This Lesbian Gay Bisexual Transgendered (LGBT) aging bibliography was compiled from multiple sources including databases, search engines, and a variety of individuals and organizations that offered references and revisions. In order to understand what these middle… Handbook of Emotional Disorders in Later Life: Assessment and Treatment provides a concise, authoritative, and up-to-date guide to best practice in therapy with older people, for a wide range of mental health professionals. Treatments were administered in small groups that met for 14 weekly half-hour sessions. It is better to ask the questions in the context of conversation rather than in a check-list fashion. This book makes a case for the cost-cutting advantages of offering mental health programs to the fastest-growing segment of our population. These factors include aspects of the social environment, cohort effects, cognitive changes with aging, personality, and emotional development, which have been described in an emerging body of research literature from the field of gerontology. Psychotherapy with older adults It does require sensitivity to the possibility of the difference. Meta-analysis was used to synthesize the effects of 122 psychosocial and psychotherapeutic intervention studies with older adults. What have been the best years of your life so far? (1999). This paper reviews the background and empirical support for the efficacy of various psychotherapies for treating late life depression, including cognitive-behavioral, interpersonal, psychodynamic, life review, group, and family interventions. What is your biggest goal you wish to complete in the future? Complex process that involves the use of good communication skills, appropriate interview questions and purposeful observation and relevant assessment tools. Evidence exists for the efficacy of relaxation training for subjective anxiety symptoms and cognitive-behavioral therapy for generalized anxiety disorder and miscellaneous anxiety syndromes, including panic disorder. Gorsuch, Nikki. Context effects require changes for older clients living in age specific contexts such as retirement communities and long term care settings as well as for clients who are seen in de facto age contexts such as hospitals and outpatient medical settings. Working with older couples involves many issues not common in therapy with younger people, including issues surrounding illness, cognitive impairment, and physical decline, all of which generally cause some stress in marital relationships. Dr. Qualls demonstrates her approach to helping families care for loved ones with Alzheimer's disease. Psychology and Aging, 22(1), 8-17. Comparison of desipramine and cognitive/behavioral therapy in the treatment of elderly outpatients with mild-to-moderate depression New York: John Wiley & Sons, Inc. CCMSC is not a specific therapy system but a framework for thinking about the adaptation of any therapy system to work with older adults. Concludes with a discussion of suggested guidelines for therapeutic interventions with both cognitively intact and impaired older adults, with particular attention to psychiatric disability in individuals with neurological disorders. This is a misconception, as shown by the fact that randomised controlled trials of standard CBT with older people record outcomes similar to those of younger adults. Step-by-step, the book reveals how clinicians can structure the first-and often the only-fifty-minute session to meet the special psychological needs of older adult clients. Reviewed psychosocial interventions for people with dementia using an integrated framework that views the symptoms and behaviors of demented individuals as not solely a manifestation of the underlying disease process, but also reflect the social and environmental context as well as the demented individual's perceptions and reactions. With cognizance of broader issues that apply to psychotherapeutic work with older adults, the original IPT framework for the treatment of depression in younger adults can be applied to older adults. This handbook provides a much-needed resource in treatment approaches for mental health professionals who provide counseling and psychotherapy to older clients. Key questions in thinking about working with older adults concern whether psychological interventions can be expected to work with older adults. Older adults face problems such as chronic illness, grief, and cognitive impairment at a much higher rate than younger clients. In this session, Dr. Knight works with a woman in her 80s who suffered abuse throughout her life, first at the hands of her father as a child, and later, in her marriage to a verbally and emotionally abusive husband. Throughout the book, key research and clinical experience is reported as underlying evidence-based treatment, but the emphasis is on practical guidance for assessment and interventions, rather than detailed discussion of methodological issues. Demonstrated efficacy compared to waiting list control groups qualifies an intervention as "probably efficacious", whereas being categorized as "well established" requires superiority to a psychological placebo group or control treatment (or equivalence to another well-established treatment). Specifically, the authors review patterns of mental health access Issues pertaining to assessment of older adults presenting with physical and psychological symptomatology, preparation of older adults for psychotherapy (including barriers to treatment access or engagement), efficacy of different forms or models of psychotherapy with older adults, and limitations of the authors current knowledge so that future clinicians and researchers may begin to address these gaps and ultimately enhance quality of care for the coming wave of older Americans. Case examples and implications for practice are presented. Clients who had been caregivers for at least 44 months improved with CB therapy. Part I focuses on a series of treatment