Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-745bb68f8f-5r2nc Total loading time: 0 Render date: 2025-02-06T13:24:38.759Z Has data issue: false hasContentIssue false

Chapter 2 - Indications for Psychotherapy in Adults in Later Life

from Part 1 - Introduction to Psychotherapy in Later Life

Published online by Cambridge University Press:  09 January 2020

By
Tyler Durns ,
Danielle Tolton ,
Sarah A. Nguyen  and
Neha Jain
Edited by
Rajesh R. Tampi ,
Brandon Yarns ,
Kristina F. Zdanys  and
Deena J. Tampi
Rajesh R. Tampi
Affiliation:
Case Western Reserve University, Ohio
Brandon Yarns
Affiliation:
VA Greater Los Angeles Healthcare System
Kristina F. Zdanys
Affiliation:
University of Connecticut
Deena J. Tampi
Affiliation:
Diamond Healthcare Corporation
Get access

Summary

Since its inception more than 100 years ago, theories and techniques of psychotherapy have experienced tremendous growth and diversification. There has been a gradual increase in our knowledge of aging as well as in our experience conducting psychotherapy with older adults. Although the core principles of psychotherapy are mostly similar to those pertaining to younger people, certain challenges and themes are unique to this population. These include a diverse range of living environments as well as an increasing need for social integration, adjusting to functional and cognitive decline, accessing services, caregiving, navigating transitions, and managing acute and chronic conditions. An increasing number of older adults are seeking treatment for a broad array of mental health problems, including depression, anxiety, insomnia, personality disorders, cognitive impairment, chronic pain, and substance use. Depending on the patient and the presenting problem, psychotherapy can be used as either a primary or an adjunctive method of treatment.

Type
Chapter
Information
Psychotherapy in Later Life , pp. 9 - 22
Publisher: Cambridge University Press
Print publication year: 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Christensen, K, Doblhammer, G, Rau, R, Vaupel, JW. Ageing populations: the challenges ahead. Lancet. 2009;374(9696):1196–1208. doi: 10.1016/S0140-6736(09)61460-4Google Scholar
Jeste, DV, Savla, GN, Thompson, WK, et al. Older age is associated with more successful aging: role of resilience and depression. Am J Psychiatry. 2013;170(2):188–196. doi: 10.1176/appi.ajp.2012.12030386Google Scholar
Delle, FA, Bassi, M, Boccaletti, ES, et al. Promoting well-being in old age: the psychological benefits of two training programs of adapted physical activity. Front Psychol. 2018;9:828. doi: 10.3389/fpsyg.2018.00828Google Scholar
Hollon, SD, DeRubeis, RJ, Shelton, RC, et al. Prevention of relapse following cognitive therapy vs medications in moderate to severe depression. Arch Gen Psychiatry. 2005;62(4):417–422.Google Scholar
Thompson, LW, Coon, DW, Gallagher-Thompson, D, Sommer, BR, Koin, D. Comparison of desipramine and cognitive/behavioral therapy in the treatment of elderly outpatients with mild-to-moderate depression. Am J Geriatr Psychiatry. 2001;9(3):225–240.Google Scholar
Alexopoulos, GS, Raue, PJ, Gunning, F, et al. “Engage” therapy: behavioral activation and improvement of late-life major depression. Am J Geriatr Psychiatry. 2016;24(4):320–326. doi: 10.1016/j.jagp.2015.11.006Google Scholar
Tavares, LR, Barbosa, MR. Efficacy of group psychotherapy for geriatric depression: a systematic review. Arch Gerontol Geriatr. 2018;78:71–80. doi: 10.1016/j.archger.2018.06.001Google Scholar
