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Behav Modif. 2015 May;39(3):390-412. doi: 10.1177/0145445514561317. Epub 2014 Dec 16.

Cognitive behavior therapy for anxiety in people with dementia: a clinician guideline for a person-centered approach.

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University College London, UK North East London NHS Foundation Trust, UK
South Essex Partnership Foundation Trust, UK.
North East London NHS Foundation Trust, UK.
University College London, UK.


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.


CBT; anxiety; cognitive-behavioral therapy; dementia; manual

[Indexed for MEDLINE]

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