Effects of Group Interventions On Cognition and Depression In Nursing Home Residents
Abstract
The effects of cognitive-behavioral group therapy, focused visual imagery group therapy, and education-discussion groups on cognition, depression, hopelessness, and dissatisfaction with life were studied among depressed nursing home residents. Seventy-six depressed subjects with mild to moderate cognitive decline participated in nurse-led 24-week protocols. Data were collected 4 weeks before the interventions, 8 and 20 weeks after treatment initiation, and 4 weeks after treatment termination. There were no significant changes in depression, hopelessness, or life satisfaction scores for any of the three conditions. Participants in the cognitive-behavioral and focused visual imagery groups showed a significant improvement beginning 8 weeks after treatment initiation on cognitive scores. These findings are encouraging indications that cognitive-behavioral and focused visual imagery group therapies may reduce cognitive impairment in depressed nursing home residents with mild to moderate cognitive decline.
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The incidence of mild to moderate depression in older adults living in long-term care facilities is estimated to be as high as 50 percent.
“The incidence of mild to moderate depression in older adults living in long-term care facilities is estimated to be as high as 50 percent.1”
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Pinquart, M., Duberstein, P. R., & Lyness, J. M. (2007) · Aging & Mental Health · doi:10.1080/13607860701529635 · Cited by 328 · see citing works
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Alexopoulos, G. S., Buckwalter, K. C., Olin, J. T., Martínez, R. A., Wainscott, C., & Krishnan, K. (2002) · Biological Psychiatry · doi:10.1016/s0006-3223(02)01468-3 · Cited by 269 · see citing works
A Randomized Trial of Dementia Care in Nursing Homes
Rovner, B. W., Steele, C. D., Shmuely, Y., & Folstein, M. F. (1996) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.1996.tb05631.x · Cited by 215 · see citing works
McDermut, W., Miller, I. W., & Brown, R. A. (2001) · Clinical Psychology: Science and Practice · doi:10.1093/clipsy.8.1.98 · Cited by 206 · see citing works
Gould, R. L., Coulson, M., & Howard, R. J. (2012) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2012.04166.x · Cited by 201 · see citing works
Cognitive therapy of depression
Hamilton, K. E., & Dobson, K. S. (2002) · Clinical Psychology Review · doi:10.1016/s0272-7358(02)00106-x · Cited by 191 · see citing works
Psychotherapeutic treatments for older depressed people
Wilson, K., Mottram, P. G., & Vassilas, C. (2008) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd004853.pub2 · Cited by 224 · see citing works
Psychological treatments for depression and anxiety in dementia and mild cognitive impairment
Orgeta, V., Qazi, A., Spector, A. E., & Orrell, M. W. (2014) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd009125.pub2 · Cited by 208 · see citing works
Goddaer, J., & Abraham, I. L. (1994) · Archives of Psychiatric Nursing · doi:10.1016/0883-9417(94)90048-5 · Cited by 157 · see citing works
Self-citationMcDermut, W. (2001) · Clinical Psychology Science and Practice · doi:10.1093/clipsy/8.1.98 · Cited by 140 · see citing works
The effectiveness of group cognitive behaviour therapy for unipolar depressive disorders
Oei, T. P. S., & Dingle, G. A. (2007) · Journal of Affective Disorders · doi:10.1016/j.jad.2007.07.018 · Cited by 117 · see citing works
Cott, C. A., Dawson, P., Sidani, S., & Wells, D. (2002) · Alzheimer Disease & Associated Disorders · doi:10.1097/00002093-200204000-00005 · Cited by 115 · see citing works
“Others have found that almost any type of social interaction can enhance cognitive ability and mood states among nursing home residents (Holmberg, 1997a; Bocsko, 1994; Abraham et al., 1992; Rogers et al., 1987).”