Liu, B, Tan, Y, Cai, D, et al. A study of the clinical effect and dropout rate of drugs combined with group integrated psychotherapy on elderly patients with depression. Shanghai Arch Psychiatry. 2018;30(1):39–46. doi: 10.11919/j.issn.1002-0829.217051Google Scholar
DeRubeis, RJ, Hollon, SD, Amsterdam, JD, et al. Cognitive therapy vs medications in the treatment of moderate to severe depression. Arch Gen Psychiatry. 2005;62:409–415.Google Scholar
Rush, AJ, Beck, AT, Kovacs, M, Hollon, S. Comparative efficacy of cognitive therapy and pharmacotherapy in the treatment of depressed patients. Cognit Ther Res. 1977;1:17–37.Google Scholar
Jacobson, NS, Hollon, SD. Cognitive-behavior therapy versus pharmacotherapy: now that the jury’s returned its verdict, it’s time to present the rest of the evidence. J Consult Clin Psychol. 1996;64:74–80.CrossRefGoogle ScholarPubMed
Hollon, SD, DeRubeis, RJ, Evans, MD, et al. Cognitive therapy and pharmacotherapy for depression: singly and in combination. Arch Gen Psychiatry. 1992;49:774–781.Google Scholar
Hobbs, MJ, Joubert, AE, Mahoney, AEJ, Andrews, G. Treating late-life depression: comparing the effects of internet-delivered cognitive behavior therapy across the adult lifespan. J Affect Disord. 2018;226:58–65. doi: 10.1016/j.jad.2017.09.026CrossRefGoogle ScholarPubMed
Egede, LE, Acierno, R, Knapp, RG, et al. Psychotherapy for depression in older veterans via telemedicine: a randomised, open-label, non-inferiority trial. Lancet Psychiatry. 2015;2(8):693–701. doi: 10.1016/S2215-0366(15)00122-4CrossRefGoogle ScholarPubMed
Moral, JCM, Terrero, FBF, Galán, AS, Rodríguez, TM. Effect of integrative reminiscence therapy on depression, well-being, integrity, self-esteem, and life satisfaction in older adults. J Posit Psychol. 2015;10(3):240–247.Google Scholar
Wu, LF. Group integrative reminiscence therapy on self-esteem, life satisfaction and depressive symptoms in institutionalized older veterans. J Clin Nurs. 2011 Aug;20(15–16):2195–2203. doi: 10.1111/j.1365-2702.2011.03699.xCrossRefGoogle Scholar
Hsieh, HF, Wang, JJ. Effect of reminiscence therapy on depression in older adults: a systematic review. Int J Nurs Stud. 2003;40(4):335–345.Google Scholar
Watt, LM, Cappeliez, P. Integrative and instrumental reminiscence therapies for depression in older adults: intervention strategies and treatment effectiveness. Aging Ment Health. 2000;4(2):166–177.Google Scholar
Duewarke, AR, Bridges, AJ. Suicide interventions in primary care: a selective review of the evidence. Fam Syst Health. 2018;36(3):289–302. doi:10.1037/fsh0000349Google Scholar
Thompson, LW, Gallagher, D. Efficacy of psychotherapy in the treatment of late-life depression. Adv Behav Res Ther. 1984;6(2):127–139.Google Scholar
Alexopoulos, GS, Raue, P, Areán, P. Problem-solving therapy versus supportive therapy in geriatric major depression with executive dysfunction. Am J Geriatric Psychiatry. 2003;11(1):46–52.Google Scholar
Gök Ugur, H, Yaman Aktaş, Y, Orak, OS, Saglambilen, O, Aydin Avci, İ. The effect of music therapy on depression and physiological parameters in elderly people living in a Turkish nursing home: a randomized-controlled trial. Aging Ment Health. 2017;12(21):1280–1286.Google Scholar
McCaffrey, R, Liehr, P, Gregersen, T, Nishioka, R. Garden walking and art therapy for depression in older adults: a pilot study. Res Gerontol Nurse. 2011;4(4):237–242. doi: 10.3928/19404921-20110201-01Google Scholar
