Cbt Model

Established in the 1950s and 1960s, cognitive behavior therapy (CBT) has become a psychotherapy modality used to treat various psychiatric and medical illnesses. CBT is commonly used to treat anxiety disorders, posttraumatic stress disorder, eating disorders, personality disorders, and chronic pain. However, CBT was originally developed to treat depression (Corey, 2013). A chronic mental disorder, depression is diagnosed more in women than men with an elevated relapse rate and “an annual prevalence rate of 6.4%” (Feng et al., 2012). Over 700 research studies have provided evidence demonstrating CBT as an empirically validated treatment for geriatric depression especially when used in conjunction with other therapeutic approaches (Crowther,

Scogin, & Norton, 2010; Feng et al., 2012).
Theoretical Orientation
CBT is an umbrella term covering rational emotive behavior therapy, cognitive therapy, and cognitive behavior modification. Based off behavior therapy, the three main CBT approaches emphasize a joint relationship with the client and counselor. Maladaptive cognitions are understood to underlie psychological stress and therapy focuses on changing behavior and emotions by changing cognitions. Treatment is time limited, concentrated on present, specific problem behaviors, and features a large educational component. The therapist uses the direction approach and interventions such as homework after therapy sessions, having the client become active in the therapy process, forming a strong therapeutic relationship, and using multiple cognitive and behavioral techniques to generate change (Corey, 2013).
Rational Emotive Behavior Therapy
Developed by Albert Ellis, rational emotive behavior therapy (REBT) was one of the first major cognitive-behavior interventions created.

REBT assumes psychological difficulties are due to the beliefs individual’s have. REBT treatment utilizes the ABC framework. In this model, an individual’s belief about a situation creates a consequence. An intervention such as cognitive restructuring produces an effect, challenging previously held, irrational beliefs (Corey, 2013). Treatment methods include belief challenging, homework, bibliotherapy, altering language patterns, psychoeducation, the use of humor, role playing, rational emotive imagery, shame-attacking exercises, operant conditioning, self-management, systematic desensitization, relaxation techniques, and modeling (Corey,

2013).
Cognitive Therapy
Aaron Beck and his daughter, Judith Beck, both contributed to the development of cognitive therapy.

Similar to REBT, cognitive therapists believe psychological issues are rooted in faulty cognition processes, assumptions inferred from erroneous information, and an inability to differentiate fantasy from reality (Corey, 2013). Psychoeducation plays a large role in changing faulty cognitions and beliefs and consists of educating the client on the connection between cognition, feelings, and behavior. Other techniques incorporated into cognitive therapy include automatic thought monitoring, automatic thought challenging, and replacing inaccurate beliefs with correct cognitions (Corey, 2013).

Cognitive Behavior Modification

Donald Meichenbaum combined behavior and cognitive therapy to create cognitive behavior modification. Behavior change occurs across three phases: self-observation, internal dialogue, and new skill development. The client begins to monitor their behavior, thoughts, and feelings after which they notice their behavior and seek ways in which to change. The therapist educates the client and helps them learn to new skills and better coping mechanisms (Corey, 2013).

Geriatric

Depression
Major depression disorder (MDD) prevalence rates range from 3-15% (Crowther et al., 2010; Gould, Coulson, & Howard, 2012). As an individual increases in age, depression symptom incidence increases especially among rural geriatric populations (Crowther et al., 2010; Lichstein et al., 2013). Incidence rates are expected to increase as the baby boomer population grows older, expanding the current geriatric population. Soon geriatric individuals will represent 20% of the population (Crowther et al., 2010). Comorbidity with other diseases such as Alzheimer’s disease, diabetes mellitus, stroke aggravates depression course and quality of life. Geriatric clients with depression are often widowed and have poor education and health (Crowther et al., 2010). Among cardiovascular diseases, depression can lead to elevated morbidity and mortality during and after recovery from a myocardial infarction (Strachowski et al., 2008). Levels of neglect, suicide, and functioning also decrease as a result (Gould et al., 2012).