modalities, including the use of psychotherapy process, group and expressive approaches, family and intergenerational interventions, and social and community interventions. CBT for late-life GAD has garnered the most consistent support, and relaxation training represents an efficacious, relatively low-cost intervention. We conclude that controlled research on psychotherapy for late-life depression is both feasible and urgently needed in palliative care, cancer care, and hospice settings. (2) Is depression the same for older adults as for younger adults? Interview a person of your choice (they may be your parents, relatives, or friends). A classic work on working with dying people and the need for professionals to be comfortable discussing death. Relaxation training, cognitive-behavioral therapy (CBT), and, to a lesser extent, supportive therapy and cognitive therapy have support for treating subjective anxiety symptoms and disorders. Caregivers in each behavioral condition also showed significant improvement in their own depressive symptoms, while caregivers in the 2 other conditions did not. This review describes current empirical evidence in gerontology and treatment outcome research that informs the practice of psychotherapy in this population and provides recommendations for conducting therapy with older adults. Professional Psychology - Research & Practice. Overcoming obstacles in providing mental health treatment to older adults: Getting in the door 0000001084 00000 n What is your favorite thing Interpersonal Psychotherapy for Older Adults with Depression - with Gregory A. Hinrichsen, PhD The basic premise of cognitive-behavior therapy (CBT) is that depression is mediated by depressogenic patterns of thinking. Barrowclough, C., King, P., Colville, J., Russell, E., Burns, A., & Tarrier, N. (2001). Cognitive Behavior Therapy with Older Adults. Describes a method that has been effective in helping students, paraprofessional counselors as well as mental health professionals identify countertransference reactions in themselves. A review of the current literature has led the authors to focus on 5 questions that are important for both researchers and clinicians: (1) How big is the issue of late-life depression? The “Guidelines for Psychological Practice with Older Adults” are intended to assist psychologists in evaluating their own readiness for working with older adults, and in seeking and using appropriate education and training to increase their knowledge, skills and experience relevant to this area of practice. 0000000016 00000 n (Eds.). Psychology and Aging, 22(1), 52-5. (Ed. They offer suggestions and strategies, such as Cognitive Behavior Therapy, for improving the LTC system and residents' physical, psychological, emotional, and social health. Journal of Consulting and Clinical Psychology, 62(3), 543-549. In this section we explore psychosocial developmental theories, including Erik Erikson’s theory on psychosocial development in late adulthood, and we look at aging as it relates to wo… New York: Basic Books, Inc. Bortz, J.J., & O'Brien, K.P. Psychotherapy in long-term care: II. At post treatment, 71% of the caregivers were no longer clinically depressed according to research diagnostic criteria, with no differences found between the two outpatient's treatments. ), (2000). The purpose of this chapter is to review what is currently understood about effective mental health care for older adults. Psychotherapy with older people Multinomial logistic regression was used to estimate the prevalence of the following measures of psychosocial health among adults with and those without epilepsy: 1) the Kessler-6 scale of Serious Psychological Distress; 2) cognitive limitation; the extent of impairments associated with psychological problems; and work limitation; 3) Social participation; and 4) the Patient Reported Outcome … The primary problem I have observed over the years is therapists failing to recognize that clients need to talk about the death of loved ones sometimes even when this is the client's stated presenting problem. CHAPTER 30 Psychosocial needs of the older adult Leslie A. Briscoe Objectives 1. Dr. Hinrichsen demonstrates effectively the process of interpersonal psychotherapy as he helps the client to understand depression, its precipitants, and the path to improvement. Research with a general adult population has not consistently supported the proposed mediational effect of depressogenic thinking (M. Whisman, 1993), as measured by the Dysfunctional Attitudes Scale (DAS) of A. T. Beck et al (1991). Wiley, John & Sons, Incorporated. This study evaluated the efficacy of desipramine alone vs. cognitive/behavioral therapy alone (CBT) vs. a combination of the two, for the treatment of depression in older adult outpatients. Journals of Gerontology Series B-Psychological Sciences & Social Sciences, 52B(4), 159-166. The differences are due to the specialized environmental context rather than to the age of the clients. Discuss the importance of pain assessment, and identify three tools used to assess pain in older adults. Anxiety disorders are a case in point. Working with caregivers requires some basic understanding of the stress and coping process as it affects caregivers for frail older adults. That is, the major reasons for changing therapy when working with an older client are not due to developmental differences but to context effects, cohort effects, and specific challenges common in later life. It will also be an important resource for experienced general therapists who wish to develop greater proficiency in working with older adults. Three research questions were explored: (1) what is the effectiveness of psychotherapeutic and psychosocial treatments (cognitive-behavioral therapy, reminiscence, psychodynamic approaches, relaxation, supportive interventions, control enhancement, psychoeducational treatments, activity treatments and training of cognitive abilities) on self-ratings of depression, clinician-rated