Laborde-Lahoz, P, El-Gabalawy, R, Kinley, J, et al. Subsyndromal depression among older adults in the USA: prevalence, comorbidity, and risk for new-onset psychiatric disorders in late life. Int J Geriatr Psychiatry. 2015;30(7):677–685. doi: 10.1002/gps.4204Google Scholar
Vanltallie, TB. Subsyndromal depression in the elderly: underdiagnosed and undertreated. Metabolism. 2005;54(5):39–44.Google Scholar
Reynolds, CF 3rd, Thomas, SB, Morse, JQ, et al. Early intervention to preempt major depression among older black and white adults. Psychiatr Serv. 2014;65(6):765–773. doi: 10.1176/appi.ps.201300216Google Scholar
Kasckow, J, Klaus, J, Morse, J, et al. Using problem solving therapy to treat veterans with subsyndromal depression: a pilot study. Int J Geriatr Psychiatry. 2014;29(12):1255–1261. doi: 10.1002/gps.4105Google Scholar
Rawtaer, I, Mahendran, R, Yu, J, et al. Psychosocial interventions with art, music, Tai Chi and mindfulness for subsyndromal depression and anxiety in older adults: a naturalistic study in Singapore. Asia Pac Psychiatry. 2015;7(3):240–250. DOI: 10.1111/appy.12201Google Scholar
Ramos, K, Stanley, MA. Anxiety disorders in late life. Psychiatr Clin North Am. 2017;41(1):55–64. doi: 10.1016/j.psc.2017.10.005Google Scholar
Leipzig, RM, Cumming, RG, Tinetti, ME. Drugs and falls in older people: a systematic review and meta-analysis: II. Cardiac and analgesic drugs. J Am Geriatri Soc. 1999;47(1):40–50.Google Scholar
Gould, RL, Coulson, MC, Howard, RJ. Efficacy of cognitive behavioral therapy for anxiety disorders in older people: a meta‐analysis and meta‐regression of randomized controlled trials. J Am Geriatr Soc. 2012 Feb;60(2):218–229. doi: 10.1111/j.1532-5415.2011.03824.xGoogle Scholar
Hall, J, Kellett, S, Berrios, R, Bains, MK, Scott, S. Efficacy of cognitive behavioral therapy for generalized anxiety disorder in older adults: systematic review, meta-analysis, and meta-regression. Am J Geriatr Psychiatry. 2016 Nov 1;24(11):1063–1073.Google Scholar
Hendriks, GJ, Keijsers, GP, Kampman, M, et al. Treatment of anxiety disorders in the elderly. Tijdschr Psychiatr. 2011;53(9):589–595.Google ScholarPubMed
Wetherell, JL, Gatz, M, Craske, MG. Treatment of generalized anxiety disorder in older adults. J Consult Clin Psychol. 2003;71(1):31–40.Google Scholar
Ayers, CR, Sorrell, JT, Thorp, SR, Wetherell, JL. Evidence-based psychological treatments for late-life anxiety. Psychol Aging. 2007;22(1):8–17.CrossRefGoogle ScholarPubMed
Thorp, SR, Ayers, CR, Nuevo, R, et al. Meta-analysis comparing different behavioral treatments for late-life anxiety. Am J Geriatr Psychiatry. 2009;17(2):105–115. doi: 10.1097/JGP.0b013e31818b3f7eGoogle Scholar
Wetherell, JL, Afari, N, Ayers, CR, et al. Acceptance and commitment therapy for generalized anxiety disorder in older adults: a preliminary report. Behav Ther. 2011;42(1):127–134. doi: 10.1016/j.beth.2010.07.002CrossRefGoogle ScholarPubMed
Hazlett-Stevens, H, Singer, J, Chong, A. Mindfulness-based stress reduction and mindfulness-based cognitive therapy with older adults: a qualitative review of randomized controlled outcome research. Clinical Gerontologist. 2018 Sep 13;42(4): 347–358.Google Scholar
Rybarczyk, B, Stepanski, E, Fogg, L, et al. A placebo-controlled test of cognitive-behavioral therapy for comorbid insomnia in older adults. J Consult Clin Psychol. 2005;73(6):1164–1174.Google Scholar
Morin, CM, Kowatch, RA, Barry, T, Walton, E. Cognitive-behavior therapy for late-life insomnia. J Consult Clin Psychol. 1993;61(1):137–146.Google Scholar
