GeroCentral

GeroCentral

Primary Care

Most adults who receive mental health services are treated in primary care, such that “primary care and general medical practices have long been considered the de facto or hidden mental health and addiction service system in the United States” (Speer & Schneider, 2003, p.86). Older adults prefer to receive mental health services in primary care, (Areán & Gum, 2013), yet evidence has shown that primary care providers fail to detect approximately 50% mental health problems of their older patients. Further, primary care provides suboptimal treatment and referral for those with known problems, possibly due to myriad barriers including stigma, ageism, medical comorbidity, misattribution of symptoms to physical illness, limited time and reimbursement incentives to address psychosocial issues, and lack of access to qualified providers (Sirey, Bruce, & Kales, 2010; Speer & Schneider, 2003; Wang et al 2005). The confluence of patient, provider, and systemic barriers to services likely disproportionately impacts minority older adults who may be least likely to venture out of a primary care setting to seek mental health treatment (Areán, et al., 2005).

Increased recognition of the critical role of primary care in mental health service delivery has led to the development and testing of models for collaborative treatment, in which mental health providers are integrated into the primary care setting. Models of integrated care share a core structure in which multiple disciplines actively collaborate in activities of evaluating, planning, and delivering coordinated mental health care to the patient and family (APA, 2008). Elements of such models typically include “provider education, patient activation, systematic treatment monitoring, mobilization of community resources and ready access to mental health services within the target system of care” (Areán, et al., 2005, p. 382).

Several randomized multisite studies (e.g. PROSPECT, PRISM-E, RESPECT-D, IMPACT) which aimed to improve detection and treatment of depressed older adults in primary care have conclusively demonstrated that collaborative care models are more effective than treatment-as-usual in improving treatment engagement, improving the course of depression, and reducing symptoms, suicidal ideation and overall functional impairment (Areán & Gum, 2013; Bruce et al 2004; Unutzer et al, 2002; Bartels et al, 2004; Oxman, Dietrich, & Schulberg, 2003). Psychotherapeutic treatments developed for older adults in primary care (e.g. IPT-PC; PST-PC) have demonstrated effectiveness when delivered as part of an interdisciplinary collaborative care model (Areán et al, 2005; Areán et al, 2008; Skultety & Zeiss, 2006).

Integrated care models have drawn on existing and newly developed assessment methods to detect and monitor psychological problems in primary care patients. Many standardized psychological measures developed for adults (Center for Epidemiological Studies-Depression Scale, CES-D; Beck Depression Inventory-II, BDI-II) and for older adults (Geriatric Depression Scale, GDS), as well as newer measures developed for primary care (Patient Health Questionnaire-9 item, PHQ-9; and the PHQ-4, which detects both depression and anxiety) have been employed to improve detection of depressed older adults (Areán & Ayalon, 2005). More recently, measures such as the Geriatric Anxiety Inventory (Pachana et al, 2007) and the Geriatric Anxiety Scale (Edelstein & Segal, 2011) have been developed to detect manifestations of anxiety disorders in older adults. A set of brief measures (The Alcohol Use Disorders Identification Test, AUDIT-C and CAGE test) including one developed for geriatric populations (Michigan Alcohol Screening Test – Geriatric, MAST-G) have been proposed to screen for alcohol use problems in primary care settings. As part of its “Foundations of Integrated Care” website, the Veteran’s Administration has developed a training program which includes instruction on screening for mental disorders including depression, anxiety, and alcohol misuse in primary care settings. The SAMHSA Center for Integrated Health Solutions also provides a toolkit of measures useful for primary care screening for depression, bipolar disorder, anxiety, substance abuse, suicide risk and trauma. However, there are sparse data regarding the psychometric properties of many of these screening tools for older adults, or their utility across varied demographic and clinical populations.