depression, … The authors provide a review of the strengths and limitations of this research literature, including a discussion of common assessment instruments. RO is similar but is more useful for its interpersonal functions. In C.R. Evidence-based psychotherapeutic interventions for geriatric depression 0000002556 00000 n New Jersey: John Wiley & Sons, Inc. Assessing and treating late-life depression: A casebook and resource guide The journal of the American Medical Association, 301(14), 1460-1467. After performing an assessment, she builds rapport with the couple and begins the work of instilling hope. The first session with seniors: A step-by-step guide Professional Psychology: Research and Practice. Drawing on the case study of a fourteen-session therapy with a woman in her seventies, it is argued that brief exploratory work can be of particular value to people nearing the end of their lives. Age Page: Depression: A Serious but Treatable Illness (National Institute on Aging) 72 patient-caregiver dyads were randomly assigned to 1 of 4 conditions and assessed pre- and post-treatment, and at 6-mo follow-up. Hinrichsen, G. A. There was no spontaneous improvement during the baseline phase. New York: Guilford Press. In D. Gallagher-Thompson, A. M. Steffen, & L. W. Thompson (Eds. Floyd, M., & Scogin, F. (1998). The nearness of death gives a special urgency and motivation to the work and time-limited therapeutic contract mirrors the reality of having only a short time left. These findings suggest that patient-specific variables should be considered when choosing treatment for clinically depressed family caregivers. For a variety of reasons, psychologists are beginning to see an increasing number of older adults in their practice. Part 1: Older Adult Development Interview Review the various theories of Aging in Chapters 14 and 15 of the text. This book also provides you with ways to improve use of your professional time, effort, and input in LTC. Clinical Psychology: Science & Practice, 12(3), 303-316. Stanley, M.A., Beck, J.G., & Glassco, J.D. These changes, in combination with managed care and market place changes have made older adult clients attractive as a client population to increasing numbers of psychologists and other mental health service providers. Reminiscence and life review provide mild to moderate stage individuals with interpersonal connections. This book provides therapists with the tools and skill sets they will need to face the challenges of administering optimal care to this growing population. (Ed) (1999). Psychotherapeutic interventions changed self-rated depression and other measures of psychological well-being by about one half standard deviation and clinician-rated depression by more than one standard deviation. Treating Alzheimer's Disease through Caregiver Family Therapy - with Sara Honn Qualls, PhD. The focus of this article is on practical considerations for therapists in LTC settings from both the published literature and personal observations (including an illustrative case example), the current policy environment, and the importance of advocacy on behalf of clients. However, CT was more acceptable than both CB and AM when patient symptoms were described as severe. Knight, B.G., & McCallum, T.J. (1998). Treatment includes both psychotherapeutic techniques and pharmacotherapy interventions. Effective treatment, therefore, has the potential to help both the older adult and their caregiver. The higher prevalence of medical disorders makes attention to physical causes of symptoms and to iatrogenic effects of medications as causes of symptoms highly important as well. 3. This article discuss strategies for overcoming these barriers including physical adaptations such as in-home psychotherapy and telephone sessions, use of support groups, strong community outreach, and liaisons with other professionals. Handbook of counseling and psychotherapy with older adults Psychotherapy with older adults: Theoretical issues, empirical findings, and clinical applications Making psychotherapy available to older people also represents an important valuing and validation of their experience. and (5) How is depression treated and how well do the treatments work? It will likely depend on the number and type of older adults seen in the practice. How specialized does a therapist need to be to work with older adults? Evidence was found for efficacy for 4 types of EBTs. 0000000850 00000 n Treatment of generalized anxiety in older adults: A preliminary comparison of cognitive-behavioral and supportive approaches %PDF-1.3 %���� ), (1999). Journal of Mental Health and Aging, 4(1), 9-46. 0000010397 00000 n Department of Health and Human Services. Geropsychological interventions in long-term care (2004). ), Handbook of neuropsychology and aging. 0000006128 00000 n Laidlaw, K., & Knight, B. & Hammen, C.L. Part of the Wiley Series in Clinical Geropsychology, Changes in Decision-Making Capacity in Older Adults: Assessment and Intervention helps to familiarize you with the legal and social contexts for decision making in potentially impaired individuals. Over the follow-up period, the CBT group maintained improvement and had significantly greater improvement than the SC group on anxiety and 1 depression measure. By applying the Selective Optimization with Compensation (SOC) model to various care settings, the editors examine current LTC practices and existing psychosocial issues confronting older LTC patients. Caregiver Family Therapy (CFT) assists families with recognizing, interpreting, and taking action to address symptoms of growing cognitive impairment while continuing to meet the needs of multiple family members. In terms of specific challenges, if the older clients are physically ill, this will pose new issues in both assessment and also in intervention with them. Do you consider yourself old? Dr. Qualls helps Michelle to explore restructuring the family and to develop a list of tasks that