Buysse, DJ, Germain, A, Moul, DE, et al. Efficacy of brief behavioral treatment for chronic insomnia in older adults. Arch Intern Med. 2011;171(10):887–895. doi: 10.1001/archinternmed.2010.535Google Scholar
Amad, A, Geoffroy, PA, Vaiva, G, Thomas, P. Personality and personality disorders in the elderly: diagnostic, course and management. Encephale. 2013;39(5):374–382. doi: 10.1016/j.encep.2012.08.006Google Scholar
Lynch, TR, Cheavens, JS, Cukrowicz, KC, et al. Treatment of older adults with co-morbid personality disorder and depression: a dialectical behavior therapy approach. Int J Geriatr Psychiatry. 2007;22(2):131–143.Google Scholar
Videler, AC, van Alphen, SPJ, van Royen, RJJ, et al. Schema therapy for personality disorders in older adults: a multiple-baseline study. Aging Ment Health. 2018;22(6):738–747. doi: 10.1080/13607863.2017.1318260Google Scholar
Liang, JH, Xu, Y, Lin, L, et al. Comparison of multiple interventions for older adults with Alzheimer disease or mild cognitive impairment: a PRISMA-compliant network meta-analysis. Medicine (Baltimore). 2018;97(20):e10744. doi: 10.1097/MD.0000000000010744Google Scholar
Joosten-Weyn Banningh, LW, Prins, JB, Vernooij-Dassen, MJ, et al. Group therapy for patients with mild cognitive impairment and their significant others: results of a waiting-list controlled trial. Gerontology. 2011;57(5):444–454. doi: 10.1159/000315933Google Scholar
Cheston, R. Psychotherapeutic work with people with dementia: a review of the literature. Br J Med Psychol. 1998;71(3):211–231.Google Scholar
Douglas, S, James, I, Ballard, C. Non-pharmacological interventions in dementia. Adv Psychiatric Treat. 2004 May;10(3):171–177.Google Scholar
Rabins, PV. Developing treatment guidelines for Alzheimer’s disease and other dementias. J Clin Psychiatry. 1996;57:37–38.Google Scholar
Woods, B, Spector, A, Jones, C, Orrell, M, Davies, S. Reminiscence therapy for dementia. Cochrane Database of Syst Rev. 2005;18(2):203–205.Google Scholar
Gum, A, Areán, PA. Current status of psychotherapy for mental disorders in the elderly. Curr Psychiatry Rep. 2004;6(1):32–38.Google Scholar
Hund, B, Reuter, K, Harter, M, et al. Stressors, symptom profile, and predictors of adjustment disorder in cancer patients. Results from an epidemiological study with the composite internal diagnostic interview, adaptation for oncology (CIDI-O). Depress Anxiety. 2016;33(2):153–161. doi: 10.1002/da.22441Google Scholar
Mitchell, AJ, Sheth, B, Gill, J, et al. Prevalence and predictors of post-stroke mood disorders: a meta-analysis and meta-regression of depression, anxiety, and adjustment disorder. Gen Hosp Psychiatry. 2017;47:48–60. doi: 10.1016/j.genhosppsych.2017.04.001Google Scholar
Haase, M, Frommer, J, Franke, GH, et al. From symptom relief to interpersonal change: treatment outcome and effectiveness in inpatient psychiatry. Psychother Res. 2008;18(5):615–624. doi: 10.1080/10503300802192158CrossRefGoogle Scholar
Hsiao, FH, Lai, YM, Chen, YT, et al. Efficacy of psychotherapy on diurnal cortisol patterns and suicidal ideation in adjustment disorder with depressed mood. Gen Hosp Psychiatry. 2014;36(2):214–219. doi: 10.1016/j.genhosppsych.2013.10.019Google Scholar
Sundquist, J, Lilja, A, Palmer, K, et al. Mindfulness group therapy in primary care patients with depression, anxiety and stress and adjustment disorders: randomized controlled trial. Br J Psychiatry. 2015;206(2):128–135. doi: 10.1192/bjp.bp.114.150243Google Scholar
