👉 Key takeaway message: it’s not chronological age that matters, but individual differences in cognitive processes. Older adults can learn and use CBT skills—and we shouldn’t withhold therapy based on assumptions about rigidity.

Older adults' skills were comparable to children, with younger adults doing best. BUT - after accounting for individual differences in cognitive flexibility (particularly perseveration), there were no age differences in skills.

Many people assume that older adults are too rigid in their ways of thinking to benefit from therapeutic techniques like cognitive restructuring. But our research shows that’s not the case.

Full paper here: www.ajgponline.org/article/S106...

Even better! I’m a big fan of exposure-based treatments - and the clinicians that do them 👏

Thanks for sharing our findings. Inhibitory learning theory predicts BE would be best. I thought it was possible there would be no group differences. However the results (small preference for BE, but little penalty from doing CR first) aligns with clinical experiences. 👉🏻✨ threat expectancy change

It's always encouraging to hear that the findings resonate with clinical experience. Treatment tolerability is a key consideration. There was only a small difference between BE and doing cognitive restructuring before exposure - with both approaches emphasising change in threat expectancies (key).

Both of these approaches that emphasise threat expectancy change are better than habituation-focused exposure. But if clients are willing, BE might be preferable given that there are consistently small benefits for clinical outcomes, plus it is faster (? more time for extra exposure trials)

Yes, this is correct. There is very little penalty for doing cognitive work first, which is what inhibitory learning models suggest. This is great news, given that cognitive restructuring often increases clients willingness to attempt exposure tasks.

So pleased you were able to share this with your supervision group! I’d love to hear what the feedback was, and how this relates to others’ experience in clinical practice?

Exposure therapy is such a powerful treatment technique. Our findings support that either application of exposure that ALSO focused on changing threat beliefs, was great! Habituation-focused exposure without the cognitive work, was less effective.

Absolutely! There was a non-significant, small effect size difference when using cognitive restructuring first - so there isn’t any real penalty from doing the cognitive work first.