as probably not a substantial claim. May combine two claims.
InterpretationreasoningACT may understand this anhedonic presentation as pursuing goals inconsistent with values or failing to pursue value-consistent goals in response to aging-related changes and losses.
“An ACT framework may conceptualize this problem as the pursuit of value-incongruent goals or failing to pursue value-congruent goals as a reaction to changes and losses that are characteristic of the aging process.”
Quote in the paperSubstantial claim- The authors state this as an assumption: Psychological inflexibility is a primary feature of psychopathology in the ACT model.
May combine two claims.
PremisecitationAnxiety and depression often co-occur and are hard to tell apart in older adults.
“Comorbidity of anxiety and depression are common and difficult to distinguish among older people (Gum & Cheavens, 2008).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Gum & Cheavens, 2008 source
May combine two claims.
PremisecitationReligiosity is more common in the current older cohort, can support connection to core values, and may be linked with better health.
“Studies suggest that religiosity, which is more common among the current cohort of older people and can facilitate a strong connection to core values, may be associated with better health (Krause, 2004).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Krause, 2004 source
May combine two claims.
InterpretationreasoningACT's values-focused goal may resonate more with older adults and may increase their active engagement in treatment.
“This goal of treatment may resonate more with older adults. This in turn may potentially make it more likely they will actively engage in treatment.”
Quote in the paperSubstantial claim- The authors state this as an assumption: Psychological inflexibility is a primary feature of psychopathology in the ACT model.
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationSuicide can be viewed as the most extreme form of experiential avoidance.
“Suicide can be considered the most extreme form of experiential avoidance (Hayes et al., 1999).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Hayes et al., 1999
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- The authors state this as an assumption: Psychological inflexibility is a primary feature of psychopathology in the ACT model.
May combine two claims.
PremisecitationOn average, older adults have lower and less variable negative affect than younger adults.
“For example, older adults, on average, exhibit lower and less variable levels of negative affect than do younger people (Labouvie-Vief, 2003).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Labouvie-Vief, 2003 source
May combine two claims.
PremisecitationEven though some cognitive abilities decline, emotion regulation appears to improve with age.
“Paradoxically, although declines in some cognitive domains occur, the ability to regulate emotions appears to improve with age (Schiebe & Carstensen, 2010).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Schiebe & Carstensen, 2010
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Probably not a substantial claim: may not pass S2 (checkable).
InterpretationreasoningA treatment that addresses both depression and anxiety across diagnoses could matter greatly for delivering care in home health settings.
“A transdiagnostic intervention for depression and anxiety may have important implications for implementation into a home health care setting.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim.
InterpretationreasoningWith disorder-specific protocols, a professional might need to learn many separate manuals for different conditions.
“Under disorder-specific treatment protocols, the professional would potentially have to learn numerous treatment manuals for the various disorders.”
Quote in the paperSubstantial claimClassified as probably not a substantial claim. May combine two claims.
InterpretationreasoningA transdiagnostic approach could let a professional use a single method for unipolar mood and anxiety disorders and for aging-related stress, which might make it more efficient to add to existing services.
“A transdiagnostic approach would enable the professional to use one approach for unipolar mood and anxiety disorders as well as stress inherent in aging, making it potentially more efficiently implemented into existing services.”
Quote in the paperSubstantial claimClassified as probably not a substantial claim. May combine two claims.
InterpretationreasoningIf ACT works and a home-based professional can deliver it competently, its transdiagnostic design could make implementation easier.
“If ACT is effective and can be competently administered by a professional already working in the home, the transdiagnostic nature of the treatment would make it potentially easier to implement.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S4 (based). May combine two claims.
Interpretationnone givenOlder adults are both understudied and becoming a more important population group.
“In conclusion, older adults are an understudied yet increasingly important segment of the population.”
Quote in the paperNot a substantial claim
The authors state this as an assumption.
Psychological inflexibility is a primary feature of psychopathology in the ACT model.
“ACT assumes that one primary factor, psychological inflexibility, is characteristic of psychopathology (Hayes et al., 1999).”
The paper relies on this without support.
Older adults with chronic illness and functional impairment, including those who are homebound or live in nursing homes, have a higher risk of mood or anxiety disorders.
“However, certain subpopulations of older adults who face chronic illness and functional impairment, such as homebound and nursing home-dwelling older adults, are at increased risk for mood or anxiety disorders.”
The paper relies on this without support.
Many older adults struggle to notice and identify their internal experiences.
“Because many older adults have difficulty noticing and identifying internal experiences, we engage in a mindfulness exercise, such as mindful breathing, at the beginning of each session in order to develop and practice this skill (Zettle, 2007).”
The paper relies on this without support.
Therapy tends to proceed more slowly with patients who have cognitive or functional impairment.
“The therapeutic process generally is slower with cognitively or functionally impaired patients, so more sessions may be needed to cover the important components.”
The paper relies on this without support.
Chronic illness and functional impairment frequently occur together in older adults who are depressed or anxious.
“Chronic illness and functional impairment are commonly co-morbid in depressed and anxious older adults.”
The paper relies on this without support.
Compared with the notion of emotional struggle, values may be easier for older adults to grasp and connect with.
“Moreover, older adults may be more likely to understand and relate to values than to the idea of emotional struggle.”
The paper relies on this without support.
Beginning therapy with the values module raises the chance that an older patient will stay engaged in treatment.
“By starting treatment with the values module the likelihood that the older adult patient will engage in treatment is increased.”
The paper relies on this without support.
Fatigue, uncomfortable emotions, and fusion with self-evaluative inner experiences are frequent obstacles to committed action.
“Common barriers are fatigue, experiencing uncomfortable emotions, and fusing with self evaluative internal experiences.”
The paper relies on this without support.
Depressed and anxious older adults often report physical complaints like fatigue or appetite loss and initially find it hard to describe their inner experiences.
“It is also common for both depressed and anxious older adults to present with somatic complaints such as fatigue or loss of appetite and find it challenging initially to describe internal experiences.”
The paper relies on this without support.
Avoidance is ineffective and may be the main problem.
“The goals of this module are to help the client understand that avoidance does not work, and in fact may be the primary problem.”
The paper relies on this without support.
Religion matters greatly to many older people.
“We explicitly incorporate religion into discussions about values because this is a very important domain for many older people.”
The paper relies on this without support.
The older adult population will grow rapidly over the next four decades, making evidence-based psychosocial treatments more important for this group.
