R-E-M psychotherapy: A manualized approach for long-term care residents with depression and dementia

Although depression and dementia are common comorbid illnesses among long-term care residents, psychotherapeutic services for these individuals have not been tailored for their particular needs and circumstances. In this article we present a new model for brief individual psychotherapy-Restore, Empower, Mobilize, or R-E-M-to treat depression in long-term care residents who have mild to moderate dementia. R-E-M treatment has three goals: (1) restore self-esteem and support a positive self-concept, (2) empower residents to make use of their existing abilities, and (3) mobilize residents and the environment to achieve and maintain long-term mental health. We describe the interventions of R-E-M treatment, the construction of a treatment manual, and a pilot evaluation of the treatment with three nursing home residents. Positive outcomes in the pilot have encouraged us to pursue additional treatment development and evaluation. Standardized treatments, such as R-E-M, that yield measurable gains are needed to ensure that long-term care residents with depression and dementia receive the mental health services they require and deserve.