A randomized trial of a group based cognitive behavior therapy program for older adults with epilepsy: the impact on seizure frequency,depression and psychosocial well-being

Few studies have examined the effectiveness of cognitive behavior therapy to manage seizures and improve psychosocial functioning in older adults with epilepsy. This study evaluated the efficacy of a 6 week group CBT program in community dwelling adults with epilepsy who were aged over 60 years. A total of 37 participants were randomly assigned to either a CBT group or a control group. Measures of depression, dysthymia, psychosocial functioning and seizure frequency were completed at pre and post intervention. Seizure frequency was significantly reduced in the CBT group compared to the control group (Cohen’s d 0.63). The results suggest that the relationship between seizure frequency and psychological and psychosocial well being in older adults requires further investigation. Although there were no significant between group differences on measures of depression and psychosocial functioning, both the CBT and control groups improved significantly from baseline.     

Breaking down Silos to improve the health of older adults: The case for medicare to cover home safety renovations

The ageing population is increasing the financial strain on the United States health care system, and society may be underinvesting in the place-based determinants of elderly health. The leading cause of injury for older Americans is falls in the home, resulting in more deaths than any other injury, as well as a significant portion of Medicare spending. While medical interventions have yielded mixed results, home safety renovations have been shown to be a cost-effective strategy to enable senior citizens to “age in place” safely, with the health care savings outweighing the upfront investment. Conservative projections demonstrate that Medicare can undertake this investment in home safety renovations with less than 2 percent of its budget, while breaking down the silos that unnecessarily encircle health and housing.     

The TEACCH program for children and adults with autism: A meta-analysis of intervention studies

The intervention program for autism known as Treatment and Education of Autistic and Related Communication Handicapped Children (TEACCH) is considered an emerging practice for autism. In the present study we used state-of-the-art meta-analytical procedures to examine the pooled clinical effects of TEACCH in a variety of outcomes. A total of 13 studies were selected for meta-analysis totaling 172 individuals with autism exposed to TEACCH. Standardized measures of perceptual, motor, adaptive, verbal and cognitive skills were identified as treatment outcomes. We used inverse-variance weighted random effects meta-analysis supplemented with quality assessment, sensitivity analysis, meta-regression, and heterogeneity and publication bias tests. The results suggested that TEACCH effects on perceptual, motor, verbal and cognitive skills were of small magnitude in the meta-analyzed studies. Effects over adaptive behavioral repertoires including communication, activities of daily living, and motor functioning were within the negligible to small range. There were moderate to large gains in social behavior and maladaptive behavior. The effects of the TEACCH program were not moderated by aspects of the intervention such as duration (total weeks), intensity (hours per week), and setting (home-based vs. center-based). While the present meta-analysis provided limited support for the TEACCH program as a comprehensive intervention, our results should be considered exploratory owing to the limited pool of studies available.