“Rapid increases in the older adult population during the next 40 years will increase the importance of evidence-based psychosocial treatments for this population.”
The paper relies on this without support.
Most research so far has concentrated on cognitive behavioral treatments for mental or behavioral health problems.
“To date, most research has focused on cognitive behavioral treatments for mental or behavioral health problems.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Research has supported the applicability of core ACT processes in a variety of clinical populations, including in older people.
“Research has supported the applicability of these core ACT processes in a variety of clinical populations, including in older people.43”
From Acceptance and commitment therapy for older people with treatment-resistant generalised anxiety disorder: The FACTOID feasibility study (2021) · cites this paper as [43]
The ACT model of psychopathology and treatment section reports research linking ACT-related avoidance processes to distress in older adults. But the Future directions and conclusion section says the rationale for ACT in older adults rests largely on research with people without depressive or anxiety disorders, and the paper describes only one small clinical pilot. That does not establish the claimed applicability of the core processes across clinical populations, including older people. (LLM, conf=0.85)
Experimental — accuracy not yet measuredThere is a significant association between experiential avoidance of distressing internal experiences and increased anxiety in later life.
“Research suggests that these core psychopathology processes persist into adulthood, with a significant association between experiential avoidance of distressing internal experiences and increased anxiety in later life (12).”
From Is acceptance and commitment therapy helpful in reducing anxiety symptomatology in people aged 65 or over? A systematic review (2022) · cites this paper as [12]
In “The ACT model of psychopathology and treatment” (page unavailable), the paper says experiential avoidance appears associated with greater distress in older adulthood and reports associations between avoidance coping or thought suppression and anxiety. It does not state that the association specifically between experiential avoidance and increased anxiety was statistically significant. (LLM, conf=0.86)
Experimental — accuracy not yet measuredThe transdiagnostic nature of ACT makes assessment and intervention for anxiety and depression more efficient because it focuses on core processes of psychological inflexibility regardless of the current mental health problem.
“The transdiagnostic nature of ACT makes assessment and intervention for anxiety and depression more efficient, as it is not necessary to distinguish between both pathologies, as it focuses exclusively on determining how core processes of psychological inflexibility contribute to psychopathology in order to intervene on them, regardless of the current mental health problem (12).”
From Is acceptance and commitment therapy helpful in reducing anxiety symptomatology in people aged 65 or over? A systematic review (2022) · cites this paper as [12]
The “Rationale for ACT with older adults” section says ACT may make assessment and treatment of anxiety and depression more efficient because it need not distinguish the disorders and instead assesses core processes contributing to the client’s problem. The citing sentence presents that proposed advantage as established and does not retain the paper’s older-adult context. Page numbers are not available in the supplied passages. (LLM, conf=0.88)
Experimental — accuracy not yet measuredThe applicability of acceptance and commitment therapy core processes has been supported in a variety of clinical populations, including older people.
“One research supported the applicability of the ACT core processes in a variety of clinical populations, including older people [25].”
From Effect of group-based acceptance and commitment therapy on older stroke survivors: study protocol for a randomized controlled trial. (2023) · cites this paper as [25]
The ACT model of psychopathology and treatment section says research suggests ACT-related core processes persist into older adulthood and reviews evidence involving several groups of older adults. It does not establish their applicability across a variety of clinical populations; the Future directions and conclusion section says the supporting research was largely conducted with people without depressive or anxiety disorders and calls for more research in clinical older-adult populations. Page numbers were not available in our copy. (LLM, conf=0.86)
Experimental — accuracy not yet measuredReorientation on personal values and associated behavior change, present moment awareness, and willingness to experience and accept negative emotions have all been found to increase with age.
“Reorientation on personal values and associated behavior change [27,28], present moment awareness, and willingness to experience and accept negative emotions have all been found to increase with age [29,30].”
From Blended Acceptance and Commitment Therapy Versus Face-to-face Cognitive Behavioral Therapy for Older Adults With Anxiety Symptoms in Primary Care: Pragmatic Single-blind Cluster Randomized Trial. (2021) · cites this paper as [27]
The Rationale for ACT with older adults section says emotion regulation appears to improve with age. The Treatment recommendations with older adults section discusses reconnecting older clients with values and increasing awareness and acceptance as treatment goals; it does not say that these capacities, or values-guided behavior, have been found to increase with age. Page numbers are unavailable in our copy. (LLM, conf=0.85)
Experimental — accuracy not yet measured
The intervention comprised up to 16 individual ACT sessions delivered in person, each lasting up to 1 hour, weekly for the first 14 sessions and fortnightly thereafter.
“The intervention comprised up to 16 individual (i.e.one-to-one) sessions of ACT, delivered in person, with each session lasting up to 1 hour.This was consistent with previous recommendations of 12-16 sessions of ACT for older people, 43,59 as well as with step 3 of the stepped-care approach for GAD. 15”
From Acceptance and commitment therapy for older people with treatment-resistant generalised anxiety disorder: The FACTOID feasibility study (2021) · cites this paper as [43]
The goal of ACT to live life in accordance with deeply held values seemed to resonate with this group who had experienced little success with control-orientated treatment strategies such as CBT in the past.
“As posited elsewhere (21), the goal of ACT to live life in accordance with deeply held values, despite the many challenges they may experience, seemed to resonate with this group who had experienced little success with control-orientated treatment strategies such as CBT in the past.”
From Optimising the acceptability and feasibility of acceptance and commitment therapy for treatment-resistant generalised anxiety disorder in older adults. (2019) · cites this paper as [21]
The goal of ACT to live life in accordance with deeply held values, despite challenges, seemed to resonate with this group.
“As posited elsewhere, 43 the goal of ACT to live life in accordance with deeply held values, despite the many challenges that may be experienced, seemed to resonate with this group; group members had experienced little success with control-orientated treatment strategies such as CBT in the past.”
From Acceptance and commitment therapy for older people with treatment-resistant generalised anxiety disorder: The FACTOID feasibility study (2021) · cites this paper as [43]
Experimental — accuracy not yet measuredSome older people may experience difficulties in recognising, describing, observing or being aware of their internal states.
“As we previously noted, 43 some older people may experience difficulties in recognising, describing, observing or being aware of their internal states.”
From Acceptance and commitment therapy for older people with treatment-resistant generalised anxiety disorder: The FACTOID feasibility study (2021) · cites this paper as [43]
Previous recommendations suggest 12-16 sessions of ACT for older people.