Instructional modules and measures that are in the public domain and available online:

Psychologists may have direct roles on integrated healthcare teams providing services to older adults in primary care, including evaluation, psychotherapeutic treatment, and mobilizing of community resources, as well as indirect roles including supervising care, promoting interdisciplinary collaboration, and research and program evaluation (APA, 2008). Practice in primary care requires competencies which draw on and extend psychologists’ foundational knowledge and skills (APA, 2013). Competencies for Psychology Practice in Primary Care were developed by the Interorganizational Work Group on Competencies for Primary Care Psychology Practice. The APA Committee on Aging (CONA) is also currently working to examine linkages between primary care and geropsychology competencies to enhance care for older adults in primary care. The full implementation of the collaborative care model, in which psychologists and interdisciplinary team members all play vital roles, holds great promise for improving the detection and treatment of mental health problems in primary care, and thereby improving the quality of life of older adults (Areán & Gum, 2013; Zeiss & Karlin, 2008).

Written by Richard A. Zweig, PhD, Ferkauf Graduate School of Yeshiva University

 

GENERAL

Areán, P. A., & Gum, A. M. (2013). Psychologists at the table in health care reform: The case of geropsychology and integrated care. Professional Psychology: Research & Practice, 44(3), 142-149. doi: 10.1037/a0031083

Areán, P. A., & Gum, A. M. (2013). Psychologists at the table in health care reform: The case of geropsychology and integrated care. Professional Psychology: Research & Practice, 44(3), 142-149. doi: 10.1037/a0031083

Posted in reference | Tagged , | Comments Off on Areán, P. A., & Gum, A. M. (2013). Psychologists at the table in health care reform: The case of geropsychology and integrated care. Professional Psychology: Research & Practice, 44(3), 142-149. doi: 10.1037/a0031083

Haley, W. E. (2005). Clinical Geropsychology and Primary Care: Progress and Prospects. Clinical Psychology: Science and Practice, 12: 336–338. doi: 10.1093/clipsy.bpi040

Haley, W. E. (2005). Clinical Geropsychology and Primary Care: Progress and Prospects. Clinical Psychology: Science and Practice, 12: 336–338. doi: 10.1093/clipsy.bpi040

Posted in reference | Tagged , | Comments Off on Haley, W. E. (2005). Clinical Geropsychology and Primary Care: Progress and Prospects. Clinical Psychology: Science and Practice, 12: 336–338. doi: 10.1093/clipsy.bpi040

Ziess, A., & Karlin, B. (2008). Integrating Mental Health and Primary Care Services in the Department of Veterans Affairs Health Care System. Journal of Clinical Psychology in Mental Health Settings, 15, 73-78.

Ziess, A., & Karlin, B. (2008). Integrating Mental Health and Primary Care Services in the Department of Veterans Affairs Health Care System.  Journal of Clinical Psychology in Mental Health Settings, 15, 73-78.

Posted in Uncategorized | Tagged , , | Comments Off on Ziess, A., & Karlin, B. (2008). Integrating Mental Health and Primary Care Services in the Department of Veterans Affairs Health Care System. Journal of Clinical Psychology in Mental Health Settings, 15, 73-78.

Liu, C. F., Cedrick, S. C., Chaney, E. F., Heagerty, P., Felker, B., Hasenberg, N., et al. (2003). Cost effectiveness of collaborative care for depression in a primary care veteran population. Psychiatric Services, 54, 698–704.

Liu, C. F., Cedrick, S. C., Chaney, E. F., Heagerty, P., Felker, B., Hasenberg, N., et al. (2003). Cost effectiveness of collaborative care for depression in a primary care veteran population. Psychiatric Services, 54, 698–704.

Posted in Uncategorized | Tagged , , , | Comments Off on Liu, C. F., Cedrick, S. C., Chaney, E. F., Heagerty, P., Felker, B., Hasenberg, N., et al. (2003). Cost effectiveness of collaborative care for depression in a primary care veteran population. Psychiatric Services, 54, 698–704.