Shimizu, K, Akizuki, N, Nakaya, N, et al. Treatment response to psychiatric intervention and predictors of response among cancer patients with adjustment disorders. J Pain Symptom Manage. 2011;41(4):684–691. doi:10.1016/j.jpainsymman.2010.07.011Google Scholar
Shear, MK, Wang, Y, Skritskaya, N, et al. Treatment of complicated grief in elderly persons: a randomized clinical trial. JAMA Psychiatry. 2014;71(11):1287–1295. doi: 10.1001/jamapsychiatry.2014.1242Google Scholar
Shear, K. Complicated grief. N Engl J Med. 2015 Jan;372:153–160. doi: 10.1056/NEJMcp1315618CrossRefGoogle ScholarPubMed
Shear, K, Frank, E, Houck, PR, Reynolds, CF 3rd. Treatment of complicated grief: a randomized controlled trial. JAMA. 2005 Jun;293(21):2601–2608. doi:10.1001/jama.293.21.2601Google Scholar
Shear, MK, Reynolds, CF 3rd, Simon, NM, et al. Optimizing treatment of complicated grief: a randomized clinical trial. JAMA Psychiatry. 2016;73(7):685–694. doi: 10.1001/jamapsychiatry.2016.0892Google Scholar
Ehde, DM, Dillworth, TM, Turner, JA. Cognitive-behavioral therapy for individuals with chronic pain: efficacy, innovations, and directions for research. Am Psychol. 2014;69(2):153–166. doi: 10.1037/a0035747CrossRefGoogle ScholarPubMed
Gatchel, RJ, Peng, YB, Peters, ML, Fuchs, PN, Turk, DC. The biopsychosocial approach to chronic pain: scientific advances and future directions. Psychol Bull. 2007;133(4):581–624. doi:10.1037/0033-2909.133.4.581Google Scholar
Mattenklodt, P, Leonhardt, C. Psychological assessment and psychotherapy for chronic pain in the elderly. Schmerz. 2015 Aug;29(4):349–361. doi: 10.1007/s00482-015-0007-3Google Scholar
Nicholas, MK, Asghari, A, Blyth, FM, et al. Self-management intervention for chronic pain in older adults: a randomized controlled trial. Pain. 2013;154:824–835. doi:10.1016/j.pain.2013.02.009CrossRefGoogle Scholar
Yi, JL, Porucznik, CA, Gren, LH, et al. The impact of preoperative mindfulness-based stress reduction on postoperative patient-reported pain, disability, quality of life, and prescription opioid use in lumbar spine degenerative disease: a pilot study. World Neurosurg. 2019;121:e786–e791. doi: 10.1016/j.wneu.2018.09.223Google Scholar
Morone, NE, Greco, CM, Moore, CG, et al. A mind-body program for older adults with chronic lower back pain: a randomized clinical trial. JAMA Intern Med. 2016 Mar;176(3):329–337. doi: 10.1001/jamainternmed.2015.8033Google Scholar
Blanchard, EB, Appelbaum, KA, Radnitz, CL, et al. A controlled evaluation of thermal biofeedback and thermal biofeedback combined with cognitive therapy in treatment of vascular headache. J Consult Clin Psychol. 1990 Apr;58(2):216–224.Google Scholar
Gfroerer, J, Penne, M, Pemberton, M, Folsom, R. Substance abuse treatment need among older adults in 2020: the impact of the aging baby-boom cohort. Drug Alcohol Depend. 2003 Mar;69(2):127–135.Google Scholar
United States Department of Health and Human Services. Substance Abuse and Mental Health Services Administration. Center for Behavioral Health Statistics and Quality. National survey on drug use and health. 2017 [cited 2018 Dec 28]. Retrieved from: www.samhsa.gov/data/nsduh/reports-detailed-tables-2017-NSDUHGoogle Scholar
Fleming, MF, Manwell, LB, Barry, KL, Adams, W, Stauffacher, EA. Brief physician advice for alcohol problems in older adults: a randomized community-based trial. J Fam Pract. 1999 May;48(5):378–384.Google ScholarPubMed
