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Therapeutic Relationship Crucial for Elderly

J Affect Disord; ePub 2017 Mar 7; Mace, et al

Assessment of patient's experience of the therapeutic relationship (TR) and of therapist ability to foster Understanding and Accepting can play a significant role in the delivery of geriatric psychosocial interventions, according to a recent study. Participants were older patients (n= 220) with major depression and executive dysfunction who received 12 weeks of problem-solving therapy or supportive therapy in a randomized control trial. Multilevel growth curve modeling and latent change scores were used to analyze TR dimensions of Understanding and Accepting at the patient level (individual patient ratings, n=194) and therapist level (ratings of each therapist averaged across participants, n=10). Researchers found:

  • TR predicted reduction of depression in both treatment groups, while treatment x TR interactions were not significant.
  • Patients treated by therapists with higher average Understanding (patient and therapist level) and Accepting (therapist level) ratings had greater decreases in depression.
  • Together, Understanding and Accepting predicted 21% of variance in depression level changes.


Mace RA, Gansler DA, Suvak MK, et al. Therapeutic relationship in the treatment of geriatric depression with executive dysfunction. [Published online ahead of print March 7, 2017]. J Affect Disord. doi:10.1016/j.jad.2017.03.006.