노인 우울증의 인지행동적 중재에 대한 일 고려
Treating Late-Life Depression: An Overview of An Evidenced-Based Cognitive-Behavioral Therapy Program
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초록
노인 우울증 증가에 대한 위기의식이 팽배하지만, 치료 프로그램의 개발 및 시행에 대한 노력은 많이 미흡한 실정이다. 본 논문의 목적은 노인 우울증의 체계적인 치료 및 중재 프로그램 개발의 필요성을 강조하고 그 방안을 모색하는 데 있다. 이를 위하여 노인 우울증의 인지행동적 치료의 이론과 실제 프로그램을 개관하였다. 다수의 경험적 연구결과에 의하면, 인지행동적 방법이 노인 우울증의 치료에 효과가 있을 뿐 아니라, 약물치료나 다른 형태의 심리치료에 비교해서 효과가 더 크거나 적어도 대등한 것으로 나타났다. Gallagher-Thompson의 노인 우울증 인지행동적 치료프로그램은 1980년대에 인지치료와 행동치료를 통합하여 노인들에게 적합하도록 고안되었다. 이 프로그램의 프로토콜은 지난 20여 년 넘게 미국 등 다양한 문화권의 노인 우울증 환자들에게 사용되어 그 치료 효과가 경험적으로 입증되었다. 본 논문은 이 치료프로그램의 회별, 단계별 과제 및 진행 과정 등을 소개하고 이러한 구조적 특성이 갖는 장점에 대해서 논의하였다. 그리고 이 프로그램의 핵심인 노인 인지행동모형을 기술하고 인지행동치료의 핵심요소들에 대해서 살펴보았다. 마지막에 우리나라 노인 우울증 치료 프로그램의 체계적인 개발을 위한 제안을 하였다.
Abstract
Depression is one of the most prevalent mental diseases in old age and results in dramatic damage in quality of life. The number of older adults in our society suffering from depression has been increasing rapidly, and the senior suicide rate is now a serious and widespread problem. This paper intended to bring attention to the need of developing a systematic intervention program to treat older adults’ depression. First, this paper reviewed empirical findings which proved cognitive-behavioral intervention as an effective approach to treating depression in older adults. Next, it provided a detailed overview of Gallagher-Thompson’s evidence-based cognitive-behavioral therapy program for treating late-life depression. A review of major components of cognitive-behavioral therapy and this particular therapy’s applications to treating late-life depression were also presented. As a conclusion, this overview was used to provide an input and suggestion for developing age-appropriate and skills-based psychological interventions for Korean older adults suffering from depression.
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