Callahan, C.M., Hui, S.L., Nienaber, N.A., Musick, B.S., & Tierney, W.M. (1994). Longitudinal study of depression and health services use among elderly primary care patients. Journal of the American Geriatrics Society, 42(8), 833-8.

Callahan, C.M., Hui, S.L., Nienaber, N.A., Musick, B.S., & Tierney, W.M. (1994).  Longitudinal study of depression and health services use among elderly primary care patients. Journal of the American Geriatrics Society, 42(8), 833-8.

Posted in Uncategorized | Tagged , , | Comments Off on Callahan, C.M., Hui, S.L., Nienaber, N.A., Musick, B.S., & Tierney, W.M. (1994). Longitudinal study of depression and health services use among elderly primary care patients. Journal of the American Geriatrics Society, 42(8), 833-8.

American Psychological Association. (1998). Interprofessional health care services in primary care settings: Implications for the education and training of psychologists. Available online.

American Psychological Association. (1998). Interprofessional health care services in primary care settings: Implications for the education and training of psychologists.  Available here.

Posted in Uncategorized | Tagged , , , | Comments Off on American Psychological Association. (1998). Interprofessional health care services in primary care settings: Implications for the education and training of psychologists. Available online.

American Psychological Association Interorganizational Work Group on Competencies for Primary Care Psychology Practice (2013). Competencies for Psychology Practice in Primary Care

American Psychological Association Interorganizational Work Group on Competencies for Primary Care Psychology Practice (2013).  Competencies for Psychology Practice in Primary Care

Posted in Uncategorized | Tagged , | Comments Off on American Psychological Association Interorganizational Work Group on Competencies for Primary Care Psychology Practice (2013). Competencies for Psychology Practice in Primary Care

Sherrod, T.P., Quinlan-Colwell, A., Lattimore, T., Shattell, M., & Kennedy-Malone, L. (2010). Older adults with bipolar disorder: Guidelines for primary care providers. Journal of Gerontological Nursing , 36(5), 20-29.

Sherrod, T.P., Quinlan-Colwell, A., Lattimore, T., Shattell, M., & Kennedy-Malone, L. (2010). Older adults with bipolar disorder: Guidelines for primary care providers. Journal of Gerontological Nursing , 36(5), 20-29.  Article online.

Posted in reference | Tagged , , | Comments Off on Sherrod, T.P., Quinlan-Colwell, A., Lattimore, T., Shattell, M., & Kennedy-Malone, L. (2010). Older adults with bipolar disorder: Guidelines for primary care providers. Journal of Gerontological Nursing , 36(5), 20-29.

American Psychological Association Presidential Task Force on Integrated Health Care for an Aging Population. (2008). Blueprint for change: Achieving integrated health care for an aging population. Washington DC: American Psychological Association. http://www.apa.org/pi/aging/programs/integrated/integrated-healthcare-report.pdf

American Psychological Association Presidential Task Force on Integrated Health Care for an Aging Population. (2008). Blueprint for change: Achieving integrated health care for an aging population. Washington DC: American Psychological Association. http://www.apa.org/pi/aging/programs/integrated/integrated-healthcare-report.pdf

Posted in reference | Tagged , , , , , , | Comments Off on American Psychological Association Presidential Task Force on Integrated Health Care for an Aging Population. (2008). Blueprint for change: Achieving integrated health care for an aging population. Washington DC: American Psychological Association. http://www.apa.org/pi/aging/programs/integrated/integrated-healthcare-report.pdf

 

ASSESSMENT

Edelstein, B. A., & Segal, D. L. (2011). Assessment of emotional and personality disorders in older adults. In K. Warner Schaie & S. L. Willis (Eds.), Handbook of the psychology of aging (7th ed, pp. 325-337). London: Academic Press. doi: 10.1016/B978-0-12-380882-0.00021-8

Edelstein, B. A., & Segal, D. L. (2011). Assessment of emotional and personality disorders in older adults. In K. Warner Schaie & S. L. Willis (Eds.), Handbook of the psychology of aging (7th ed, pp. 325-337). London: Academic Press. doi: 10.1016/B978-0-12-380882-0.00021-8

