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Older Adults and Depression

What are Evidence-Based Practices (EBPs) for Depression in Older Adults?

1. Effective treatments can reduce the severity of depression in up to 80 percent of older adults.

A. True

B. False


2. Cognitive behavioral therapy (CBT) is designed to change ___________ that cause or maintain depression.

A. Brain waves

B. Thought patterns

C. Behaviors

D. All of the above.

E. B and C above


3. According to this paper, which of the following is not an EBP for treatment of depression in older adults? 

A. Psychotherapy interventions

B. Physical exercise therapy

C. Antidepressant medications

D. Multidisciplinary geriatric mental health outreach services

E. Collaborative and integrated mental and physical health care


4. In spite of the name, EBPs aren't always based on solid scientific research as long as they produce good outcomes.

A. True

B. False


5. A "randomized controlled trial" is the gold standard for assessing the effectiveness of an intervention.

A. True

B. False


6. Randomized controlled trials are the best form of evidence for the effectiveness of an intervention because:

A. People are randomly selected in these kinds of experiments.

B. Outcomes are less likely to be subject to “selection bias”.

C. They are less often subject to manipulation by the researchers.


7. Both psychotherapy interventions and antidepressant medications are specific clinical interventions.

A. True

B. False


8. "Multidisciplinary geriatric mental health outreach services" can incorporate psychotherapy and antidepressant medications.

A. True

B. False


9. Some "Promising Practices" can be effective for older adults with depression, but...

A. They are not usually promising enough.

B. The level of evidence is not as high for EBPs.

C. They often promise more than they deliver.


Psychotherapy Interventions

10. Psychotherapy interventions described in this paper were chosen because they meet the American Psychological Association’s criteria for evidence-based psychotherapy for older adults.

A. True

B. False


11. Which of the following is not one of the 6 evidence based psychotherapies discussed in this paper?

A. Cognitive behavioral therapy

B. Behavioral therapy

C. Biofeedback therapy

D. Reminiscence therapy

E. Interpersonal Therapy


12. Cognitive Behavioral Therapy (CBT) is based on the theory that depression is caused and supported by a combination of:

A. Hopelessness

B. A pessimistic world view

C. A belief that one cannot have influence on day to day events

D. All of the above


13. Studies have shown that CBT alone and CBT in combination with antidepressant medication are more effective than an antidepressant alone.

A. True

B. False


14. CBT is a billable treatment that is covered by all mental health plans and public insurance.

A. True

B. False


15. Behavioral Therapy (BT) for depression in older adults addresses how behaviors affect:

A. Reasoning

B. Actions

C. Mood


16. According to this paper, which of the following is not something the practitioner teaches older adults to do in BT sessions?

A. Monitor their mood record pleasant and unpleasant events.

B. Notice connections between pleasant/unpleasant events and pleasant/unpleasant moods.

C. Party more.

D. Participate in more pleasant events.


17. Research has shown that BT is effective in reducing depression symptoms, improving the older adult's coping strategies, and also improving the older adult’s sex life.

A. True

B. False


18. Mental heath practitioners wanting to provide BT need training and supervision to ensure fidelity to the model.

A. True

B. False


19. Problem Solving Treatment (PST) uses math and logic problems to help older adults overcome feelings depression.

A. True

B. False


20. PST is based on the idea that deficiencies in social problem-solving skills increase the risk for symptoms of depression

A. True

B. False


21. This paper identifies 7 concrete steps to PST. Which of the following is not one of them?

A. Clarify and define the problem

B. Set a realistic goal

C. Ask for help if needed

D. Generate multiple solutions

E. Evaluate and compare solutions,


22. One study found that PST delivered in the primary care setting is not different than:

A. An antidepressant medication

B. A placebo

C. Cognitive behavioral therapy

D. A and C above

E. A and B above


23. The based on research, PST is most effective when delivered through collaborative care systems in the primary care setting (sometimes called PST-PC).

A. True

B. False


24. Interpersonal Psychotherapy (IPT) seeks to address symptoms of depression associated with interpersonal problems, including:

A. Grief following the loss of a loved one

B. Disputes with others

C. Difficulty adapting to a major life change

D. Poor social skills

E. All of the above


25. IPT focuses on four areas. One of these is unresolved grief. Which of the following is not something the IPT practitioner does to help the older adult?