“This was consistent with previous recommendations of 12-16 sessions of ACT for older people, 43,59”
From Acceptance and commitment therapy for older people with treatment-resistant generalised anxiety disorder: The FACTOID feasibility study (2021) · cites this paper as [43]
People who display psychological inflexibility exert energy and resources toward experiential avoidance and neglect and disengage from core values.
“People who display psychological inflexibility are considered to exert energy and resources toward experiential avoidance, as well as neglecting and disengaging from core values in their lives (12).”
From Is acceptance and commitment therapy helpful in reducing anxiety symptomatology in people aged 65 or over? A systematic review (2022) · cites this paper as [12]
A traditional CBT approach that challenges the validity of older people's thoughts concerning loss or disablement may be less beneficial because such thoughts may not be unrealistic.
“A traditional CBT approach that might challenge the validity of older people's thoughts concerning loss or disablement, may be less beneficial because such thoughts, while excessive and maladaptive, may not be unrealistic (Petkus and Wetherell, 2013).”
From A meta-analysis of third wave mindfulness-based cognitive behavioral therapies for older people (2017) · cites this paper as Petkus and Wetherell, 2013
The existing research on the use of ACT in older adults is limited to rationales, case studies, and pilot studies.
“The existing research on the use of ACT in older adults is limited to rationales (Petkus & Wetherell, 2013), case studies (Roberts & Sedley, 2016), and pilot studies (Davison, Eppingstall, Runci, & O'Connor, 2017).”
From Supported Web-Based Acceptance and Commitment Therapy for Older Family Caregivers (CareACT) Compared to Usual Care. (2022) · cites this paper as Petkus & Wetherell, 2013
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Older Adults Are Less Accurate Than Younger Adults at Identifying Symptoms of Anxiety and Depression
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Self-citationAge at onset of generalized anxiety disorder in older adults
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A Profile of Older Americans: 2010
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“home placement (Gibbons et al., 2002), greater functional”
Modular psychotherapy for anxiety in older primary care patients
Wetherell, J. L., Ayers, C. R., Sorrell, J. T., Thorp, S. R., Nuevo, R., Belding, W., Gray, E., Stanley, M. A., Areán, P. A., Donohue, M., et al. (2009) · The American Journal of Geriatric Psychiatry · doi:10.1097/jgp.0b013e3181a31fb5 · Cited by 78 · see citing works
Self-citationGellis, Z. D., & Bruce, M. L. (2010) · The American Journal of Geriatric Psychiatry · doi:10.1097/jgp.0b013e3181b21442 · Cited by 76 · cited 1× · see citing works
“However, studies have produced mixed findings on their effectiveness with some subpopulations, such as depressed, medically ill homebound older adults (Ayalon, Fialova, Arean, & Onder, 2010; Gellis & Bruce, 2010).”
The Association Between Self-Reported Anxiety Symptoms and Suicidality
Diefenbach, G. J., Woolley, S. B., & Goethe, J. W. (2009) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0b013e318196127c · Cited by 67 · see citing works
Caring for Mental Illness in the United States: A Focus on Older Adults
Klap, R. (2003) · American Journal of Geriatric Psychiatry · doi:10.1176/appi.ajgp.11.5.517 · Cited by 66 · see citing works
Gum, A. M., Iser, L., & Petkus, A. (2010) · The American Journal of Geriatric Psychiatry · doi:10.1097/jgp.0b013e3181c29495 · Cited by 64 · cited 1× · see citing works
“Due to barriers experienced by this population such as functional impairment and disability, many do not receive adequate mental health services (Gum et al., 2010).”
Self-citationDulin, P. L., & Passmore, T. (2010) · Journal of Traumatic Stress · doi:10.1002/jts.20512 · Cited by 63 · cited 1× · see citing works
“Engaging in avoidance may mediate the association between past trauma exposure and increased distress later in life (Dulin & Passmore, 2010).”
Age at Onset of Generalized Anxiety Disorder in Older Adults
Chou, K.-L. (2009) · The American Journal of Geriatric Psychiatry · doi:10.1097/jgp.0b013e31818f3a93 · Cited by 61 · see citing works
Cognitive style predictors of affect change in older adults
Isaacowitz, D. M., & Seligman, M. E. P. (2002) · The International Journal of Aging and Human Development · doi:10.2190/j6e5-np5k-2uc4-2f8b · Cited by 58 · see citing works
Márquez-González, M., Romero-Moreno, R., & Losada, A. (2010) · Casebook of clinical geropsychology · doi:10.1093/med/9780199583553.003.0003 · Cited by 57 · see citing works
Cukrowicz, K. C., Ekblad, A. G., Cheavens, J. S., Rosenthal, M. Z., & Lynch, T. R. (2008) · Aging & Mental Health · doi:10.1080/13607860801936714 · Cited by 56 · see citing works
Petkus, A. J., Gum, A. M., Small, B., Malcarne, V. L., Stein, M. B., & Wetherell, J. L. (2010) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.2377 · Cited by 54 · cited 1× · see citing works
“Other research suggests that in chronically ill, functionally impaired older adults, anxiety and depressive symptoms commonly co-occur (r=0.71; Petkus et al., 2010).”
InfluentialSelf-citationAge differences in dynamical emotion-cognition linkages
Chow, S.-M., Hamagani, F., & Nesselroade, J. R. (2007) · Psychology and Aging · doi:10.1037/0882-7974.22.4.765 · Cited by 53 · cited 1× · see citing works
“In one study, poor performance on challenging cognitive tasks led to more distress among younger adults than among older individuals, despite the fact that cognitive decline is a concern with particular relevance to older adults (Chow et al., 2007).”
Religion, aging, and health: exploring new frontiers in medical care
Krause, N. (2004) · Southern Medical Journal · doi:10.1097/01.smj.0000146488.39500.03 · Cited by 50 · see citing works
Psychiatric comorbidity and depression in older adults
Gum, A. M., & Cheavens, J. S. (2008) · Current Psychiatry Reports · doi:10.1007/s11920-008-0006-5 · Cited by 40 · cited 1× · see citing works
“Comorbidity of anxiety and depression are common and difficult to distinguish among older people (Gum & Cheavens, 2008).”
