Cognitive behavior therapy for anxiety in people with dementia: a clinician guideline for a person-centered approach.
A 10-session CBT manual tailored for dementia-related anxiety is ready to copy, even though it has not yet posted outcome data.
01Research in Context
What this study did
Charlesworth et al. (2015) wrote a step-by-step manual for 10 sessions of CBT. The plan is made for older adults who have both dementia and anxiety.
The authors added memory aids, shorter exercises, and caregiver tips. They call the package 'person-centered' because it fits each client's remaining strengths.
What they found
The paper shows the protocol only. It does not give outcome numbers. No results on whether anxiety went down are reported.
How this fits with other research
Matson et al. (2013) came first. Their 'Peaceful Mind' manual also used CBT for dementia anxiety and did show positive numbers in a small trial. Charlesworth et al. (2015) extends that idea by adding more detail for clinicians.
Chan et al. (2017) ran a 10-session group too, but used mindfulness instead of CBT. Both manuals last 10 weeks and serve mild-to-moderate dementia, showing that short weekly programs are feasible.
Channell et al. (2022) took a different path. They treated anxiety in autism with single-case DRA, not CBT. The two studies do not clash; they simply show behavior analysts have more than one tool for anxiety across populations.
Why it matters
You now have a ready-made CBT roadmap when an older client with dementia shows worry, pacing, or repeated questions. Borrow the memory aids, keep sessions short, and involve caregivers. Track anxiety with simple ratings to see if the package works in your own practice.
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02At a glance
03Original abstract
This article describes a 10-session cognitive-behavioral therapy (CBT) used in a randomized controlled trial with people with anxiety and mild-to-moderate dementia. The aim of the therapy is to reduce symptoms of anxiety by increasing a sense of safety and self-efficacy. The therapy is characterized by a person-centered approach to CBT, using individual tailoring to accommodate for cognitive deficits and other challenges. Three phases of therapy are described: (a) socialization to model (including overcoming barriers to participation), goal setting, and formulation; (b) application of cognitive and behavioral change techniques to address unhelpful autonomic reactions, "strategic" reactions, "rules for living," and interpersonal aspects; and (c) consolidation and ending in the context of chronic, deteriorating illness. The approach prioritizes direct work with the person with dementia, with the involvement of a "supportive other" where available and when necessary. The protocol is designed for use by therapists with prior experience in CBT.
Behavior modification, 2015 · doi:10.1177/0145445514561317