A. Facilitate mourning

B. Help the older adult find new activities and relationships to compensate for the loss

C. Help the older adult find groups to join to compensate for the loss

D. Help the older adult overcome poor social skills


26. IPT used in conjunction with medication provides the greatest prevention of future depression episodes.

A. True

B. False


27. Which of the following statements is true of Reminiscence Therapy (RT)?

A. It involves the discussion of past activities, events and experiences with another person or group of people.

B. It uses hypnotherapy to help older adults remember their lives.

C. It is based on the idea that when an older adult remembers their past they mostly remember good things.


28. Structured RT is typically provided by giving older adults with depression a recording device and instructing them to talk about their lives for posterity.

A. True

B. False


29. Which of the following statements is not true of reminiscence therapy?

A. Reminiscence approaches can be used during the assessment process to bolster older adults’ confidence and self-esteem.

B. Reminiscence therapy is typically provided in a group setting.

C. Practitioners can use reminiscence materials to develop therapeutic resource states that facilitate change.

D. Reminiscence therapy is used primarily to help the older adult with depression recall happier times.


30. Cognitive Bibliotherapy (CB) is effective for treating mild or moderate levels of depression in older adults.

A. True

B. False


31. Which of the following statements is not true of CB?

A. CB involves reading books and completing written exercises

B. CB participants read and do written exercises in order to learn about depression and ways to reduce its symptoms

C. CB participants read and write about whatever makes them feel better.

D. CB reading materials and exercises are often completed at participants' homes and at their own pace.


32. The book Feeling Good, by David Burns, was read by older adults in all studies of cognitive bibliotherapy published to date.

A. True

B. False


33. Practitioners who recommend CB should consider the older adult’s:

A. Reading ability

B. Visual acuity

C. Concentration

D. Motivation to engage in a self-help program

E. All of the above


Antidepressant Medications

34. Research has shown that for older adults, the combination of psychotherapy and antidepressant medications is always more effective than antidepressant medication alone.

A. True

B. False


35. Medication treatment may be the most appropriate treatment for:

A. Older adults who have depression with psychotic symptoms

B. Older adults with severe depression that has responded to antidepressant medications in the past

C. Older adults with severe depression that does not respond to psychotherapy

D. A and B above.

E. A, B and C above.


36. Prescribing antidepressant medication may be better than psychotherapy for older adults with depression because:

A. There may be transportation challenges associated with attending therapy sessions

B. The older adult may face issues with physical mobility

C. Some older adults with depression may also suffer impaired cognition

D. All of the above


37. Classes of antidepressant medication prescribed for symptoms of depression in older adults do not include:

A. SSRIs

B. PCBs

C. TCAs

D. MAOIs

E. Other non-SSRIs


38. As people age, changes in body fat distribution and other physical characteristics change the way that they metabolize or break down medications, including antidepressants.

A. True

B. False


39. Interactions between antidepressant and other medications are not an important consideration when prescribing for older adults with depression.

A. True

B. False


Multidisciplinary Geriatric Mental Health Outreach Services

40. Multidisciplinary geriatric mental health outreach programs provide treatment in the homes of older adults or in places where older adults spend time rather than in clinics.

A. True

B. False


41. Multidisciplinary services do not usually involve which of the following?

A. Psychiatrists

B. Psychologists

C. Pharmacists

D. Social workers

E. Nurses


42. Multidisciplinary outreach programs can increase access to mental health services for older adults with mental disorders, nearly half of whom fail to get treatment otherwise.

A. True

B. False


Psychogeriatric Assessment and Treatment in City Housing

43. Psychogeriatric Assessment and Treatment in City Housing (PATCH) is an outreach program in the city of Baltimore, MD.

A. True

B. False


44. The PATCH model uses building managers, janitors, and tenant services personnel to identify at risk older residents of public housing.

A. True

B. False


45. PATCH services are provided by a team that includes:

A. A psychiatrist

B. A nurse

C. A case manager

D. A and C above

E. A, B and C above


Prevention of Suicide in Primary Care Elderly: Collaborative Trial (PROSPECT)

46. Prevention of Suicide in Primary Care Elderly: Collaborative Trial (PROSPECT) is primarily a suicide watch program for older adults.

A. True

B. False


47. PROSPECT integrates mental health services into the primary care setting specifically to:

A. Reduce depression and thoughts of suicide among older adults.

B. Prevent suicide among older primary care patients.

C. Combine the value of primary care and mental health to reduce costs for older adults.

D. A and B above.


Other Models of Collaborative and Integrated Mental and Physical Health Care

48. All of the studies in this paper except one compare collaborative and integrated care to typical primary care for older adults with depression.

A. True

B. False


49. In the one study comparing collaborative and integrated care to an enhanced referral model, older adults were more likely to engage in treatment with the integrated model.

A. True

B. False


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