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Adapting manualized Behavioural Activation treatment for older adults with depression

Published online by Cambridge University Press:  20 May 2014

Madeline Pasterfield
Department of Psychology, University of Sheffield, Sheffield, UK
Della Bailey
Department of Health Sciences, University of York, York, UK
Deborah Hems
Department of Health Sciences, University of York, York, UK
Dean McMillan*
Department of Health Sciences, University of York, and the Hull York Medical School, York, UK
David Richards
University of Exeter Medical School, Exeter, UK
Simon Gilbody
Department of Health Sciences, University of York, and the Hull York Medical School, York, UK
*Author for correspondence: Dr D. McMillan, Department of Health Sciences, University of York, and the Hull York Medical School, York, UK (email:


There is growing evidence that Behavioural Activation is an effective treatment for older adults with depression. However, there is a lack of detail given in studies about any adaptations made to interventions or efforts made to remove treatment barriers. Factors such as co-morbid physical health problems, cognitive impairment and problems with social support suggest there may be specific treatment considerations when developing interventions for this group. This article aims to describe adaptations made to a general adult Behavioural Activation manual using literature on treatment factors for older adults as an organizational framework. This information may be of use to mental health workers delivering behavioural interventions to older adults with depression and documents the initial phase of developing a complex intervention.

Service models and forms of delivery
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2014 

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