BackgroundEffectiveness of Treatments of Depression in Older Ambulatory Patients
McCusker, J., Cole, M. G., Keller, E., Bellavance, F., & Bérard, A. (1998) · Archives of Internal Medicine · doi:10.1001/archinte.158.7.705 · Cited by 113 · see citing works
Is group psychotherapy effective in older adults with depression? A systematic review
Krishna, M., Jauhari, A., Lepping, P., Turner, J., Crossley, D., & Krishnamoorthy, A. (2011) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.2546 · Cited by 111 · see citing works
“Characteristics of therapists: Abraham et al. (1992) employed nurse specialists with experience in each psychotherapeutic intervention.”
BackgroundMethodInfluentialJonsson, U., Bertilsson, G., Allard, P., Gyllensvärd, H., Söderlund, A., Tham, A., & Andersson, G. (2016) · PLOS ONE · doi:10.1371/journal.pone.0160859 · Cited by 87 · see citing works
“Four of these trials evaluated various forms of CBT: CBT-based group interventions [17, 18], group-based Competitive Memory Training (COMET) for depressive rumination [19], and a behavioural activation intervention Fig 1.”
BackgroundPrevalence and Treatment of Diagnosed Depression among Elderly Nursing Home Residents in Ohio
Levin, C. A., Wei, W., Akıncıgil, A., Lucas, J. A., Bilder, S. M., & Crystal, S. (2007) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2007.07.010 · Cited by 89 · see citing works
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D'Silva, S., Poscablo, C., Habousha, R., Kogan, M., & Kligler, B. (2012) · Psychosomatics · doi:10.1016/j.psym.2012.04.006 · Cited by 82 · see citing works
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Karel, M. J., & Hinrichsen, G. A. (2000) · Clinical Psychology Review · doi:10.1016/s0272-7358(99)00065-3 · Cited by 79 · see citing works
Jorm, A. F. (1995) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/bf00794942 · Cited by 69 · see citing works
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Boey (1999) · Pure Amsterdam UMC · doi:10.1002/(sici)1099-1166(199908)14:8 · Cited by 95 · see citing works
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Orgeta, V., Leung, P., del-Pino-Casado, R., Qazi, A., Orrell, M., Spector, A. E., & Methley, A. M. (2022) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd009125.pub3 · Cited by 103 · see citing works
Barton, D. L., & Loprinzi, C. L. (2002) · Clinical Breast Cancer · doi:10.3816/cbc.2002.s.023 · Cited by 56 · see citing works
Draper, B., Brodaty, H., Low, L., Saab, D., Lie, D., Richards, V., & Paton, H. (2001) · International Psychogeriatrics · doi:10.1017/s1041610201007505 · Cited by 52 · see citing works
Buettner, L. L., & Fitzsimmons, S. (2002) · American Journal of Alzheimer's Disease & Other Dementias® · doi:10.1177/153331750201700205 · Cited by 48 · see citing works
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Cody, R. A., & Drysdale, K. (2013) · Clinical Gerontologist · doi:10.1080/07317115.2012.731474 · Cited by 43 · see citing works
Rosen, J., Rogers, J. C., Marin, R. S., Mulsant, B. H., Shahar, A., & Reynolds, C. F. (1997) · The American Journal of Geriatric Psychiatry · doi:10.1097/00019442-199700530-00009 · Cited by 41 · see citing works
Fitzsimmons, S. (2001) · Journal of Gerontological Nursing · doi:10.3928/0098-9134-20010501-06 · Cited by 42 · see citing works
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Perry, J., Galloway, S., Bottorff, J. L., & Nixon, S. H. (2005) · Journal of Gerontological Nursing · doi:10.3928/0098-9134-20050401-10 · Cited by 40 · see citing works
Who are the residents of a nursing home in Singapore?
Yap, L. K. P., Au, S. Y. L., Ang, Y. H., et al. (2003) · PubMed · Cited by 35 · see citing works
Salzman, C. (1999) · PubMed · Cited by 36 · see citing works
Agronin, M. (2009) · Current Psychiatry Reports · doi:10.1007/s11920-009-0005-1 · Cited by 32 · see citing works
“Even mild to moderately demented individuals have benefi ted from various forms of group therapy, including cognitive-behavioral therapy [ 25 ], validation therapy [26], and a skills-training group focused on activities of daily living [27].”
