Advice

Cognitive behavioural therapy (CBT) and dementia

What is cognitive behavioural therapy (CBT)?

Cognitive behavioural therapy (CBT) is a type of talking therapy that aims to help people understand the links between how they think and reason (‘cognitive’) and how this then affects how they feel and act (‘behavioural’). 

Through CBT, a therapist aims to help the person notice and identify particular thoughts, actions and responses to things which might be unhelpful. They will then support the person to consider different ways to think about things and learn new skills and techniques.

Is CBT suitable for a person with dementia?

As with any talking therapy, the effectiveness of CBT will vary from one person to another. This will depend on the type and stage of the person’s dementia, as well as their personality, life history and how they feel about therapy in general.

CBT is usually most suitable for people in the early to middle stages of dementia, but it will depend on how their memory, cognition, and language are affected. They will also need to have some awareness of their condition and how it may be affecting their thoughts and behaviours. These are all key abilities needed to benefit from CBT.  

For a person in the later stage of dementia, CBT is unfortunately not likely to be effective.

How can CBT help a person with dementia?

CBT cannot treat dementia, however it may be useful for mental health symptoms that the person is experiencing, such as anxiety or depression. For example, a person who has just been diagnosed with dementia may find CBT helpful as a way of developing coping skills.

CBT can help a person with dementia by allowing them to recognise unhelpful thoughts and giving them the tools to replace them with more positive ones. It may help the person with their independence, self-esteem and overall wellbeing.

How can CBT help carers?

Carers may also find CBT helpful, although again it will depend on the individual’s personality, life history and thoughts about this type of therapy.  

CBT can help carers to become more aware of their thoughts and feelings, and how these apply to their behaviours and reactions. Looking at new ways to manage feelings, especially in difficult situations, may help the carer feel more in control and able to continue supporting the person with dementia. 

Finding and choosing a CBT therapist

A good first step is to speak to your GP to find out about CBT options through the NHS.

You might want to look for a therapist privately instead. For more information on this, take a look at our information on getting treatment for depression, anxiety or apathy.

When looking for a therapist, bear in mind that CBT for a person with dementia will probably have to be adapted for the person’s level of abilities. This could include:

• having shorter sessions 
• using prompts and memory aids
• writing down what has been discussed for the person to refer back to at home
• only practicing a small amount of skills per session
• pausing regularly during sessions to summarise and check understanding
• if the person agrees, asking a family member to join sessions so they can help the person put techniques into practice at home

CBT is likely to be most effective if the therapist already has experience of working with people with dementia.