The Efficacy of Individual Psychological Interventions With Non-Clinical Older Adults
A Systematic Review
Abstract
Abstract. A number of reviews and meta-analyses have consistently documented the positive effect of individual psychological intervention with clinical older adults suffering from late-life depression, anxiety disorders, or other mental illnesses. However, many older adults without clinical disorders might seek and benefit from individual psychological interventions too. Given the aging populations across the globe, knowing the potential efficacy of individual psychological interventions with non-clinical older adults therefore is important. However, the research on this topic has not been reviewed systematically. This was the primary aim of the present review. Secondarily, we wanted to find out how many of these studies were conducted in a European context. A systematic literature search identified nine eligible studies yielding an aggregated sample size of 983. Two of these were European. Eight of the nine studies (including one European) reported significant positive effects of individual psychological interventions, that is, increases in psychological well-being and decreases in depression symptoms and distress. Effect sizes were extracted or calculated when possible to estimate the magnitude of the intervention effects. These effect sizes varied across studies and ranged from trivial in size to large and even very large, the median being a medium effect size. The results from the present review suggest that non-clinical older adults benefit from individual psychological interventions. However, the limited number of studies available for review precludes conclusions regarding the comparative efficacy of different types of psychological interventions in this population. Directions for future research are discussed.
References References marked with an asterisk (*) indicate studies included in the review.
1969). Analysis of a life satisfaction index. Journal of Gerontology, 24, 470–474. https://doi.org/10.1093/geronj/24.4.470
(2006). Common themes and issues in geriatric psychotherapy. Psychiatry (Egdmont), 2, 53–56.
(1966). Target complaints as criteria of improvement. American Journal of Psychotherapy, 20, 184–192. https://doi.org/10.1176/appi.psychotherapy.1966.20.1.184
(1996). Beck Depression Inventory-II manual. San Antonio, TX: Psychological Corporation.
(1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561–571. https://doi.org/10.1001/archpsyc.1961.01710120031004
(1974). The measurement of pessimism: The Hopelessness Scale. Journal of Consulting and Clinical Psychology, 42, 861–865. https://doi.org/10.1037/h0037562
(1969). Structure of psychological well being. Chicago, IL: Aldine Publishing.
(2008). The Patient Dignity Inventory: A novel way of measuring dignity-related distress in palliative care. Journal of Pain and Symptom Management, 36, 559–571. https://doi.org/10.1016/j.jpainsymman.2007.12.018
(1977). Statistical power analysis for the behavioral sciences (revised ed.). Cambridge, MA: Academic Press.
(1995). The McGill Quality of Life Questionnaire: a measure of quality of life appropriate for people with advanced disease. A preliminary study of validity and acceptability. Palliative Medicine, 9, 207–219. https://doi.org/10.1177/026921639500900306
(2017). Four decades of outcome research on psychotherapies for adult depression: An overview of a series of meta-analyses. Canadian Psychology, 58, 7–19. https://doi.org/10.1037/cap0000096
(2018). Who benefits from psychotherapies for adult depression? A meta-analytic update of the evidence. Cognitive Behaviour Therapy, 47, 91–106. https://doi.org/10.1080/16506073.2017.1420098
(1982). The Brief Symptom Inventory (BSI): Administration, scoring and procedures manual. Baltimore, MD: Clinical Psychometric Research.
(2000). The Enright Forgiveness Inventory user manual. Madison, WI: International Forgiveness Institute.
(2017). EFPA statement on psychologists practicing psychotherapy July 2017. Retrieved from http://www.efpa.eu/professional-development/2017-efpa-statement-on-psychologists-practicing-psychotherapy-(july-2017)
. (2009). Berlin Declaration on the Quality of Life for Older Adults: Closing the gap between scientific knowledge and intervention. Zeitschrift fur Gerontologie und Geriatrie, 42, 163–164. https://doi.org/10.1007/s00391-009-0033-9
(1992).
(Use of the Quality of Life Inventory in problem assessment and treatment planning for cognitive therapy of depression . In A. FreemanF. M. DattilioEds., Comprehensive casebook of cognitive therapy (pp. 27–52). New York, NY: Plenum.2012). Interventions for generalized anxiety disorder in older adults: Systematic review and meta-analysis. Journal of Anxiety Disorders, 26, 1–11. https://doi.org/10.1016/j.janxdis.2011.08.010
(1987). Quality of life and persons with melanoma: Preliminary model testing. Cancer Nursing, 10, 338–346. https://doi.org/10.1097/00002820-198712000-00006
(*1992). Examining Key Variables in Selected Reminiscing Modalities. International Psychogeriatrics, 4, 279–290. https://doi.org/10.1017/S1041610292001315
(*2012). Feasibility, acceptability and potential effectiveness of Dignity Therapy for older people in care homes: A phase II randomized controlled trial of a brief palliative care psychotherapy. Palliative medicine, 26, 703–712. https://doi.org/10.1177/0269216311418145
(1960). A rating scale for depression. Journal of Neurology, Neurosurgery, and Psychiatry, 23, 56–62. https://doi.org/10.1136/jnnp.23.1.56
(*2009). A palliative care intervention in forgiveness therapy for elderly terminally ill cancer patients. Journal of Palliative Care, 25, 51–60.
