Implementation and Effectiveness of Cognitive Behavioral Therapy for Insomnia in Geriatric Primary Care.

Objectives: We evaluated a plan for implementation and effectiveness of cognitive behavioral therapy for insomnia (CBT-I) in geriatric primary care by a geropsychologist.

Methods: The flow of referrals to a geropsychologist was tracked and, among those eligible and interested in participating, success in deprescribing sleep medications and the effectiveness of CBT-I were documented.

Results: Seventy patients were referred for evaluation of whom 62 were eligible for CBT-I; 34 began CBT-I and 29 completed a full course of treatment.

Treating depression in an urban primary care setting: Introducing an adapted therapeutic approach to improve behavioral health engagement in primary care.

Depression is common in patients attending primary care clinics especially for those in socioeconomically disadvantaged urban neighborhoods. A number of behavioral health collaborative care models exist to screen, assess, and treat patients within primary care clinics. This paper discusses the implementation of a behavioral health care program using the Improving Mood Promoting Access to Collaborative Treatment (IMPACT) model within an urban primary care clinic setting in New York City, that serves a large population of ethnically diverse and socioeconomically disadvantaged patients.

National dissemination of interpersonal psychotherapy for depression in veterans: therapist and patient-level outcomes.

Objective: To evaluate the effects of training in and delivery of interpersonal psychotherapy (IPT) for depression throughout the U.S. Department of Veterans Affairs health care system on therapists' competency and patients' clinical outcomes.

Influencing public policy to improve the lives of older Americans.

Aging of the U.S. population raises numerous public policy issues about which gerontological researchers, policy experts, and practitioners have much to contribute.

The Mood Disorder Burden Index: a scale for assessing the burden of caregivers to adults with unipolar or bipolar disorder.

We present a brief measure of caregiver burden, the Mood Disorder Burden Index (MDBI), for use with family members and close friends of adults with major depressive disorder (MDD) or bipolar disorder (BD). The MDBI assesses burden in three core domains (patients' mood symptoms, caregivers' worry about the future, and caregivers' interpersonal difficulties with the patient) and includes an optional module that assesses caregiver burden associated with patients' pharmacotherapy or psychotherapy. The MDBI was administered to caregivers of older individuals (i.

[Interpersonal psychotherapy in the treatment of depression in older adults].

In this paper, the authors explain why Interpersonal Psychotherapy (PTI) is a particularly apt psychosocial treatment for depression in older adults ; they discuss issues that can emerge in the process of implementing PTI with older adults ; review the research conducted on older adults treated with PTI, and present two case summaries to illustrate the application of PTI to this population. PTI suits depressed older adults especially well because its foci match many of the issues that older adults face and that for some can trigger depression. In addition, PTI is a good fit for older adults because of its psychoeducational component, use of the medical paradigm, and collaborative, problem-focused, time-limited nature.

Pikes Peak model for training in professional geropsychology.

The aging of the population will increase demand for psychological services for older adults, which challenges the profession of psychology to provide those services. In response to that challenge, professional geropsychology has been developing over the past few decades to meet current and prepare for anticipated future demand. The development of a range of training opportunities is important to enable psychologists to work effectively with older adults.

Impact of close family members on older adults' early response to depression treatment.

This study of 130 depressed older adults and their spouses or adult children examined the impact of caregiver burden specific to patients' depressive symptoms on patients' response to antidepressant treatment. Primary care patients completed medical, psychiatric, and neuropsychological assessments prior to treatment, and interviews were conducted with their identified family member. As hypothesized, caregivers' depression-specific burden predicted greater depression severity for the patient at the 6th week of treatment after accounting for patients' pretreatment characteristics, caregivers' depressive symptoms, and caregivers' relationship satisfaction.

Doctoral clinical geropsychology training in a primary care setting.

Most older adults diagnosed with a mental disorder receive treatment in primary care settings that lack personnel skilled in geropsychological diagnosis and treatment. The Ferkauf Older Adult Program of Yeshiva University endeavors to bridge this gap by providing training in geriatric psychology, through coursework and diverse clinical practica, to clinical psychology doctoral students within a large urban professional psychology program. In an innovative effort to provide the most disadvantaged elderly with comprehensive mental health treatment and maximize trainee exposure to an interdisciplinary treatment model, the program also pairs selected doctoral psychology trainees with medical residents to optimize integrated mental health service delivery for primary care elderly.

Predictors of medication discontinuation by patients with first-episode schizophrenia and schizoaffective disorder.

Background: Enhancing medication adherence early in the course of schizophrenia and schizoaffective disorder may substantially improve long-term course. Although extensively studied in multi-episode patients, little data exist on medication adherence by first-episode patients.

Method: Medication adherence was assessed during the first year of treatment and following recovery from the first relapse in patients treated by a standardized medication algorithm.