Nuevo, R., Wetherell, J. L., Montorio, I., Ruiz, M. Á., & Cabrera, I. (2009) · Aging & Mental Health · doi:10.1080/13607860802591088 · Cited by 34 · see citing works
Self-citationThought suppression and meaning in life: a longitudinal investigation
Krause, N. (2007) · The International Journal of Aging and Human Development · doi:10.2190/2044-390u-7106-5610 · Cited by 34 · cited 1× · see citing works
“Engaging in thought suppression as a mechanism to cope with unwanted thoughts has been associated with less subjective sense of meaning in life in community-dwelling older adults (Krause, 2007).”
Behavioral health needs and problem recognition by older adults receiving home-based aging services
Gum, A. M., Petkus, A., McDougal, S. J., Present, M., King‐Kallimanis, B., & Schonfeld, L. (2009) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.2135 · Cited by 32 · see citing works
Self-citationPetkus, A. J., Gum, A., & Wetherell, J. L. (2012) · Depression and Anxiety · doi:10.1002/da.20912 · Cited by 26 · see citing works
Self-citationThought suppression and treatment outcome in late-life depression
Rosenthal, M. Z., Cheavens, J. S., Compton, J. S., Thorp, S. R., & Lynch, T. R. (2005) · Aging & Mental Health · doi:10.1080/13607860512331334040 · Cited by 24 · see citing works
Exploring inclusion and challenging policy in mainstream education
Bhagat, F. (2007) · British Journal of Nursing · doi:10.12968/bjon.2007.16.21.27725 · Cited by 20 · see citing works
Ayers, C. R., Petkus, A., Liu, L., Patterson, T. L., & Wetherell, J. L. (2010) · Journal of Experimental Psychopathology · doi:10.5127/jep.003110 · Cited by 19 · cited 1× · see citing works
“Additionally, using avoidance as a coping strategy is also associatedwith increased depression (Andrew&Dulin, 2007) and persistent anxiety (Ayers et al., 2010).”
Self-citationUnder diagnosis of alcohol misuse in the older adult population
Loukissa, D. (2007) · British Journal of Nursing · doi:10.12968/bjon.2007.16.20.27570 · Cited by 18 · cited 1× · see citing works
“Additionally, it is important to assess for substance abuse as an internal control strategy as these problems are commonly misdiagnosed or undetected in older adults (Loukissa, 2007).”
Ayalon, L., Fialová, D., Areán, P. A., & Onder, G. (2010) · International Psychogeriatrics · doi:10.1017/s1041610209991797 · Cited by 17 · cited 1× · see citing works
“Additionally, using avoidance as a coping strategy is also associatedwith increased depression (Andrew&Dulin, 2007) and persistent anxiety (Ayers et al., 2010).”
Diefenbach, G. J., Tolin, D. F., Gilliam, C. M., & Meunier, S. A. (2008) · Behavior Modification · doi:10.1177/0145445508314269 · Cited by 9 · see citing works
Petkus, Gum, & Malcarne (2010) · International Journal of Geriatric Psychiatry · Cited by 5 · see citing works
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- Petkus, A. J., Gum, A. M., & Wetherell, J. L. (in press). Thought supression is associated with increased anxiety and depression in homebound older adults. Depression and Anxiety.
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Sorted by citations
The potential effects of meditation on age-related cognitive decline: a systematic review.
Gard, T., Hölzel, B. K., & Lazar, S. W. (2014) · Annals of the New York Academy of Sciences · doi:10.1111/nyas.12348 · Cited by 363 · see citing works
Magnon, V., Dutheil, F., & Vallet, G. T. (2021) · Scientific Reports · doi:10.1038/s41598-021-98736-9 · Cited by 149 · see citing works
Fuchs, C., Lee, J. K., Roemer, L., & Orsillo, S. M. (2013) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2011.12.004 · Cited by 139 · see citing works
Karlin, B. E., Walser, R. D., Yesavage, J., Zhang, A., Trockel, M., & Taylor, C. B. (2013) · Aging & Mental Health · doi:10.1080/13607863.2013.789002 · Cited by 89 · see citing works
Wetherell, J. L., Petkus, A. J., Alonso‐Fernandez, M., Bower, E. S., Steiner, A. R. W., & Afari, N. (2016) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.4330 · Cited by 78 · see citing works
Self-citationAlonso-Fernández, M., López-López, A., Losada, A., González, J. L., & Wetherell, J. L. (2016) · Pain Medicine · doi:10.1111/pme.12885 · Cited by 73 · see citing works
Self-citationCognitive and neuroscientific perspectives of healthy ageing
Prince, J. B., Davis, H. L., Tan, J., Muller-Townsend, K. L., Markovic, S. J., Lewis, D. M. G., Hastie, B., Thompson, M. B., Drummond, P. D., Fujiyama, H., et al. (2024) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2024.105649 · Cited by 68 · see citing works
“…considerable clinical utility when tailored to older adults, such as novel health assessment methodologies combined with modern cognitive and behavioural interventions such as acceptance and commitment therapy (Petkus and Wetherell, 2013) or mindfulness-based therapy (Hazlett-Stevens et al., 2019).”
A meta-analysis of third wave mindfulness-based cognitive behavioral therapies for older people
Kishita, N., Takei, Y., & Stewart, I. (2017) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.4621 · Cited by 60 · see citing works
Davison, T. E., Eppingstall, B., Runci, S., & O'Connor, D. W. (2017) · Aging & Mental Health · doi:10.1080/13607863.2016.1156051 · Cited by 55 · see citing works
“This may be particularly advantageous with the current cohort of LTC residents, who commonly have limited knowledge of mental health disorders, and may be less likely than younger adults to engage in a therapy designed to address specific symptoms (Petkus & Wetherell, 2013).”
BackgroundBhattacharyya, K. K. (2021) · Springer eBooks · doi:10.1007/978-3-030-88870-1_6 · Cited by 51 · see citing works
Witlox, M., Garnefski, N., Kraaij, V., de Waal, M. W. M., Smit, F., Bohlmeijer, E., & Spinhoven, P. (2021) · Journal of Medical Internet Research · doi:10.2196/24366 · Cited by 43 · see citing works
“These results suggest that ACT interventions constitute a positive treatment experience for older adults, which could be related to several aspects of the treatment that have been theorized to be especially appealing to this age group [27].”
