title: Cognitive behavior therapy for anxiety in people with dementia: a clinician guideline for a person-centered approach.
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.
authors.affiliation: University College London, UK North East London NHS Foundation Trust, UK g.charlesworth@ucl.ac.uk.
authors.forename: Georgina
authors.initials: G
authors.lastname: Charlesworth
authors.affiliation: South Essex Partnership Foundation Trust, UK.
authors.forename: Susan
authors.initials: S
authors.lastname: Sadek
authors.affiliation: North East London NHS Foundation Trust, UK.
authors.forename: Astrid
authors.initials: A
authors.lastname: Schepers
authors.affiliation: University College London, UK.
authors.forename: Aimee
authors.initials: A
authors.lastname: Spector
mesh_terms: D001007:Anxiety / Q000523:psychology / Q000628:therapy*; D001008:Anxiety Disorders / Q000523:psychology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003704:Dementia / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008875:Middle Aged; D020377:Self Efficacy
keywords: CBT; anxiety; cognitive-behavioral therapy; dementia; manual