Integrating Religion and Spirituality Into Treatment for Late-Life Anxiety: Three Case Studies

Generalized anxiety disorder (GAD) is common in older adults and, although cognitive behavioral therapy (CBT) is an efficacious treatment for late-life GAD, effect sizes are only moderate and attrition rates are high. One way to increase treatment acceptability and enhance current cognitive behavioral treatments for GAD in older adults might be to incorporate religion/spirituality (R/S). The cases presented here illustrate the use of a 12-week modular CBT intervention for late-life anxiety, designed to allow incorporation of R/S elements in accordance with patient preferences. The three women treated using this protocol chose different levels and methods of R/S integration into therapy. All three women showed substantial improvement in worry symptoms, as well as a variety of secondary outcomes following treatment; these gains were maintained at 6-month follow-up. These preliminary results suggest that the incorporation of R/S into CBT might be beneficial for older adults with GAD. Strengths, limitations, and future directions are discussed.

► Integrating religion/spirituality into CBT for late-life GAD may increase treatment acceptability for older adults.
► The cases presented in this study illustrate how religion/spirituality may be incorporated into CBT based on patient preferences.
► Guidelines for integrating religion/spirituality into specific CBT skills are discussed.
► All three patients in this study showed substantial improvement in worry symptoms and a variety of secondary outcomes following treatment.