The power of personality in successful ageing: a comprehensive review of larger quantitative studies
Pocnet, C., Popp, J., & Jopp, D. S. (2020) · European Journal of Ageing · doi:10.1007/s10433-020-00575-6 · Cited by 46 · see citing works
The fear of Alzheimer’s disease: mediating effects of anxiety on subjective memory complaints
Norman, A. L., Woodard, J. L., Calamari, J. E., Gross, E. Z., Pontarelli, N., Socha, J., DeJong, B., & Armstrong, K. (2020) · Aging & Mental Health · doi:10.1080/13607863.2018.1534081 · Cited by 38 · see citing works
“The routine evaluation of anxiety in persons seeking dementia evaluations would appear to be a necessary firststep for identifying older adults who might benefit from interventions for anxiety (Petkus & Wetherell, 2013; Stanley, Beck, & Glassco, 1996; Stanley, Diefenbach, & Hopko, 2004).”
BackgroundAcceptance and Commitment Therapy
Mendoza-Ruvalcaba, N. M., von Humboldt, S., Arias‐Merino, E. D., & Leal, I. M. P. (2021) · Springer eBooks · doi:10.1007/978-3-030-22009-9_70 · Cited by 38 · see citing works
Frinking, E., Jans-Beken, L., Janssens, M., Peeters, S. C. T., Lataster, J., Jacobs, N., & Reijnders, J. S. A. M. (2019) · Aging & Mental Health · doi:10.1080/13607863.2019.1673309 · Cited by 31 · see citing works
“Because living in accordance with deeply held values may be more rooted in older people (Petkus & Wetherell, 2013), it might be beneficial for older adults to clarify values and promote engagement in meaningful or valued activities that might prevent or mitigate the subjective experience of…”
BackgroundPsychological flexibility in older adulthood: a scoping review.
Plys, E., Jacobs, M. L., Allen, R. S., & Arch, J. J. (2023) · Aging & Mental Health · doi:10.1080/13607863.2022.2036948 · Cited by 29 · see citing works
“PF/PI is a core component of the ACT model and may be particularly relevant among older adults because of the significance of acceptance and values-based actions in theories of aging (Petkus & Wetherell, 2013).”
BackgroundPetkus, A. J., Gum, A., & Wetherell, J. L. (2012) · Depression and Anxiety · doi:10.1002/da.20912 · Cited by 26 · see citing works
“Such transdiagnostic interventions for depression and anxiety in homebound older adults would potentially be more efficient than disorder-specific treatments[40] and is consistent with recent developments in psychotherapy research in younger adults with depression or anxiety.”
ResultSelf-citationWitlox, M., Kraaij, V., Garnefski, N., de Waal, M. W. M., Smit, F., Hoencamp, E., Gussekloo, J., Bohlmeijer, E. T., & Spinhoven, P. (2018) · Trials · doi:10.1186/s13063-018-2731-3 · Cited by 23 · see citing works
Lappalainen, P., Pakkala, I., Lappalainen, R., & Nikander, R. (2022) · Clinical Gerontologist · doi:10.1080/07317115.2021.1912239 · Cited by 25 · see citing works
“The existing research on the use of ACT in older adults is limited to rationales (Petkus & Wetherell, 2013), case studies (Roberts & Sedley, 2016), and pilot studies (Davison, Eppingstall, Runci, & O’Connor, 2017).”
MethodJacobs, M. L., Luci, K., & Hagemann, L. (2018) · Clinical Gerontologist · doi:10.1080/07317115.2017.1391917 · Cited by 22 · see citing works
“Theoretically, ACT may be an ideal intervention for this population because of its emphasis on values-based action and purposeful, meaningful living, as well as its transdiagnostic nature (Petkus & Wetherell, 2013).”
BackgroundAcceptance and commitment therapy with older adults
Roberts, S. L., & Sedley, B. (2016) · Clinical Case Studies · doi:10.1177/1534650115589754 · Cited by 22 · see citing works
Latent Profile Analyses of Depressive Symptoms in Younger and Older Oncology Patients
Saracino, R. M., Cham, H., Rosenfeld, B. D., & Nelson, C. J. (2018) · Assessment · doi:10.1177/1073191118784653 · Cited by 23 · see citing works
Lawrence, V., Kimona, K., Howard, R. J., Serfaty, M. A., Wetherell, J. L., Livingston, G., Wilkinson, P., Walters, K., Jones, R., Wuthrich, V. M., et al. (2019) · Age and Ageing · doi:10.1093/ageing/afz082 · Cited by 19 · see citing works
“As posited elsewhere [21], the goal of ACT to live life in accordance with deeply held values, despite the many challenges they may experience, seemed to resonate with this group who had experienced little success with control-orientated treatment strategies such as CBT in the past.”
BackgroundSelf-citationLong-term effects of a memory group intervention reported by older adults
Matthews, M. L., Wells, Y., Pike, K. E., & Kinsella, G. (2018) · Neuropsychological Rehabilitation · doi:10.1080/09602011.2018.1544570 · Cited by 18 · see citing works
“This approach has been suggested as theoretically and developmentally appropriate for older adults in the context of gains and losses in later life (Petkus & Wetherell, 2013).”
BackgroundSelf-rated health and mental health among older incarcerated males
Vogel, C. E., Molinari, V., Andel, R., & Barry, L. C. (2020) · Aging & Mental Health · doi:10.1080/13607863.2020.1795621 · Cited by 17 · see citing works
“…shows an increase in feelings of meaningfulness in community-living older persons with chronic health or life conditions they cannot change (Petkus & Wetherell, 2013), it may also be useful for older incarcerated males who have a high prevalence of multiple chronic conditions or who are…”
BackgroundEffects of acceptance and commitment therapy on cognitive function: A systematic review
Liu, H., Liu, N., Chong, S. T., Koh, E. B. Y., & Badayai, A. R. A. (2023) · Heliyon · doi:10.1016/j.heliyon.2023.e14057 · Cited by 17 · see citing works
Lester, E. G., & Murrell, A. R. (2021) · Aging & Mental Health · doi:10.1080/13607863.2021.1950613 · Cited by 17 · see citing works
“Relatedly, ACT serves to undermine cognitive fusion (e.g. believability) and experiential avoidance (Petkus & Wetherell, 2013) and has shown positive effects for reducing self-stigma and internalized shame (Luoma & Platt, 2015).”