Gordon, AJ, Conigliaro, J, Maisto, SA, et al. Comparison of consumption effects of brief interventions for hazardous drinking elderly. Subst Use Misuse. 2003 Jan;38(8):1017–1035.Google Scholar
Outlaw, FH, Marquart, JM, Roy, A, et al. Treatment outcomes for older adults who abuse substances. J Appl Gerontol. 2012 Feb;31(1):78–100.Google Scholar
Slaymaker, VJ, Owen, P. Alcohol and other drug dependence severity among older adults in treatment: measuring characteristics and outcomes. Alcoholism Treat Q. 2008 Jun;26(3):259–273.Google Scholar
Oslin, DW, Pettinati, H, Volpicelli, JR. Alcoholism treatment adherence: older age predicts better adherence and drinking outcomes. Am J Geriatr Psychiatry. 2002 Nov;10(6):740–747.Google Scholar
Sorocco, KH, Ferrell, SW. Alcohol use among older adults. J Gen Psychol. 2006 Oct;133(4):453–467.Google Scholar
Barrick, C, Connors, GJ. Relapse prevention and maintaining abstinence in older adults with alcohol-use disorders. Drugs Aging. 2002 Aug;19(8):583–594.Google Scholar
Steptoe, A., Deaton, A., Stone, A. Psychological wellbeing, health and ageing. Lancet. 2015;385(9968):640–648. doi: 10.1016/S0140-6736(13)61489-0Google Scholar
Jeste, DV and Palmer, BW. A call for a new positive psychiatry of ageing. Br J Psychiatry. 2013;202:81–83. doi: 10.1192/bjp.bp.112.110643Google Scholar
Marquine, MJ, Zlatar, ZZ, Sewell, DD. Positive geriatric and cultural psychiatry. In: Jeste, DV, Palmer, BW, editors. Positive psychiatry. Arlington, VA: American Psychiatric Publishing; 2015. p. 305–324.Google Scholar
Preschl, B, Maercker, A, Wagner, B, et al. Life-review therapy with computer supplements for depression in the elderly: a randomized controlled trial. Aging Ment Health. 2012;16(8):964–974. doi: 10.1080/13607863.2012.702726Google Scholar
Frieswijk, N, Steverink, N, Buunk, BP, Slaets, JPJ. The effectiveness of a bibliotherapy in increasing the self-management ability of slightly to moderately frail older people. Patient Educ Couns. 2006;61(2):219–227.Google Scholar
D’Zurilla, TJ, Nezu, AM. Problem-solving therapy: a social competence approach to clinical intervention. 2nd ed. New York: Springer; 1999.Google Scholar
Nezu, AM, Maguth Nezu, C, D’Zurilla, TJ. Problem-solving therapy: a treatment manual. New York: Springer; 2013.Google Scholar
Kropf, N, Cummings, S. Problem-solving therapy: theory and practice. In: Evidence-based treatment and practice with older adults: theory, practice, and research. Oxford: Oxford University Press; 2017. p. 87–102.Google Scholar
Brodie, DA, Inoue, A, Shaw, DG. Motivational interviewing to change quality of life for people with chronic heart failure: a randomised controlled trial. Int J Nurs Stud. 2008;45(4):489–500.Google Scholar
Kang, HY, Gu, MO. Development and effects of a motivational interviewing self-management program for elderly patients with diabetes mellitus. J Korean Acad Nurs. 2015;45(4):533–543. doi: 10.4040/jkan.2015.45.4.533Google Scholar
Burke, BL, Arkowitz, H, Menchola, M. The efficacy of motivational interviewing: a meta-analysis of controlled clinical trials. J Consult Clin Psychol. 2003;71(5):843–861.Google Scholar
Heisel, M, Talbot, NL, King, DA, Tu, XM, Duberstein, PR. Adapting interpersonal psychotherapy for older adults at risk for suicide. Am J Geriatr Psychiatry. 2015;23(1):87–98. doi: 10.1016/j.jagp.2014.03.010Google Scholar
Sutipan, P, Intarakamhang, U, Macaskill, A. The impact of positive psychological interventions on well-being in healthy elderly people. J Happiness Stud. 2017;18(1):269–91.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×