The Effect of Cognitive Behavioral Therapy (CBT)-Based Psychoeducation on Cognitive Flexibility and Rumination in the Elderly

NCT07139197 | Not Yet Recruiting DMC

• 1 other identifier: AU-SBF-LA-01
• Study Type: interventional
• Target: 38
• Locations: 1 country
• Sites: 1

Brief Summary

This study aimed to investigate the effect of psychoeducation on rumination and cognitive flexibility in elderly individuals residing in nursing homes. Cognitive Behavioral Therapy (CBT)-based psychoeducation has recently been applied to multiple specific groups around the world and in our country. In general, executive functioning skills and, more specifically, cognitive flexibility appear to be important for the ability to use certain CBT techniques; however, considering that these skills naturally decline with age, further research is needed. It is anticipated that the results of this study will contribute to applications in the field of psychiatric nursing.

Conditions

Cognitive Flexibility; Rumination; Elderly (People Aged 65 or More); Psychoeducation

Keywords

elderly; psychoeducation; cognitive flexibility; rumination; cognitive behavioral therapy

Outcome Measures

Primary Outcomes (2)

• Cognitive Flexibility Inventory

  The inventory was adapted into Turkish. The five-point Likert-type inventory consists of two subscales, "alternatives" and "control," and 20 items. The "alternatives" subscale consists of statements regarding the possibility of finding alternative solutions to difficult situations or alternative explanations for life circumstances and human behavior. The "control" subscale consists of statements about the controllability of difficult situations. The lowest possible score on the inventory is 20, and the highest possible score is 100. Items 2, 4, 7, 9, 11, and 17 of the scale are reverse-coded. High scores on the inventory indicate high cognitive flexibility. In the Turkish version of the inventory, the Cronbach's alfa coefficient (Cronbach's alpha) was calculated as .90 for the entire inventory, .90 for the alternatives subscale, and .84 for the control subscale.

  8 weeks

• Self-Critical Rumination Scale

  The scale was adapted into Turkish. The scale is a unidimensional scale with a 4-point Likert scale (1 = Never, 2 = Somewhat, 3 = Mostly, 4 = Completely). The scale's fit indices were found to be chi-square/degrees of freedom (x²/df) = 3, Root Mean Square Error of Approximation (RMSEA) = .08, Tucker-Lewis Index (TLI) = .93, Comparative Fit Index (CFI) = .94, and Standardized Root Mean Square Residual (SRMR) = .04. In criterion-related validity, the correlation between the Ruminative Responses Scale short form (RRS) and the RRS was found to be r = .73, with the obsessive thinking subscale r = .73 and the deep thinking subscale r = .68. The internal consistency coefficient of the scale was Cronbach's alfa coefficient (Cronbach's alpha) = .89, and the test-retest reliability coefficient, measured five weeks apart, was .83.

  8 weeks

Secondary Outcomes (1)

• Standardized Mini Mental Test (SMMT)

  1 weeks

Study Arms (2)

Intervention Group: Cognitive Behavioral Therapy (CBT)-Based Psychoeducation Program

EXPERIMENTAL

Participants in this group will receive a cognitive-behavioral psychoeducation program aimed at improving cognitive flexibility and reducing rumination. Pre-test assessments will be conducted before group allocation.

Behavioral: Cognitive Behavioral Approach-Based Psychoeducation Program

Control Group: Usual Care (Standard Nursing Home Care)

NO INTERVENTION

Participants in this group will not be subject to any intervention during the study period. Pre-test assessments will be conducted by an independent evaluator simultaneously with the intervention group. Upon completion of the study, control group participants will be offered the opportunity to participate in the psycho-education program if they wish.

Interventions

Cognitive Behavioral Approach-Based Psychoeducation Program BEHAVIORAL

Intervention Group: Cognitive Behavioral Approach-Based Psychoeducation Program Participants will receive a cognitive-behavioral psychoeducation program designed to improve cognitive flexibility and reduce rumination. The sessions include structured activities, discussions, and exercises based on cognitive-behavioral principles. Pre-test assessments will be conducted before group allocation. Control Group: No intervention will be provided during the study period. Participants will complete pre-test assessments administered by an independent evaluator. After the study concludes, control group participants will be offered the opportunity to participate in the psychoeducation program if they wish.

Intervention Group: Cognitive Behavioral Therapy (CBT)-Based Psychoeducation Program

Eligibility Criteria

• Age: 65 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Older Adult (65+)

You may qualify if:

• Be 65 years of age or older,
• Be willing to participate in the study,
• Not have hearing or vision problems that would prevent understanding the training to be provided,
• Have communication and comprehension skills,
• Be literate,
• Have a Standardized Mini Mental Test score between 25 and 30 points.

You may not qualify if:

• Having any hearing or vision problems.
• Having physical, neurological, or psychological health problems that could disrupt group harmony and integrity.
• Having an illness or problem that could prevent them from responding to the measurement tools used in the study.
• Having a Standardized Mini Mental Test score below 25.

Sponsors & Collaborators

• Ataturk University: lead

Study Sites (1)

Kars Huzurevi Yaşlı Bakım ve Rehabilitasyon Merkezi / Kars Huzur Evi Elderly Care and Rehabilitation Center

Kars, Center, 36100, Turkey (Türkiye)

Location

MeSH Terms

Conditions

Rumination Syndrome

Condition Hierarchy (Ancestors)

Gastrointestinal Diseases; Digestive System Diseases; Feeding and Eating Disorders; Mental Disorders

Central Study Contacts

Leyla ALTUN, Research Assistant/PhD student

CONTACT

+90 545 650 57 82; leyla.altun21@ogr.atauni.edu.tr

Özlem Şahin ALTUN, Associate Professor, Ph.D.

CONTACT

+90 530 289 52 92; ozlemsahinaltun@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Masking Details: During the pre-test phase, both the participants and the independent evaluators will be unaware of the group distribution. The allocation of group assignments will be determined subsequent to the completion of baseline assessments. Following randomisation, participants will be informed of the group distribution due to the nature of the psychoeducational intervention; however, the baseline assessment results will be conducted blindly.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Research Assistant

Model Details: This study is planned to be conducted using a randomized controlled, pre-test-post-test, control group, and 1-month follow-up test experimental study design.To prevent contamination between groups, data collection for the intervention and control groups will be conducted at different times, except for the pre-test stage, which will be administered simultaneously by an independent assessor. The control group will not be subject to any intervention during the study period, but will be offered the psychoeducation programme after the study is completed if they wish.

Study Record Dates

• First Submitted: August 17, 2025
• First Posted: August 24, 2025
• Study Start: September 1, 2025
• Primary Completion: September 15, 2025
• Study Completion (Estimated): June 15, 2026
• Last Updated: September 4, 2025

Record last verified: 2025-08

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)