BackgroundMethodHyer, L. A., Carpenter, B. D., Bishmann, D., & Wu, H.-S. (2005) · Clinical Psychology Science and Practice · doi:10.1093/clipsy.bpi031 · Cited by 37 · see citing works
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Holmberg, S. K. (1997) · Geriatric Nursing · doi:10.1016/s0197-4572(97)90042-2 · Cited by 29 · see citing works
The effectiveness of counselling with older people: Results of a systematic review
Hill, A. J., & Brettle, A. (2005) · Counselling and Psychotherapy Research · doi:10.1080/14733140500510374 · Cited by 25 · see citing works
Elders' perceptions of the role of group psychotherapy in fostering self-transcendence
Young, C. A., & Reed, P. G. (1995) · Archives of Psychiatric Nursing · doi:10.1016/s0883-9417(95)80057-3 · Cited by 25 · see citing works
NURSING INTERVENTIONS for Depression in Newly Admitted Nursing Home Residents
Ryden, M. B., Pearson, V., Kaas, M. J., Hanscom, J., Lee, H., Krichbaum, K. E., Wang, J., & Snyder, M. (1999) · Journal of Gerontological Nursing · doi:10.3928/0098-9134-19990301-10 · Cited by 23 · see citing works
Psychological therapies for depression in older adults residing in long-term care settings
Davison, T. E., Bhar, S., Wells, Y., Owen, P. J., You, E., Doyle, C., Bowe, S. J., & Flicker, L. (2024) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd013059.pub2 · Cited by 21 · see citing works
Kush, F. R., & Fleming, L. M. (2000) · Group Dynamics: Theory, Research, and Practice · doi:10.1037/1089-2699.4.2.176 · Cited by 18 · see citing works
Geropsychiatric Nursing: The State of the Science
Kolanowski, A. M., & Piven, M. L. S. (2006) · Journal of the American Psychiatric Nurses Association · doi:10.1177/1078390306292158 · Cited by 15 · see citing works
The Efficacy of an Integrated Group Treatment Program for Depressed Assisted Living Residents
Cummings, S. M. (2003) · Research on Social Work Practice · doi:10.1177/1049731503253645 · Cited by 17 · see citing works
Failure to thrive: The silent epidemic of the elderly
Kimball, M. J., & Williams, C. L. (1995) · Archives of Psychiatric Nursing · doi:10.1016/s0883-9417(95)80007-7 · Cited by 16 · see citing works
Cognitive nursing interventions with long-term care residents: Effects on neurocognitive dimensions
Abraham, I. L., & Reel, S. (1992) · Archives of Psychiatric Nursing · doi:10.1016/0883-9417(92)90088-z · Cited by 16 · see citing works
Self-citationGroup psychoeducative cognitive-behaviour therapy for mixed anxiety and depression with older adults
Bains, M. K., Scott, S., Kellett, S., & Saxon, D. H. (2014) · Aging & Mental Health · doi:10.1080/13607863.2014.908459 · Cited by 16 · see citing works
“Also the existing evidence base for depression CBT groups contains a number of RCTs (Abraham et al., 1992; Are an et al., 1993; Are an et al., 2005; Haringsma et al., 2006; Hautzinger & Welz, 2004; Klausner et al., 1998; Konnert et al., 2009; Kunik et al., 2008; Rokke et al., 2000; Wilkinson et al., 2009), which may h…”
BackgroundResultInfluentialBeech, B. F. (2000) · Journal of Psychiatric and Mental Health Nursing · doi:10.1046/j.1365-2850.2000.00298.x · Cited by 14 · see citing works
Rehabilitation of Memory and Memory Self-Efficacy in Cognitively Impaired Nursing Home Residents
McDougall, G. J. (2001) · Clinical Gerontologist · doi:10.1300/j018v23n03_11 · Cited by 14 · see citing works
Training in Long-Term Care Facilities
Hyer, L. A., & Ragan, A. M. (2003) · Clinical Gerontologist · doi:10.1300/j018v25n03_02 · Cited by 14 · see citing works
COUNSELLING OLDER PEOPLE: WHAT CAN WE LEARN FROM RESEARCH EVIDENCE?