(1990). Fostering hope in terminally-ill people. Journal of Advanced Nursing, 15, 1250–1259. https://doi.org/10.1111/j.1365-2648.1990.tb01740.x
(2015). A systematic review and meta-analysis of psychotherapy for late-life depression. American Journal of Geriatric Psychiatry, 23, 261–273. https://doi.org/10.1016/j.jagp.2014.04.003
(*2000). Home-delivered mental health services for aged rural home health care recipients. Journal of Applied Gerontology, 19, 460–475. https://doi.org/10.1177/073346480001900406
(2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16, 606–613. https://doi.org/10.1046/j.1525-1497.2001.016009606.x
(*2010). Brief problem-solving treatment in primary care (PST-PC) was not more effective than placebo for elderly patients screened positive of psychological problems. International Journal of Geriatric Psychiatry, 25, 968–980. https://doi.org/10.1002/gps.2435
(2020). Psychotherapy improves the well-being of elderly Danish care recipients. GeroPsych, 1–10. https://doi.org/10.1024/1662-9647/a000223
(1987). The emergence of the third age. Ageing and Society, 7, 133–160. https://doi.org/10.1017/S0144686X00012538
(2010). Is depression viewed as an inevitable consequence of age? The “understandability phenomenon” in older people. Clinical Gerontologist, 33, 194–209. https://doi.org/10.1080/07317111003773627
(2009). The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: Explanation and elaboration. Journal of Clinical Epidemiology, 62, e1–e34. https://doi.org/10.1016/j.jclinepi.2009.06.006
(*2009). Combining acceptance and commitment therapy and cognitive behavioral therapy for the treatment of chronic pain in older adults. Clinical Case Studies, 8, 296–308. https://doi.org/10.1177/1534650109337527
(1990).
(An eclectic definition of psychotherapy . In J. K. ZeigW. M. MunionEds., What is psychotherapy? Contemporary perspectives (pp. 218–220). San Francisco, CA: Jossey-Bass.2017). An existential perspective on death anxiety, retirement, and related research problems. Canadian Journal on Aging/Revue Canadienne Du Vieillissement, 36, 246–255. https://doi.org/10.1017/s0714980816000465
(1977). The CES-D Scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401. https://doi.org/10.1177/014662167700100306
(1965). Society and adolescent self-image. Princeton, NJ: Princeton University Press.
(*2011). Improving function in age-related macular degeneration: Design and methods of a randomized clinical trial. Contemporary Clinical Trials, 32, 196–203. https://doi.org/10.1016/j.cct.2010.10.008
(*2007). Improving quality of life in diverse rural older adults: A randomized trial of a psychological treatment. Psychology and Aging, 22, 657–665. https://doi.org/10.1037/0882-7974.22.4.657
(1986).
(Geriatric Depression Scale (GDS): Recent evidence and development of a shorter version . In T. L. BrinkEd., Clinical gerontology: A guide to assessment and intervention (pp. 165–173). New York, NY: The Haworth Press.2015). Depression and quality of life in older persons: A review. Dementia and geriatric cognitive disorders, 40, 311–339. https://doi.org/10.1159/000437299
(1996). State-Trait Anger Expression Inventory: Professional manual, research edition. Odessa, FL: Psychological Assessment Resources.
(*2004). Transmissive reminiscence therapy with college students and institutionalized senior adults. Journal of Intergenerational Relationships, 1, 35–52. https://doi.org/10.1300/J194v01n04_04
(1990). EuroQol – a new facility for the measurement of health-related quality of life. Health Policy, 16, 199–208. https://doi.org/10.1016/0168-8510(90)90421-9
. (2002). The Madrid international plan of action on ageing. Retrieved from https://www.un.org/development/desa/ageing/madrid-plan-of-action-and-its-implementation.html
. (2017). World Population Ageing 2017 Report. Retrieved from http://www.un.org/en/development/desa/population/theme/ageing/WPA2017.shtml
. (2019). A meta-analysis of the effect of therapist experience on outcomes for clients with internalizing disorders. Psychotherapy Research, 29(7), 846–859. https://doi.org/10.1080/10503307.2018.1469802
(1993). SF-36 Health Survey Manual and Interpretation Guide. Boston, MA: The Health Institute, New England Medical Center.
(2015). World report on ageing and health. Retrieved from https://www.who.int/ageing/events/world-report-2015-launch/en/
. (2017). Depression and other common mental disorders: Global health estimates. Retrieved from https://www.who.int/mental_health/management/depression/prevalence_global_health_estimates/en/
. (1982). Development and validation of a geriatric depression screening scale: A preliminary report. Journal of Psychiatric Research, 17, 37–49. https://doi.org/10.1016/0022-3956(82)90033-4
(1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67, 361–370. https://doi.org/10.1111/j.1600-0447.1983.tb09716.x
(1965). A Self-Rating Depression Scale. Archives of General Psychiatry, 12, 63–70. https://doi.org/10.1001/archpsyc.1965.01720310065008
(