Disaster Mental Health Services Review of Care for Older Persons After Disasters
Gibson, A., Walsh, J., & Brown, L. M. (2017) · Disaster Medicine and Public Health Preparedness · doi:10.1017/dmp.2017.60 · Cited by 17 · see citing works
“Although empirical validation is still required, preliminary research indicates that cognitive techniques, delivered in tandem with life-review interventions, may offer a way forward in effectively treating older persons following disasters.7 Acceptance and commitment therapy (ACT), which posits that distress arises f…”
BackgroundInfluentialRoche, M. J. L., & Lustig, K. B. (2012) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2012.04.002 · Cited by 15 · see citing works
“…series reviews a wide range of culturaladaptations of acceptance-based behavior therapies (ABBTs), includingAcceptance andCommitmentTherapy (ACT; Petkus & Wetherell, 2013–this issue), MindfulnessBased Stress-Reduction (MBSR; Dutton, Bermudez, Matas, Majid, & Myers, 2013–this issue), Culturally…”
BackgroundAtefi, G. L., van Knippenberg, R. J. M., Bartels, S. L., Losada-Baltar, A., Márquez-González, M., Verhey, F. R. J., & de Vugt, M. E. (2024) · JMIR Aging · doi:10.2196/53489 · Cited by 15 · see citing works
“In the context of personalizing ACT interventions, facilitating skill building and modifying behavioral responses in older adults with regard to potential concurrent challenging circumstances (eg, health conditions) might be especially important [52].”
BackgroundSun, Y., Tian, Z., Ma, Y., Zhu, Q., Zheng, R., Guan, Y., & Zhang, X. (2025) · Journal of Psychiatric and Mental Health Nursing · doi:10.1111/jpm.13138 · Cited by 12 · see citing works
Delhom, I., Mateu-Mollá, J., & Lacomba-Trejo, L. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.976363 · Cited by 10 · see citing works
Lin, S. S.-H., Jacobs, M. L., Halli-Tierney, A., Carroll, D. G., & Allen, R. S. (2023) · Clinical Gerontologist · doi:10.1080/07317115.2023.2276291 · Cited by 10 · see citing works
“Acceptance and commitment therapy (ACT) is theoretically an ideal intervention for older adults struggling with depression, anxiety, and adjustment to changes in later life (Petkus & Wetherell, 2013; Plys et al., 2022).”
Deraas, T., Hopstock, L. A., Henriksen, A., Morseth, B., Sand, A.-S., Njølstad, I., Pedersen, S., Sagelv, E. H., Johansson, J., & Grimsgaard, S. (2021) · Pilot and Feasibility Studies · doi:10.1186/s40814-021-00921-0 · Cited by 10 · see citing works
New horizon in improving ageing with improvisational theatre
Keisari, S., Krueger, K. R., Ben‐David, B. M., & Hainselin, M. (2024) · Age and Ageing · doi:10.1093/ageing/afae087 · Cited by 9 · see citing works
Acceptance and Commitment Therapy
Márquez‐González, M., & Losada‐Baltar, A. (2017) · Springer eBooks · doi:10.1007/978-981-287-082-7_97 · Cited by 9 · see citing works
Being Mindful About the Use of Mindfulness in Clinical Contexts
Dimidjian, S., & Kleiber, B. (2012) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2012.02.006 · Cited by 8 · see citing works
Chojak, A. (2023) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2023.03.007 · Cited by 7 · see citing works
Atefi, G., van Knippenberg, R. J. M., Bartels, S. L., Losada‐Baltar, A., Márquez‐González, M., Verhey, F. R. J., & de Vugt, M. E. (2025) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2025.2477600 · Cited by 9 · see citing works
“…significant life events such as retirement, new functional impairments due to (chronic) illness, or the challenges of caregiving, particularly when the care recipient’s condition worsens, can pose challenges in caregivers’ sense of connection with deeply held core values (Petkus & Wetherell, 2013).”
Bryant, C. (2017) · Mental health and illness worldwide · doi:10.1007/978-981-10-2414-6_21 · Cited by 8 · see citing works
Akzeptanzund Commitment-Therapie im Alter
Wilz, G., Reiter, C., & Risch, A. K. (2017) · Psychotherapie im Alter · doi:10.30820/1613-2637-2017-1-83 · Cited by 7 · see citing works
Calidad de Vida, Bienestar Psicológicoy Valores en Personas Mayores
Noriega, C., Velasco, C., Pérez-Rojo, G., Carretero, I., Horrillo, A. C., & López, J. (2017) · Clínica Contemporánea · doi:10.5093/cc2017a1 · Cited by 9 · see citing works
Zarling, A. L., Kim, J., Russell, D. W., & Cutrona, C. E. (2023) · JMIR Aging · doi:10.2196/47943 · Cited by 6 · see citing works
“First, theories of adult development and successful aging suggest that an ACT approach to treatment could be useful for older adults [37].”
Poverty: third wave behavioral approaches
Thompson, M. (2015) · Current Opinion in Psychology · doi:10.1016/j.copsyc.2014.11.010 · Cited by 6 · see citing works
Die Bedeutung von Akzeptanz für psychische Probleme im höheren Lebensalter
Barnow, S., Löw, C., Arens, E. A., Schäfer, A., & Pruessner, L. (2019) · Psychotherapeut · doi:10.1007/s00278-019-0362-0 · Cited by 5 · see citing works
Verdoodt, K., Batink, T., Simons, M., Janssens, M., Peeters, S., Lataster, J., Jacobs, N., & Reijnders, J. (2023) · Educational Gerontology · doi:10.1080/03601277.2022.2160571 · Cited by 5 · see citing works
Nikparvar, F., Sasanian, F., Spencer, C. M., & Stith, S. M. (2023) · Journal of Interpersonal Violence · doi:10.1177/08862605231169736 · Cited by 6 · see citing works
“…are congruent with values, list of kind behaviors -Homework: Feedback from previous session, review of last week’s homework, case-by-case review of behaviors according to the training core life values and use their resources and their energy for experiential avoidance (Petkus & Wetherell, 2013).”
BackgroundChen, F., Zhou, Q., Wu, J., & Xu, X. (2023) · BMC Complementary Medicine and Therapies · doi:10.1186/s12906-023-04160-z · Cited by 5 · see citing works
“One research supported the applicability of the ACT core processes in a variety of clinical populations, including older people [25].”
