Anxiety is a prevalent condition in older adults with neurocognitive disorders such as dementia. Interventions based on cognitive behavioral therapy (CBT) appear to be an emerging area of treatment innovation for treating anxiety in older adults with cognitive impairment. Drawing on the empirical literature on CBT for late-life anxiety and recent trials of CBT for anxiety in persons with mild-to-moderate dementia, this article provides an overview of the customization of CBT to the needs of older adults with anxiety and cognitive impairment. Adaptations for assessment, case conceptualization, socialization, therapeutic alliance, and treatment strategies are discussed. A case study to illustrate implementation of these adaptations is presented. Limitations to the current state of the literature on the efficacy and feasibility of CBT for anxiety in older adults with cognitive impairment are identified, and future directions for treatment research are proposed.

Chronic pain is often resistant to traditional medical management and other types of professional intervention. As such, several investigators have conducted studies of pain self-management programs. These self-management programs, however, were often led by therapists and shared much in common with traditional cognitive behavioral therapy (CBT); the efficacy of which, despite some inconsistencies, is largely supported in the literature. Although, like CBT, many therapist led programs involve a component of self-management in the form of “homework assignments,” it is important to evaluate the effectiveness of pain self-management, which is not therapist led. Within the context of controlled investigation, we evaluated a pain self-management program that involved use of a comprehensive self-help pain management book for older adults. Contrary to expectation, we did not identify any differences in the outcomes observed in the self-help patient group as compared to the control group (i.e., participants who did not receive the pain management book until after the study was completed) despite a great deal of satisfaction with the manualized program that was expressed by the participants. The implications of these findings are discussed.