Few studies have examined the effectiveness of cognitive behavior therapy to manage seizures and improve psychosocial functioning in older adults with epilepsy. This study evaluated the efficacy of a 6 week group CBT program in community dwelling adults with epilepsy who were aged over 60 years. A total of 37 participants were randomly assigned to either a CBT group or a control group. Measures of depression, dysthymia, psychosocial functioning and seizure frequency were completed at pre and post intervention. Seizure frequency was significantly reduced in the CBT group compared to the control group (Cohen's d 0.63). The results suggest that the relationship between seizure frequency and psychological and psychosocial well being in older adults requires further investigation. Although there were no significant between group differences on measures of depression and psychosocial functioning, both the CBT and control groups improved significantly from baseline.