Posted in reference | Tagged , | Comments Off on Edelstein, B. A., & Segal, D. L. (2011). Assessment of emotional and personality disorders in older adults. In K. Warner Schaie & S. L. Willis (Eds.), Handbook of the psychology of aging (7th ed, pp. 325-337). London: Academic Press. doi: 10.1016/B978-0-12-380882-0.00021-8

Areán, P.A. & Ayalon, L. (2005). Assessment and treatment of depressed older adults in primary care. Clinical Psychology: Science and Practice, 12 (3), 321-335.

Areán, P.A. & Ayalon, L. (2005). Assessment and treatment of depressed older adults in primary care.  Clinical Psychology: Science and Practice, 12 (3), 321-335.

Posted in reference | Tagged , , | Comments Off on Areán, P.A. & Ayalon, L. (2005). Assessment and treatment of depressed older adults in primary care. Clinical Psychology: Science and Practice, 12 (3), 321-335.

 

TREATMENT

Zeiss, A. M., & Karlin, B.E. (2008). Integrating mental health and primary care services in the Department of Veterans Affairs health care system. Journal of Clinical Psychology in Medical Settings, 15(1), 73-78. doi:10.1007/s10880-008-9100-4

Zeiss, A. M., & Karlin, B.E. (2008). Integrating mental health and primary care services in the Department of Veterans Affairs health care system. Journal of Clinical Psychology in Medical Settings, 15(1), 73-78. doi:10.1007/s10880-008-9100-4

Posted in reference | Tagged , | Comments Off on Zeiss, A. M., & Karlin, B.E. (2008). Integrating mental health and primary care services in the Department of Veterans Affairs health care system. Journal of Clinical Psychology in Medical Settings, 15(1), 73-78. doi:10.1007/s10880-008-9100-4

Unutzer, J., Katon, W., Callahan, C. M., Williams, J. W., Hunkeler, E., Harpole, L., et al. (2002). Collaborative care management of late-life depression in the primary care setting: A randomized controlled trial. Journal of the American Medical Association, 288, 2836–2845.

Unutzer, J., Katon, W., Callahan, C. M., Williams, J. W., Hunkeler, E., Harpole, L., et al. (2002). Collaborative care management of late-life depression in the primary care setting: A randomized controlled trial. Journal of the American Medical Association, 288, 2836–2845.

Posted in reference | Tagged , | Comments Off on Unutzer, J., Katon, W., Callahan, C. M., Williams, J. W., Hunkeler, E., Harpole, L., et al. (2002). Collaborative care management of late-life depression in the primary care setting: A randomized controlled trial. Journal of the American Medical Association, 288, 2836–2845.

Skultety, K. M., & Zeiss, A. (2006). The treatment of depression in older adults in the primary care setting: An evidence-based review. Health Psychology, 25(6), 665-674. doi:10.1037/0278-6133.25.6.665

Skultety, K. M., & Zeiss, A. (2006). The treatment of depression in older adults in the primary care setting: An evidence-based review. Health Psychology, 25(6), 665-674. doi:10.1037/0278-6133.25.6.665

Posted in reference | Tagged , , | Comments Off on Skultety, K. M., & Zeiss, A. (2006). The treatment of depression in older adults in the primary care setting: An evidence-based review. Health Psychology, 25(6), 665-674. doi:10.1037/0278-6133.25.6.665

Sirey, J., Bruce, M., & Kales, H. (2010). Improving antidepressant adherence and depression outcomes in primary care: The treatment initiation and participation program. American Journal of Geriatric Psychiatry 18(6), 554-562.

Sirey, J., Bruce, M., & Kales, H. (2010). Improving antidepressant adherence and depression outcomes in primary care: The treatment initiation and participation program. American Journal of Geriatric Psychiatry 18(6), 554-562.