Gould, R. L., Wetherell, J. L., Serfaty, M. A., Kimona, K., Lawrence, V., Jones, R., Livingston, G., Wilkinson, P., Walters, K., Novere, M. L., et al. (2021) · Health Technology Assessment · doi:10.3310/hta25540 · Cited by 4 · see citing works
Self-citationRawlinson, C. V., Gould, R. L., McDermott, C. J., Thompson, B. T., Weeks, K., Gossage-Worrall, R., Serfaty, M. A., Graham, C. D., McCracken, L. M., White, D. A., et al. (2024) · The Cognitive Behaviour Therapist · doi:10.1017/s1754470x24000333 · Cited by 4 · see citing works
“Although each (Petkus and Wetherell, 2013; Wetherell et al ., 2011) and MND commonly affects those in their 60s and older Present moment awareness exercise included at the start of each session as this may help plwMND manage periods when they can no longer move (Pagnini et al ., 2014) A range of…”
Marks, R. (2021) · Journal Of Aging Research And Healthcare · doi:10.14302/issn.2474-7785.jarh-21-3979 · Cited by 4 · see citing works
The Contribution of Psychological Inflexibility and Metacognitive Processes to Emotional Distress.
Quan, H., & Zettle, R. D. (2023) · Journal of Cognitive Psychotherapy · doi:10.1891/jcpsy-d-21-00014 · Cited by 3 · see citing works
Nejad-Ebrahim Soumee, Z., tajigharajeh, S., Mousavi, S. E., Nazarali, Z., Bakhshani, N.-M., Nasrabadi, S., Mohebi, M. D., Ahmadi, R., & Sarani Yaztappeh, J. (2024) · Current Psychology · doi:10.1007/s12144-024-06801-z · Cited by 3 · see citing works
“If these people are treated, it is usually pharmacological, although many prefer counseling (Petkus & Wetherell, 2013).”
Johansson, J., Deraas, T., Hopstock, L. A., Henriksen, A., & Grimsgaard, S. (2025) · BMJ Open · doi:10.1136/bmjopen-2024-095810 · Cited by 3 · see citing works
Psychotherapy for older adults with depression: a narrative review
Gum, A. M., & Crawford, N. O. (2026) · Neuropsychopharmacology · doi:10.1038/s41386-026-02327-z · Cited by 3 · see citing works
Bruschetta, R., Latella, D., Formica, C., Campisi, S., Failla, C., Marino, F., Isidoro, S. I., Giambò, F. M., Bonanno, L., Cerasa, A., et al. (2024) · Bioengineering · doi:10.3390/bioengineering11080787 · Cited by 3 · see citing works
Campbell, R., Podugu, S. D. V. P. R., & Morris, M. (2025) · Clinical Gerontologist · doi:10.1080/07317115.2025.2487008 · Cited by 3 · see citing works
“Identifying models that promote well-being while accommodating the chronicity and complexity of conditions is essential (Petkus & Wetherell, 2013).”
InfluentialSlot, M., Reijnders, J. S. A. M., Janssens, M., Simons, M., Lataster, J., & Jacobs, N. (2024) · International Journal of Applied Positive Psychology · doi:10.1007/s41042-024-00194-x · Cited by 4 · see citing works
“Another explanation for this current finding may be that previous studies often attributed increasing levels of acceptance with aging to diminishing negative affect (Petkus & Wetherell, 2013).”
Stiekema, A. P. M., Heugten, C. M. V., & de Vugt, M. E. (2018) · Aging & Mental Health · doi:10.1080/13607863.2018.1498446 · Cited by 3 · see citing works
“…of ACT for cognitively impaired people with ABI as well for older people have been suggested in the literature (Kangas & McDonald, 2011; Petkus & Wetherell, 2013; Soo et al., 2011) and can potentially be used to create an adaptation of ACT for the application in dementia, ABI and SMI…”
MethodCreate Social Responses to a Changing Environment
Gibson, A., Kusmaul, N., Leedahl, S. N., & Rizzo, V. M. (2019) · Springer eBooks · doi:10.1007/978-3-030-26334-8_7 · Cited by 3 · see citing works
María, M.-G., Virginia, F.-F., Rosa, R.-M., & Andrés, L. (2013) · INFORMACIO PSICOLOGICA · doi:10.14635/ipsic.2014.105.3 · Cited by 3 · see citing works
Psychotherapeutic Interventions
Cassidy‐Eagle, E. L., & Hitching, R. (2024) · Springer eBooks · doi:10.1007/978-3-031-53976-3_15 · Cited by 2 · see citing works
Shumaker, E., Nilsson, S. H., Mak, W. J., Miodownik, A., & Kehn, M. M. (2022) · Elsevier eBooks · doi:10.1016/b978-0-323-91497-0.00126-0 · Cited by 3 · see citing works
Adamowicz, J. L., Thomas, E. B. K., Hsu, T., Denburg, N. L., & Roche, A. I. (2022) · Clinical Gerontologist · doi:10.1080/07317115.2022.2131496 · Cited by 2 · see citing works
“As such, an ACT approach could be useful to improve successful aging, as it can be used to help older adults accept physical health declines that are not within their control, while helping them to continue identifying goals in adaptive ways (Petkus et al., 2013).”
BackgroundBleck, K., & Debus, A. (2023) · Psychotherapie im Alter · doi:10.30820/1613-2637-2023-3-393 · Cited by 2 · see citing works
Depression im Alter – Eine Frage der Emotionsregulation
Becker-Hingst, N. (2023) · Springer eBooks · doi:10.1007/978-3-658-41449-8 · Cited by 1 · see citing works
Acceptance and Commitment Therapy
Márquez‐González, M., & Losada‐Baltar, A. (2015) · Springer eBooks · doi:10.1007/978-981-287-080-3_97-1 · Cited by 2 · see citing works
The neural and psychological mechanisms of yoga and mindfulness meditation
Gard, T. (2015) · doi:10.26481/dis.20150320tg · Cited by 2 · see citing works
Conceptualization and Management of Chronic Pain in an Over 65 Using an ACT Lens—A Single Case Study
Campbell, R., Prasadarao, P. S. D. V., & Morris, M. (2021) · Clinical Case Studies · doi:10.1177/1534650120978299 · Cited by 1 · see citing works
“One of the seemingly greatest benefits of using an ACT model with older persons is the transdiagnostic nature of the therapy (Petkus & Wetherell, 2013).”
