Does cognitive-behavioural therapy promote meaning making? A preliminary test in the context of geriatric depression.

OBJECTIVES This study examined the extent to which cognitive-behavioural therapy (CBT) for geriatric depression promoted meaning made of stress. DESIGN Fifty-one participants received CBT and were assessed at pre- and post-treatment. METHODS The primary outcome was the Integration of Stressful Life Experiences Scale (ISLES) and demographic factors were examined as moderators of changes over time. RESULTS Those with more education showed improvement in their ability to regain positive values, worldviews, and purpose in life after a stressor. CONCLUSIONS It appears that CBT promotes some forms of meaning made of stress for those with higher education. PRACTITIONER POINTS Cognitive-behavioural therapy as it is routinely practiced may help highly educated older adults regain their Footing in the World (e.g., maintain positive values, worldviews, and purpose in life) in the aftermath of a stressful life event. Cognitive-behavioural therapy appears to offer fewer gains for less educated older adults (in terms of Footing in the World) as well as for other aspects of meaning-making, such as the ability to 'make sense' of a significant stressor. Although more empirical work is necessary, meaning-oriented interventions (e.g., 're-authoring' a fragmented self-narrative; Neimeyer, 2009, p. 97) hold promise as useful adjuncts to routine therapy that could augment outcomes.