Posted in reference | Tagged , | Comments Off on Sirey, J., Bruce, M., & Kales, H. (2010). Improving antidepressant adherence and depression outcomes in primary care: The treatment initiation and participation program. American Journal of Geriatric Psychiatry 18(6), 554-562.

Oxman, TE, Deitrich, AJ & Schulberg HC (2003). The depression care manager and mental health specialist as collaborators within primary care. American Journal of Geriatric Psychiatry, 11, 507–516.

Oxman, TE, Deitrich, AJ  & Schulberg HC (2003). The depression care manager and mental health specialist as collaborators within primary care. American Journal of Geriatric Psychiatry, 11, 507–516.

Posted in reference | Tagged , | Comments Off on Oxman, TE, Deitrich, AJ & Schulberg HC (2003). The depression care manager and mental health specialist as collaborators within primary care. American Journal of Geriatric Psychiatry, 11, 507–516.

Bruce, M. L., Ten Have, T. R., Reynolds, C. F., III, Katz, I. I., Schulberg, H. C., Mulsant, B. H., . . . Alexopoulos, G. S. (2004). Reducing suicidal ideation and depressive symptoms in depressed older primary care patients: A randomized controlled trial. JAMA: Journal of the American Medical Association, 291, 1081–1091. doi:10.1001/jama.291.9.1081

Bruce, M. L., Ten Have, T. R., Reynolds, C. F., III, Katz, I. I., Schulberg, H. C., Mulsant, B. H., . . . Alexopoulos, G. S. (2004). Reducing suicidal ideation and depressive symptoms in depressed older primary care patients: A randomized controlled trial. JAMA: Journal of the American Medical Association, 291, 1081–1091. doi:10.1001/jama.291.9.1081

Posted in reference | Tagged , , , | Comments Off on Bruce, M. L., Ten Have, T. R., Reynolds, C. F., III, Katz, I. I., Schulberg, H. C., Mulsant, B. H., . . . Alexopoulos, G. S. (2004). Reducing suicidal ideation and depressive symptoms in depressed older primary care patients: A randomized controlled trial. JAMA: Journal of the American Medical Association, 291, 1081–1091. doi:10.1001/jama.291.9.1081

Areán, P. A., Ayalon, L., Hunkeler, E., Lin, E. H., Tang, L., Harpole, L.,. . . Unützer, J. (2005). Improving depression care for older, minority patients in primary care. Medical Care, 43, 381–390. doi:10.1097/01.mlr.0000156852.09920.b1

Areán, P. A., Ayalon, L., Hunkeler, E., Lin, E. H., Tang, L., Harpole, L.,. . . Unützer, J. (2005). Improving depression care for older, minority patients in primary care. Medical Care, 43, 381–390. doi:10.1097/01.mlr.0000156852.09920.b1

Posted in reference | Tagged , | Comments Off on Areán, P. A., Ayalon, L., Hunkeler, E., Lin, E. H., Tang, L., Harpole, L.,. . . Unützer, J. (2005). Improving depression care for older, minority patients in primary care. Medical Care, 43, 381–390. doi:10.1097/01.mlr.0000156852.09920.b1

Areán, P.A. & Ayalon, L. (2005). Assessment and treatment of depressed older adults in primary care. Clinical Psychology: Science and Practice, 12 (3), 321-335.

Areán, P.A. & Ayalon, L. (2005). Assessment and treatment of depressed older adults in primary care.  Clinical Psychology: Science and Practice, 12 (3), 321-335.

Posted in reference | Tagged , , | Comments Off on Areán, P.A. & Ayalon, L. (2005). Assessment and treatment of depressed older adults in primary care. Clinical Psychology: Science and Practice, 12 (3), 321-335.

Speer, D. C., & Schneider, M. G. (2003). Mental health needs of older adults and primary care: Opportunity for interdisciplinary geriatric team practice. Clinical Psychology: Science and Practice, 21, 85–101.