need to be accomplished to protect the well-being of her mother, sister, and herself and her family. This chapter begins by reviewing what current research indicates with respect to the symptom profile of generalized anxiety among community elders, with particular reference to the interrelationship between anxiety and depression. The model further asserts that the social context of older adults and the fact that they are members of earlier-born cohorts should be recognized and incorporated into the psychotherapeutic process. Possible reasons for this are discussed. Time's winged chariot: Short-term psychotherapy in later life Clinical Psychology: Science and Practice, 12(3), 321-335. In the model, context means that changes in therapy are often related to the social-environmental context of older adults both in the community and more especially within hospital and nursing home settings, rather than to their developmental stage. Clinical Psychology: Science & Practice, 12(3), 339-353. 0000003280 00000 n Cohort differences are based on maturing in a specific historical time period, leading to a focus on generational groups such as Depression-era generation, GI Generation, Baby Boomers, rather than on age groups. It is likely to be somewhat similar to working with younger adults in medical care settings and rehabilitations settings. Assessments were conducted using a behavioral interview. Aims of therapeutic work with older people and the difficulties for therapists who work with this group are addressed. 289-307). Knight, B.G. Changes in Decision-Making Capacity in Older Adults: Assessment and Intervention Psychotherapy in long-term care: By Powers, David V. The authors conducted a review of the geriatric anxiety treatment outcome literature by using specific coding criteria and identified 17 studies that met criteria for evidence-based treatments (EBTs). Hartman-Stein's approach is to teach couples better ways to cope with the challenges of aging with the resources they have available. There is also a higher frequency of grief work and of attention to caregiving issues. It also requires some knowledge of history before one was born or at least the willingness to learn that history from clients. Probably efficacious therapies for the older adult included cognitive behavioral treatment of sleep disorders and psychodynamic, cognitive, and behavioral treatments for clinical depression. Qualls, S. H., & Smyer, M. A. Before each interview session, familiarize yourself with the questions you are going to ask. Offering options gives her or him a greater sense of control of the immediate environment. Two composite indexes of treatment response were derived to identify treatment responder status and high end-state functioning. 4. While somewhat less different and therefore less specialized than the institutional settings, seeing clients who are living a post-retirement lifestyle, especially if some of their lives are spent in age-segregated environments, requires learning the social rules of those environments. Arean, P., Hegel, M., Vannoy, S., Fan, M. Y., & Unutzer, J. The Gerontologist, 48(3), 311-323. Psychotherapy in long-term care: I. Proposed reasons for this age difference include a greater effect of the "common factors" of psychotherapy (S. Ilardi and W. Craighead, 1994) and an increased need to specifically treat hopelessness in older adults. Many older adults are facing life milestones such as marriage, parenting, advancing in their careers, grand-parenting, and eventually retiring (Belsky, 2013, 366). This book provides you with insight on the psychological issues facing LTC residents whether you are: physicians and geriatricians who care for older adults in the LTC system; nurses and geriatric nurse specialists; social workers; activity coordinators; physical, occupational, and speech therapists within an LTC setting who are seeking ways to explain behavior and empower the residents they care for; or psychologists and psychiatrists whose practice focuses on older adults. (3) How is depression assessed? Three research questions were explored: (1) what is the effectiveness of psychotherapeutic and psychosocial treatments (cognitive-behavioral therapy, reminiscence, psychodynamic approaches, relaxation, supportive interventions, control enhancement, psychoeducational treatments, activity treatments and training of cognitive abilities) on self-ratings of depression, clinician-rated depression, and other measures of subjective well-being in older adults; (2) the influences of moderator variables, and (3) whether the effects of psychosocial and psychotherapeutic interventions vary by age. Rosowsky, E. (Ed), Abrams, R. C. (Ed), & Zweig, R. A. 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To appropriately adapt these techniques, characteristics unique to older adults: an overview,... Cognitive and behavioral Impairments and help to optimize remaining abilities life-stage context ( pp the cost-cutting of... They age they are also experiencing physical, financial, psychosocial interview questions for older adults, emotional and... Authors found that psychodynamic approaches appear helpful for understanding and treating late-life depressive psychosocial interview questions for older adults! Need for community-based health promotion interventions for a variety of psychosocial interview questions for older adults, psychologists are beginning to an. 'Re looking forward to in the door Yang, Janet A., & Scogin F.!, 489-498 the scientific basis for psychotherapeutic interventions with older adults: getting in the folks you! Health disorders that may occur in older adults interview a person of your life so psychosocial interview questions for older adults... 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And relevant assessment tools psychosocial interview questions for older adults between treatment modality and length of caregiving on symptom-oriented..
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