Table 1.

Evidence-based psychotherapeutic treatment approaches for older adults

Approach	Description
Cognitive behavioral therapy (CBT)	CBT includes a wide range of therapies that focus on the detection and modification of dysfunctional (cognitive, behavioral, emotional and motivational) behavior. Typical primary goals in the depression treatment of home-living vulnerable older adults are to support the patients’ maintaining or regaining of their self-determination, to engage more often in pleasant activities and to implement helpful coping strategies for stressful situations. Low intensity versions of CBT have been developed as short, manualized interventions with flexible delivery and adapted for older adults (e.g. [26]). More recent developments of CBT are based on mindfulness, acceptance and values and might be particularly suitable when processing chronic illness, pain, loss or limited resources. Other recent approaches (e.g. cognitive behavioral analysis system of psychotherapy) are more eligible to improve interactional difficulties, as often present in the context of care.
Problem solving therapy (PST)	Variants of PST aim to reduce psychological distress. In a highly structured process, PST therapists develop patients’ problem solving capabilities by psychoeducation, interactive exercises, and motivational homework assignments. Thus, PST can support depressed home-living vulnerable patients in dealing with common stressors in their daily life (e.g. resulting from medical illness and limited resources) and meeting their needs. PST is also suitable for patients with cognitive impairments.
Life review therapy (LRT)	LRT is a form of reminiscence therapy in which patients are encouraged and systematically instructed to remember and articulate their memories in a structured and emotion-activating mode to deepen their self-knowledge, self-acceptance and integrity. Furthermore, they are supported in identifying biographical coping skills as well as developing a life balance and meaning.
Interpersonal therapy (IPT)	IPT is focused on solving interpersonal problems which often precede depression. It postulates four interpersonally relevant problem areas: role transitions, grief, interpersonal role dispute and interpersonal deficits. To improve communication skills and interpersonal functioning communication analyses, role play and coaching can be used. A wide range of interpersonal conflicts in the context of long-term home healthcare can be assigned to one of those problem areas (e.g. end of working life, loss of own home, conflict with caregivers) and thus be addressed with IPT.
Psychodynamic psychotherapy (PDT)	Variants of (short-term) PDT focus on the therapeutic relationship to gain insight into biographical causes and unconscious intrapsychic and intrapersonal conflicts that drive their symptoms or maladaptive functioning. General PDT techniques (e.g. exploratory inquiry, interpretation and clarification) can be used in older adults, with limitation to sufficient cognitive capacity of the client. More recent PDT developments take late life development goals into account. Supportive and containing strategies address older patients’ need for support in emotional regulation.