Metacognitive training for depression in later life (MCT-Silver) is a cognitive-behaviorally based group therapy, which focuses on helping participants gain (metacognitive) distance from their thought patterns that contribute to depression. Differing from other versions of MCT, MCT-Silver addresses issues specific to depression in later life (i.e., geriatric depression), such as coping with physical changes and loss, as well as adapting to new (social) roles (for example, finding new meaning in life after retirement). MCT-Silver includes modules on identifying and re-defining values in later life and how one may move toward acceptance of situations that cannot be prevented or changed. Like D-MCT, MCT-Silver addresses cognitive and metacognitive biases that contribute to the onset and maintenance of depression through fun and engaging exercises, as well as using examples from daily life. It also helps participants gain insight into unhelpful thought strategies (e.g., rumination, catastrophizing), which may initially seem helpful but often contribute to increased emotional distress.
Although MCT-Silber was developed with individuals 60 and older in mind, everyone’s life course plays out differently and some individuals will not face some of these issues until much later (if at all!). Due to improvements in medicine, the process of aging is currently much different than it was for our parents and grandparents. Nonetheless, aging is an unavoidable part of life and most of us will experience age-related changes in one way or another, and in some people these may trigger or contribute to depressive symptoms.
The feasibility and acceptance of a beta-version of MCT-Silver among older adults was recently confirmed in an open-label pilot study (Schneider, Bücker, Riker, Karamatskos & Jelinek, 2018). The training led to a significant reduction in depressive symptoms at a large effect (Cohen’s d = 1.06) among a sample of older adults (average age = 68 years) concurrently completing intensive inpatient treatment for depression. There was also a significant reduction in dysfunctional attitudes at a small effect (d = 0.33). Moreover, participants endorsed MCT-Silver positively, and indicated that they found it to be a helpful and useful part of their treatment, which they would recommend to others.
- Dr. Brooke Schneider
- M.Sc. Lara Bücker
- Prof. Dr. Lena Jelinek
- Prof. Dr. Steffen Moritz
- Dr. med. Evangelos Karamatskos
- Dr. Sandra Leh-Seal (Praxis für Neuropsychologie & Entwicklungsförderung (NEF), Meilen, Zürich, Schweiz)
Schneider, B.C., Bücker, L., Riker, S. & Jelinek, L. (2018). A pilot study of metacognitive training for depression in older adults. Zeitschrift für Neuropsychologie, 29, 7-19.