Hill, A., & Brettle, A. (2006) · Journal of Social Work Practice · doi:10.1080/02650530600931807 · Cited by 13 · see citing works
“These findings are supported by Abraham et al. (1992), Rattenbury and Stones (1989) and Toseland et al. (1997).”
BackgroundResultManaging Cognitive Impairment in the Elderly: Conceptual, Intervention and Methodological Issues
Buckwalter, K. C., Stolley, J. M., & Farran, C. J. (1999) · Worldviews on Evidence-based Nursing presents the archives of Online Journal of Knowledge Synthesis for Nursing · doi:10.1111/j.1524-475x.1999.00127.x · Cited by 10 · see citing works
Elsegood, K. J., & Wongpakaran, N. (2011) · Research in Gerontological Nursing · doi:10.3928/19404921-20110706-02 · Cited by 9 · see citing works
“In contrast to the current study, Abraham et al. (1992) found that guided imagery enhanced residents’ cognitive abilities.”
BackgroundResultInfluentialGerontopsychosomatik und Alterspsychotherapie. Gegenwärtige Entwicklung und zukünftige Anforderungen
Heuft, G., & Schneider, G. (2001) · VS Verlag für Sozialwissenschaften eBooks · doi:10.1007/978-3-322-99712-8_5 · Cited by 9 · see citing works
Brief Psychotherapy for Depression in Primary Care: A Systematic Review of the Evidence
Ja, N., Rb, T., McDuffie, J. R., Kronish, I. M., Benjamin, D., & Jw, W. (2011) · Europe PMC (PubMed Central) · Cited by 8 · see citing works
Nursing Strategies and Quality of Life Outcomes: A Systematic Review
Burckhardt, C., & Hanestad, B. (2003) · Nordic journal of nursing research · doi:10.1177/010740830302300102 · Cited by 12 · see citing works
“Summary Characteristics of the Studies Citation Diagnosis Mean Sample Design Effect Age Size Size Special Nursing Allen (29) Elderly 80 19 Program 0 Cox (38) Elderly 65 39 Experimental 1.08 Ferrell (41) Cancer 60 83 Experimental .32 Hawthorne (51) Cardiac 56 21 Experimental 0 Heslop (52) Pulmonary 70 75 Experimental 0…”
InfluentialCognitive Behavioral Group Therapy for Residents in Assisted-Living Facilities
Kaas, M. J., & Lewis, M. L. (1999) · Journal of Psychosocial Nursing and Mental Health Services · doi:10.3928/0279-3695-19991001-12 · Cited by 6 · see citing works
Addressing Mental Health in Aged Care Residents
Bhar, S. S., Koder, D., Jayaram, H., Silver, M., & Davison, T. E. (2022) · Advances in Psychiatry and Behavioral Health · doi:10.1016/j.ypsc.2022.06.002 · Cited by 5 · see citing works
Antidepressant Treatment of Depression in Rural Nursing Home Residents
Kerber, C. S., Dyck, M. J., Culp, K. R., & Buckwalter, K. C. (2008) · Issues in Mental Health Nursing · doi:10.1080/01612840802274651 · Cited by 5 · see citing works
Group Therapy: A Cognitive-behavioral Interactive Approach
Rose, S. D. (1998) · Comprehensive Clinical Psychology · doi:10.1016/b0080-4270(73)00197-8 · Cited by 4 · see citing works
Development of a Scale: Barriers to CBT Homework Completion Scale
Callan, J. A. (2007) · D-Scholarship@Pitt (University of Pittsburgh) · Cited by 3 · see citing works
Bhar, S. S., Davison, T. E., Schofield, P. E., Quinn, S. J., Ratcliffe, J., Waloszek, J. M., Dunkerley, S., Silver, M., Linossier, J., Koder, D., et al. (2023) · BMC Geriatrics · doi:10.1186/s12877-023-04257-7 · Cited by 3 · see citing works
“Most studies evaluating psychological treatments for depressive symptoms in residents have used qualified clinicians [37, 39–41].”