BackgroundMethodInfluentialPachana, N. A., & Byrne, G. J. (2021) · Cambridge University Press eBooks · doi:10.1017/9781139087469.014 · Cited by 1 · see citing works
Espírito‐Santo, H., Costa-Santos, H., Simões, L., Lemos, L., Grasina, A., & Daniel, F. (2022) · Revista Española de Geriatría y Gerontología · doi:10.1016/j.regg.2022.09.009 · Cited by 1 · see citing works
Sánchez, L. J. R., Cangas, A. J., & Barbero-Rubio, A. (2014) · Dialnet (Universidad de la Rioja) · Cited by 1 · see citing works
Bryant, C. (2016) · Mental Health and Illness Worldwide · doi:10.1007/978-981-10-0370-7_21-1 · Cited by 1 · see citing works
김효영, & Lee, H.-J. (2017) · Korean Journal of Health Psychology · doi:10.17315/kjhp.2017.22.1.006 · Cited by 1 · see citing works
Sucht und Angststörungen im Alter: Grundlagen und Interventionen in Beratung und Therapie
Wagner, D. (2018) · Psychotherapie: Praxis · doi:10.1007/978-3-662-53196-9_6 · Cited by 1 · see citing works
Pachana, N. A., Laidlaw, K., Gillanders, D. T., & Laidlaw, K. (2014) · Oxford University Press eBooks · doi:10.1093/oxfordhb/9780199663170.013.035 · Cited by 1 · see citing works
Amiri, S., Ehteshamzadeh, P., Hafezi, F., & Borna, M. R. (2021) · Middle East Journal of Rehabilitation and Health Studies · doi:10.5812/mejrh.109550 · Cited by 1 · see citing works
“On the other hand, ACT also teaches skills such as living in the present, considering and focusing on recent experiences, strengthening emotional awareness, accepting negative emotions and thoughts without prejudice and judgment (15), reducing the frequency of negative emotions and thoughts such as rumination and conc…”
BackgroundInfluentialAcceptance and Commitment Therapy and Other Third Wave Therapies
Gould, R. L., & Wetherell, J. L. (2020) · Comprehensive Clinical Psychology · doi:10.1016/b978-0-12-818697-8.00024-8 · Cited by 1 · see citing works
Self-citationAcceptance and Commitment Therapy groups with older adults
Loyal, A., & Gillanders, D. T. (2019) · FPOP Bulletin Psychology of Older People · doi:10.53841/bpsfpop.2019.1.147.9 · Cited by 1 · see citing works
Sadler, P., Gardner, I., Hart, S. J., Aradhye, S., & Nolan, J. (2022) · Psychotherapy and Counselling Journal of Australia · doi:10.59158/001c.71197 · Cited by 1 · see citing works
Terapias conductuales de tercera generación en personas mayores: una revisión de la literatura
Ruiz Sánchez, L. J., & Callejón Ruiz, Z. (2017) · Psychology, Society, & Education · doi:10.25115/psye.v6i2.512 · Cited by 1 · see citing works
von Humboldt, S. (2020) · Springer eBooks · doi:10.1007/978-3-319-69892-2_88-2 · Cited by 1 · see citing works
Anxiety disorders in older adulthood
Petkus, A., Merz, C., & Wetherell, J. L. (2014) · The Wiley Handbook of Anxiety Disorders · doi:10.1002/9781118775349.ch29 · Cited by 2 · see citing works
Self-citationManagement of Depression in the Elderly: A Scoping Study
Kittrell, A. (2016)
Finding Courage: A Case of an Older Adult with Cognitive Impairment Due to a Medical Condition
Lim, J. P., Choo, C. C., & Doshi, K. (2019) · Springer eBooks · doi:10.1007/978-981-13-7631-3_8
Acceptance and Commitment Therapy
Mendoza-Ruvalcaba, N. M., von Humboldt, S., Arias‐Merino, E. D., & Leal, I. M. P. (2019) · Springer eBooks · doi:10.1007/978-3-319-69892-2_70-1
Monitoring everyday life in aging & dementia
Bartels, S. L. (2020) · doi:10.26481/dis.20200917sb
Morse, C. (2020) · Brock University Digital Repository (Brock University)
von Humboldt, S. (2021) · Springer eBooks · doi:10.1007/978-3-030-22009-9_88
Lenze, A. J. P. E. J., & Wetherell, J. L. (2013) · Oxford University Press eBooks · doi:10.1093/med/9780199796816.003.0009
Self-citationvon Humboldt, S. (2019) · Springer eBooks · doi:10.1007/978-3-319-69892-2_88-1
Ferenbach, C. (2020) · FPOP Bulletin Psychology of Older People · doi:10.53841/bpsfpop.2020.1.150.35
Helpful clinical models for trainee therapists working with older people
James, I. A. (2021) · FPOP Bulletin Psychology of Older People · doi:10.53841/bpsfpop.2021.1.156.34
Chen, F., Zhou, Q., Wu, J., & Xu, X. (2023) · Research Square · doi:10.21203/rs.3.rs-2744518/v1
Zarling, A. L., Kim, J., Russell, D. W., & Cutrona, C. E. (2023) · doi:10.2196/preprints.47943
Sampath, H., & Soohinda, G. S. (2023) · Springer eBooks · doi:10.1007/978-981-99-5772-9_3
Una interpretación contextual y conductual de la responsabilidad moral
Miranda-Rodríguez, R. A. (2023) · Revista Mexicana de Análisis de la Conducta · doi:10.5514/rmac.v49.i2.87776
Chikwe, C., & Zadhasn, Z. (2023) · Journal of Personality and Psychosomatic Research · doi:10.61838/kman.jppr.1.4.2
- Authors
- Petkus, A. J., & Wetherell, J. L.
- Affiliations
- San Diego State University (US)
- University of California San Diego (US)
- Corresponding author
- Wetherell, Julie Loebach
- Venue
- Cognitive and Behavioral Practice
- Publisher
- Elsevier BV
- Published
- 2013-02
- Volume
- 20
- Issue
- 1
- Pages
- 47-56
- ISSN
- 1077-7229 (ISSN-L)
- PMC
- PMC4795910
- OpenAlex
- W2093291877
- Cited by
- 108
- References
- 67
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 10 · 2023: 15 · 2022: 7 · 2021: 13 · 2020: 9 · 2019: 9 · 2018: 6 · 2017: 8 · 2016: 4 · 2015: 6 · 2014: 4 · 2013: 3 · 2012: 3
- FWCI
- 3.79
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Cognitive and Behavioral Practice (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Aging (F31AG042218)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Aging and Gerontology Research
- Keywords
- acceptance and commitment therapy, older adults, gerontological theory, depression, anxiety, treatment adaptation, mental health services for older adults, underserved populations, old age
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