Speer, D. C., & Schneider, M. G. (2003). Mental health needs of older adults and primary care: Opportunity for interdisciplinary geriatric team practice. Clinical Psychology: Science and Practice, 21, 85–101.

Posted in Uncategorized | Tagged , , | Comments Off on Speer, D. C., & Schneider, M. G. (2003). Mental health needs of older adults and primary care: Opportunity for interdisciplinary geriatric team practice. Clinical Psychology: Science and Practice, 21, 85–101.

Roy-Byrne, P. B., Katon, W., Cowley, D. S., & Russo, J. (2001). A randomized effectiveness trial of collaborative care for patients with panic disorder in primary care. Archives of General Psychiatry, 58, 869–876.

Roy-Byrne, P. B., Katon, W., Cowley, D. S., & Russo, J. (2001). A randomized effectiveness trial of collaborative care for patients with panic disorder in primary care. Archives of General Psychiatry, 58, 869–876.

Posted in Uncategorized | Tagged , , , | Comments Off on Roy-Byrne, P. B., Katon, W., Cowley, D. S., & Russo, J. (2001). A randomized effectiveness trial of collaborative care for patients with panic disorder in primary care. Archives of General Psychiatry, 58, 869–876.

Emery, E.E., Lapidos, S., Eisenstein, A., Ivan, I., & Golden, R. (2012). The BRIGHTEN Program: Implementation and evaluation of a program to Bridge Resources of an Interdisciplinary Geriatric Health Team via Electronic Networking. The Gerontologist, 52 (6): 857-865. DOI: 10.1093/geront/gns034.

Emery, E.E., Lapidos, S., Eisenstein, A., Ivan, I., & Golden, R. (2012). The BRIGHTEN Program: Implementation and evaluation of a program to Bridge Resources of an Interdisciplinary Geriatric Health Team via Electronic Networking.  The Gerontologist, 52 (6): 857-865.  DOI: 10.1093/geront/gns034.

Posted in Uncategorized | Tagged , , , | Comments Off on Emery, E.E., Lapidos, S., Eisenstein, A., Ivan, I., & Golden, R. (2012). The BRIGHTEN Program: Implementation and evaluation of a program to Bridge Resources of an Interdisciplinary Geriatric Health Team via Electronic Networking. The Gerontologist, 52 (6): 857-865. DOI: 10.1093/geront/gns034.

Bogner, H.R., Morales, K.H., Post, E.P., Bruce, M.L. (2007). Diabetes, depression, and death: a randomized controlled trial of a depression treatment program for older adults based in primary care (PROSPECT). Diabetes Care, 30(12), 3005-10.

Bogner, H.R., Morales, K.H., Post, E.P., Bruce, M.L. (2007). Diabetes, depression, and death: a randomized controlled trial of a depression treatment program for older adults based in primary care (PROSPECT). Diabetes Care, 30(12), 3005-10.

Posted in Uncategorized | Tagged , , , | Comments Off on Bogner, H.R., Morales, K.H., Post, E.P., Bruce, M.L. (2007). Diabetes, depression, and death: a randomized controlled trial of a depression treatment program for older adults based in primary care (PROSPECT). Diabetes Care, 30(12), 3005-10.

Bartels, S. J., Coakley, E. H., Zubritsky, C., Ware, J. H., Miles, K. M., Area´n, P. A., et al. (2004). Improving access to geriatric mental health services: A randomized trial comparing treatment engagement with integrated versus enhanced referral care for depression, anxiety, and at-risk alcohol use. American Journal of Psychiatry, 161, 1455–1462.

Bartels, S. J., Coakley, E. H., Zubritsky, C., Ware, J. H., Miles, K. M., Area´n, P. A., et al. (2004). Improving access to geriatric mental health services: A randomized trial comparing treatment engagement with integrated versus enhanced referral care for depression, anxiety, and at-risk alcohol use. American Journal of Psychiatry, 161, 1455–1462.

