Cognitive impairment in older adults usually progresses slowly and is caused by a variety of brain diseases, most commonly Alzheimer's disease. The resulting memory loss and impaired executive function call for therapeutic strategies that will optimize functioning. Interpersonal Psychotherapy for Cognitive Impairment (IPT-ci), builds upon traditional IPT to improve coping ability and help older patients and their caregivers manage the effects of cognitive impairment, particularly in the early phase when behavior changes are often misunderstood. IPT-ci can also provide a template for long term management that anticipates further declines in cognitive functioning over time.
Clinician's Guide to Interpersonal Psychotherapy in Late Life offers an overview of IPT principles and the development of IPT-ci, including essential background information for those new to the field of clinical geriatrics, and a thorough demonstration of the IPT-ci approach from the initial interview through long-term follow up. Chapters on late-life depression, cognitive impairment/dementia, and executive function provide key points of reference for working with this population, with special attention paid to the role of concerned family members and caregivers. The volume is replete with case examples representing a range of patients and issues; detailed analysis clarifies the application of IPT-ci elements. Clinicians will find this a practical resource for treating older patients and assisting their caregivers from the first visit to lifelong management.
Interpersonal Psychotherapy for Cognitive Impairment (IPT-ci) aims to improve coping skills of older adults. It builds on traditional Interpersonal Psychotherapy, an evidence-based treatment that has been found useful in treating depressed elders. Cognitive impairment, a common occurrence in the older population due to disease or age-related causes of changes in brain function, calls for additional strategies to optimize functioning. IPT-ci seeks to help older patients and their caregivers manage the effects of cognitive impairment, particularly in the early phase when behavior changes are often misunderstood, as well as to plan for potential future declines in cognitive functioning.
Part I offers an overview of IPT principles and the development of IPT-ci, as well as essential background information for those new to the field of clinical geriatrics. Chapters on late-life depression, cognitive impairment/dementia, and executive function provide key points of reference for working with this population. Part II demonstrates the IPT-ci approach from the initial interview through long-term follow up. Special attention is paid to the role of concerned family members or caregivers and the role transition they are going through becoming caregivers.
This guide is replete with case examples, numbered for easy reference and representing a range of patients and issues. Detailed analysis clarifies the application of IPT-ci elements. Clinicians will find this guide a practical resource for treating older patients and assisting their caregivers from the first visit to lifelong management.
"A clear, well written guide that should help clinicians and researchers expand the use of IPT for the elderly."--Peter V. Rabins, MD, MPH, Co-Director, Division of Geriatric Psychiatry and Neuropsychiatry, John Hopkins School of Medicine
"Dr. Miller draws from a deep well of professional and research experience to create a guide for clinicians who work with older adults with cognitive problems and depression. The book builds upon the remarkable success of Interpersonal Psychotherapy (IPT) in effectively treating depression and other disorders. The book is a creative adaptation of IPT that is rich with clinical examples and practical advice. Clinician's Guide is a unique contribution to psychotherapeutic efforts to provide thoughtful and humane care to older persons struggling with loss of cognitive ability and depression as well as their family members."--Gregory A. Hinrichsen, PhD, Associate Professor of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Bronx, N.Y.; Health and Aging Policy Fellow, Washington, D.C.
"Dr. Miller is the first geriatric psychiatrist to translate and appropriately modify evidence-based IPT to address the needs of persons with early changes in cognition and executive function. This innovative guide takes a welcome person-and-family-centered approach, highlighting distressing early cognitive changes and their concomitant social and personal consequences. Diverse and plentiful in-depth case vignettes illustrate how to optimize understanding and function as well as minimize depression in both persons with cognitive decline and their family members. This is the mental health professional's guide for our present and future as an aging society."--Lisa P. Gwyther, MSW, LCSW, Director, Duke Aging Center Family Support Program; President, Gerontological Society of America, 2008
"Through careful explanation of strategies and tactics and through vivid case descriptions, Dr. Miller demonstrates that not only is it possible to use psychotherapy with depressed elders with cognitive impairment, but that such individuals are likely to take particular comfort from being able to do the work of interpersonal psychotherapy and to reap the benefits in terms of improved depressive symptoms. Dr. Miller is to be congratulated on this clear and highly useful aid to clinicians working with depression in older individuals."--Ellen Frank, Distinguished Professor of Psychiatry and Professor of Psychology University of Pittsburgh School of Medicine
"Given the demographic imperative to meet the mental health needs of our aging population, Miller takes on an important and ambitious task in his book...we are in need of wise, clinically informed approaches to the treatment of late-life mental illness. For those readers looking for a useful clinical text that is well written, clinically engaging, and brimming with helpful and moving case examples, this book is for you!"--As reviewed by Deborah King in PsycCRITIQUES
Table of Contents:
SECTION I: Rationale and Background for IPT
1. Overview of Basic Principles of Interpersonal Psychotherapy
2. Rationale and Background for IPT
3. A Concise Review of Gerontology/Geriatric Medicine
4. Overview of Late Life Depression
5. The Cognitive Impairment Spectrum: MCI to Dementia
6. Manifestations of Executive Dysfunction
SECTION II: Principles of IPT for Cognitive Impairment
7. IPT Basics
8. Incorporating Family/Caregivers into the Treatment Process from the First Meeting
9. Specific Foci in IPT: Grief, Role, Transition, Role Dispute, Interpersonal Deficits
10. The Caregiver's Own Role Transition
11. Flexible Individual or Joint Sessions
12. Reaching Steady State and Long Term Planning
Postscript Future Directions for IPT
About the Author:
Mark D. Miller, MD, is an Associate Professor of Geriatric Psychiatry as Western Psychiatric Institute and Clinic at the University of Pittsburgh Medical Center. Dr. Miller serves as the Medical Director of the Late Life Depression Center, where he conducts clinical research. He also has worked directly with a variety of patients at the Benedum Geriatric Center since 1987.