Cognitive Behavioral Treatment for Older Adults with Generalized Anxiety Disorder: A Therapist Manual for Primary Care Settings
Abstract
At least four academic clinical trials have demonstrated the utility of cognitive behavior therapy (CBT) for older adults with generalized anxiety disorder (GAD). These data may not generalize, however, to more heterogeneous and functionally impaired patients and the medical settings in which they typically receive care. A recent pilot project suggested the potential benefits of a new version of CBT for GAD among older patients in primary care. The manual developed and tested in this pilot project is presented here. Treatment components include motivation and education, relaxation skills, cognitive therapy, problem-solving-skills training, exposure exercises, and sleep-management-skills training. Procedures are designed to be administered flexibly to maximize attention to individual patient needs. Examples of session summaries, patient handouts, and homework forms are provided.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
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?
The CBT protocol used in this study was based on elements of earlier CBT protocols for generalized anxiety disorder in younger adults and was modified for flexible delivery to older adults in primary care.
“The CBT protocol utilized in this study is based on elements of prior CBT protocols for GAD in younger adults (Borkovec & Costello, 1993; Craske, Barlow, & O’Leary, 1992) and modified to include a flexible delivery format to meet the needs of older adults in primary care medical settings (Stanley, Diefenbach, & Hopko, 2004).”
From Cognitive-behavioral therapy for late-life anxiety: Similarities and differences between Veteran and community participants (2015) · cites this paper as Stanley, Diefenbach, & Hopko, 2004
Cites
Behavioral and Pharmacological Therapies for Late-Life Insomnia: A Randomized Controlled Trial
Morin, C. M., Colecchi, C., Stone, J., Sood, R., & Brink, D. (1999) · JAMA · doi:10.1001/jama.281.11.991 · Cited by 1,095 · see citing works
Borkovec, T. D., & Costello, E. (1993) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.61.4.611 · Cited by 756 · see citing works
Psychological treatment of panic: Work in progress on outcome, active ingredients, and follow-up
Margraf, J., Barlow, D. H., Clark, D. M., & Telch, M. J. (1993) · Behaviour Research and Therapy · doi:10.1016/0005-7967(93)90036-t · Cited by 377 · see citing works
Cognitive behavioral treatment of anxiety in later life
Gorenstein, E. E., Papp, L. A., & Kleber, M. S. (1999) · Cognitive and Behavioral Practice · doi:10.1016/s1077-7229(99)80050-9 · Cited by 26 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Stanley, M. A., Wilson, N. L., Novy, D. M., Rhoades, H. M., Wagener, P. D., Greisinger, A. J., Cully, J. A., & Kunik, M. E. (2009) · JAMA · doi:10.1001/jama.2009.458 · Cited by 247 · see citing works
Self-citationEvidence-based psychological treatments for late-life anxiety
Ayers, C. R., Sorrell, J. T., Thorp, S. R., & Wetherell, J. L. (2007) · Psychology and Aging · doi:10.1037/0882-7974.22.1.8 · Cited by 235 · see citing works
A lifespan view of anxiety disorders
Lenze, E. J., & Wetherell, J. L. (2011) · Dialogues in Clinical Neuroscience · doi:10.31887/dcns.2011.13.4/elenze · Cited by 227 · see citing works
Adherence to Depression Treatment in Older Adults: A Narrative Review
Zivin, K., & Kales, H. C. (2008) · Drugs & Aging · doi:10.2165/00002512-200825070-00003 · Cited by 110 · see citing works
Stanley, M. A., Wilson, N. L., Amspoker, A. B., Kraus-Schuman, C., Wagener, P. D., Calleo, J. S., Cully, J. A., Teng, E., Rhoades, H. M., Williams, S., et al. (2014) · Depression and Anxiety · doi:10.1002/da.22239 · Cited by 96 · see citing works
Self-citationKishita, N., & Laidlaw, K. (2017) · Clinical Psychology Review · doi:10.1016/j.cpr.2017.01.003 · Cited by 87 · 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
Predictors of CBT outcome in older adults with GAD
Hundt, N. E., Amspoker, A. B., Kraus-Schuman, C., Cully, J. A., Rhoades, H., Kunik, M. E., & Stanley, M. A. (2014) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2014.09.012 · Cited by 33 · see citing works
Self-citationBarrera, T. L., Cully, J. A., Amspoker, A. B., Wilson, N. L., Kraus-Schuman, C., Wagener, P. D., Calleo, J. S., Teng, E. J., Rhoades, H. M., Masozera, N., et al. (2015) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2015.04.005 · Cited by 28 · see citing works
Self-citationBier, N., Grenier, S., Brodeur, C., Gauthier, S., Gilbert, B., Hudon, C., Lepage, É., Ouellet, M.-C., Viscogliosi, C., & Belleville, S. (2015) · International Psychogeriatrics · doi:10.1017/s1041610214001902 · Cited by 28 · see citing works
Shepardson, R. L., Funderburk, J. S., & Weisberg, R. B. (2016) · Families, Systems, & Health · doi:10.1037/fsh0000175 · Cited by 20 · see citing works
Bentham, C., & Eaves, L. (2022) · Behavioral Sleep Medicine · doi:10.1080/15402002.2021.1933488 · Cited by 20 · see citing works
- Authors
- Stanley, M. A., Diefenbach, G. J., & Hopko, D. R.
- Affiliations
- Texas Medical Center (US)
- The University of Texas Health Science Center at Houston (US)
- Venue
- Behavior Modification
- Publisher
- SAGE Publications
- Published
- 2004-01
- Volume
- 28
- Issue
- 1
- Pages
- 73-117
- ISSN
- 0145-4455 (ISSN-L)
- 1552-4167
- OpenAlex
- W2040944543
- Cited by
- 54
- References
- 4
- Citations by year
- 2025: 1 · 2023: 1 · 2022: 2 · 2021: 4 · 2019: 1 · 2018: 1 · 2017: 1 · 2016: 3 · 2015: 3 · 2014: 8 · 2013: 3 · 2012: 3
- FWCI
- 4.22
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Behavior Modification (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (R01-MH53932, R01MH053932)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- cognitive behavioral therapy, generalized anxiety disorder, older adults, primary care, treatment manual, relaxation techniques, problem-solving training, sleep management, motivation, cognitive therapy, homework
- MeSH terms
- Aged, Anxiety Disorders, Behavior Therapy, Humans, Manuals as Topic, Pilot Projects, Primary Health Care, Cognitive Behavioral Therapy, Guidelines as Topic
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
