Guided self-help for generalized anxiety disorder in older adults

Abstract

Objective: The main objective of this study was to examine the efficacy of a guided self-help treatment based on cognitive behavioral principles (CBT-GSH) for generalized anxiety disorder (GAD) in older adults.

Methods: Three older adults aged from 66 to 70 and diagnosed with GAD were included in a single-case experimental multiple-baseline protocol. Data were collected using daily self-monitoring, standardized clinician ratings, and self-report questionnaires at pretest, posttest, and 6-month and 12-month follow-ups. Treatment consisted of awareness training, worry interventions, relaxation training, pleasant activities scheduling, and relapse prevention. Participants used a manual presenting weekly readings and at-home practice exercises. They also received weekly supportive phone calls from a therapist.

Results: At posttest, participants showed improvement on worries and GAD severity, on psychological process variables targeted by treatment (intolerance of uncertainty, negative problem orientation, cognitive avoidance, and perceived usefulness of worry), and on secondary variables associated with GAD (anxiety, depression, sleep difficulties, cognitive functioning, and disability). These results were generally maintained at 12 months after the end of treatment. Participants had favorable opinions toward the treatment.

Conclusion: The results of this study suggest that CBT-GSH is both feasible and effective for the treatment of GAD in older adults.

Keywords:

• generalized anxiety disorder
• guided self-help
• cognitive behavioral therapy
• older adults
• single-case design

Acknowledgements

This work was supported by the Fonds de recherche du Québec – Santé (FRQS): Theme Networks (Quebec Network for Research on Aging (Seniors' Mental Health Research Section)). Sebastien Grenier and Carol Hudon are each supported by a salary award from the FRQS (SG: Chercheur-boursier, Junior 1; CH: Chercheur-boursier, Senior). The authors thank the participants and the following people who worked on this project: Elizabeth Aubin, Malya Choinière, Claudie Bax-D'Auteuil, Caroline Dussault, Virginie Favre, Gabriel Grenier Melançon, and Isabelle René de Cotret of Université de Sherbrooke; Pierre-Hugues Carmichael of Centre de recherche du CHU de Québec; Alexandra Champagne, Elisabeth Beaunoyer, Caroline Camateros, and Roxanne Pilon of Université Laval.

Disclosure statement

No potential conflict of interest was reported by the authors.