BackgroundEvaluation of an Information Exchange Program for Primary Care Patients with Depression
Beusterien, K. M., Buesching, D. P., Robison, R. N., Keats, M., TOMLINSON, J. R., COFRAN, K. W., Bailit, H. L., Adler, D. A., Bungay, K. M., Schrammel, P. N., et al. (2000) · Disease Management · doi:10.1089/dis.2000.3.1 · Cited by 2 · see citing works
Depressive Disorders in the Elderly: A Review
Chiu, E., Ames, D. J., Draper, B., & Snowdon, J. A. (2009) · Wiley eBooks · doi:10.1002/9780470745892.ch5 · Cited by 2 · see citing works
Cognitive Therapy: A Well-Thought-Out Strategy
Joseph, D. H. (1995) · Nursing Forum · doi:10.1111/j.1744-6198.1995.tb00466.x · Cited by 1 · see citing works
A therapeutic group in the community for the elderly with functional psychiatric illnesses
Procter, E., & Alwar, L. (1995) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.930100107 · Cited by 1 · see citing works
“Groups for the depressed elderly have used cognitive behavioural techniques (see Morris and Morris, 1991 for a review), focused imaging (Abraham et al., 1992), autobiographical Address for correspondence: Dr E. A. Procter, Stonehouse Hospital, Cotton Lane, Dartford, Kent DA2 6AU, UK.”
MethodAzulai, A. (2016) · Libraries and Cultural Resources (University of Calgary) · doi:10.11575/prism/27556 · Cited by 1 · see citing works
Bains, M. K. (2012) · White Rose eTheses Online (University of Leeds, The University of Sheffield, University of York)
Aniljose, P. S. (2007) · Shodhganga
Ortiz, I. (2000) · Evidence-Based Mental Health · doi:10.1136/ebmh.3.1.21
Fellner, K. D., & Reddon, J. R. (2009) · Springer eBooks · doi:10.1007/978-0-387-09757-2_36
The Use of Imagery in Alleviating D epression
Schultz, D. (2016) · Routledge eBooks · doi:10.4324/9781315231563-22
Chapter 24. Clinical Psychiatry in the Nursing Home
Lantz, M., Blissett, K.-A., & Streim, J. E. (2022) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615375196.ds24
Hummel, J., Weisbrod, C., Boesch, L., Himpler, K., Dutzi, I., Baldauf, B. J., Oster, P., & Kopf, D. (2026) · BMC Geriatrics · doi:10.1186/s12877-026-06983-0
“Another study in subjects around the age of our study was conducted in nursing homes with nurse led interventions [34].”
- Authors
- ABRAHAM, I. L., NEUNDORFER, M. M., & CURRIE, L. J.
- Affiliations
- University of Virginia (US)
- Case Western Reserve University (US)
- Venue
- Nursing Research
- Published
- 1992-07
- Volume
- 41
- Issue
- 4
- Pages
- 196???202
- ISSN
- 0029-6562 (ISSN-L)
- OpenAlex
- W2024022049
- Cited by
- 73
- References
- 0
- Citations by year
- 2026: 1 · 2024: 1 · 2023: 3 · 2022: 3 · 2016: 3 · 2014: 2 · 2012: 4
- FWCI
- 2.51
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Nursing Research (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5t01mh019362-03, 5r01nr001566-02)
- National Institute of Mental Health (1T01MH19362)
- National Institute of Nursing Research (1R01NR01566)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Health Professions › General Health Professions › Geriatric Care and Nursing Homes
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- group therapy, cognitive behavioral therapy, nursing home residents, depression, cognitive decline, hopelessness, life satisfaction, nurse-led intervention, older adults
- MeSH terms
- Aged, Aged, 80 and over, Audiovisual Aids, Cognition Disorders, Depressive Disorder, Humans, Imagination, Morale, Nursing Homes, Patient Education as Topic, Personal Satisfaction, Psychotherapy, Group, Relaxation Therapy, Nursing Evaluation Research, Cognitive Behavioral Therapy
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