Posted in Uncategorized | Tagged , , , | Comments Off on Bartels, S. J., Coakley, E. H., Zubritsky, C., Ware, J. H., Miles, K. M., Area´n, P. A., et al. (2004). Improving access to geriatric mental health services: A randomized trial comparing treatment engagement with integrated versus enhanced referral care for depression, anxiety, and at-risk alcohol use. American Journal of Psychiatry, 161, 1455–1462.

Stuart, M.R. & Lieberman , J.A. (2002). The fifteen minute hour: Practical therapeutic intervention in primary care. Philadelphia: Saunders.

Stuart, M.R. & Lieberman , J.A. (2002). The fifteen minute hour: Practical therapeutic intervention in primary care. Philadelphia: Saunders.

Posted in reference | Tagged , , | Comments Off on Stuart, M.R. & Lieberman , J.A. (2002). The fifteen minute hour: Practical therapeutic intervention in primary care. Philadelphia: Saunders.

Stanley, M. A., Diefenbach, G. J., Hopko, D.R. (2004). Cognitive behavioral treatment for older adults with generalized anxiety disorder: A therapist manual for primary care settings. Behavior Modification, 28, 73-117.

Stanley, M. A., Diefenbach, G. J., Hopko, D.R. (2004). Cognitive behavioral treatment for older adults with generalized anxiety disorder: A therapist manual for primary care settings. Behavior Modification, 28, 73-117.

Posted in reference | Tagged , , , , , | Comments Off on Stanley, M. A., Diefenbach, G. J., Hopko, D.R. (2004). Cognitive behavioral treatment for older adults with generalized anxiety disorder: A therapist manual for primary care settings. Behavior Modification, 28, 73-117.

Sorocco, KH & Lauderdale, S. (2001). Cognitive Behavior Therapy with Older Adults: Innovations Across Care Settings . New York, NY: Springer.

Sorocco, KH & Lauderdale, S. (2001). Cognitive Behavior Therapy with Older Adults: Innovations Across Care Settings . New York, NY: Springer.

Posted in reference | Tagged , , , , , , , , , | Comments Off on Sorocco, KH & Lauderdale, S. (2001). Cognitive Behavior Therapy with Older Adults: Innovations Across Care Settings . New York, NY: Springer.

Cully, J.A., Paukert, A., Falco, J., & Stanley, M.A. (2009). Cognitive-behavioral therapy: Innovations for cardiopulmonary patients with depression and anxiety. Cognitive and Behavioral Practice, 16 , 394-407.

Cully, J.A., Paukert, A., Falco, J., & Stanley, M.A. (2009). Cognitive-behavioral therapy: Innovations for cardiopulmonary patients with depression and anxiety. Cognitive and Behavioral Practice, 16 , 394-407.

Posted in reference | Tagged , , , , , , , | Comments Off on Cully, J.A., Paukert, A., Falco, J., & Stanley, M.A. (2009). Cognitive-behavioral therapy: Innovations for cardiopulmonary patients with depression and anxiety. Cognitive and Behavioral Practice, 16 , 394-407.

Arean, P., Hegel, M., Vannoy, S., Fan, M., & Unuzter, J. (2008). Effectiveness of problem-solving therapy for older, primary care patients with depression: Results from the IMPACT project. The Gerontologist, 48, 311-323. doi:10.1093/geront/48.3.311

Arean, P., Hegel, M., Vannoy, S., Fan, M., & Unuzter, J. (2008). Effectiveness of problem-solving therapy for older, primary care patients with depression: Results from the IMPACT project. The Gerontologist, 48, 311-323. doi:10.1093/geront/48.3.311

Posted in reference | Tagged , , , , , , | Comments Off on Arean, P., Hegel, M., Vannoy, S., Fan, M., & Unuzter, J. (2008). Effectiveness of problem-solving therapy for older, primary care patients with depression: Results from the IMPACT project. The Gerontologist, 48, 311-323. doi:10.1093/geront/48.3.311