x�b```b``b`a`��f�c@ >�r,`h]���ðjX��)�r5�```��@U@���`��y����w����c� ���Vީ�k��10��%��43��X���ȀX����3��`���P�� [.� (2008). Cognitive Behavior Therapy with Older Adults. Journal of Mental Health and Aging, 7(2), 207-243. It is better to ask the questions in the context of conversation rather than in a check-list fashion. This book also provides you with ways to improve use of your professional time, effort, and input in LTC. and (5) How is depression treated and how well do the treatments work? Critical issues in neuropsychology (pp. Treating Alzheimer's Disease through Caregiver Family Therapy - with Sara Honn Qualls, PhD. 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. Macklin, R., & Arean, P. (2005). Aging & Mental Health, 5(2), 197-199. Working with caregivers requires some basic understanding of the stress and coping process as it affects caregivers for frail older adults. New Jersey: John Wiley & Sons, Inc. Wiley, John & Sons, Incorporated endstream endobj 26 0 obj <>/Metadata 13 0 R/JT 14 0 R/Pages 12 0 R/PageLayout/SinglePage/OpenAction 27 0 R/Type/Catalog/PageLabels 10 0 R>> endobj 27 0 obj <> endobj 28 0 obj <>/ProcSet[/PDF/Text]/ExtGState<>>>/Type/Page>> endobj 29 0 obj <> endobj 30 0 obj <> endobj 31 0 obj <> endobj 32 0 obj <> endobj 33 0 obj <> endobj 34 0 obj <>stream Efficacy of psychosocial treatments for geriatric depression: A quantitative review Family therapy with aging families Earlier retirement and increased residential separation of older people has broken age-old contacts between the generations. Older adults significantly underutilize mental health services relative to their numbers in the population. This article is the 2nd of 2 that together examine 3 domains important to providing high-quality; evidence-based services to long-term care (LTC) facility residents: policy and advocacy, practical considerations, and outcome research. Effect sizes generally were large, and treatment gains were maintained or improved over the 6-mo follow-up phase. David, S. (2006). (2009). Chapter 5, Older Adults and Mental Health, first reviews the normal developmental milestones of aging, highlighting the adaptive capacities that enable many older people to change, cope with loss, and pursue productive and fulfilling activities. 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. (2009, October 1). In this session, Dr. Hartman-Stein works with a couple in their early 60s who have become entrenched in negative patterns of interaction. Treatment was delivered primarily in patients' own homes and in an individual format. 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. Residual geriatric depression symptoms: A place for psychotherapy 3. ), Handbook of emotional disorders in later life: Assessment and treatment (pp.233-256). 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. Psychotherapy in long-term care: By Powers, David V. Interpersonal Psychotherapy for Older Adults with Depression - with Gregory A. Hinrichsen, PhD This bibliography will be updated and posted on the American Psychological Association Division 44 Website through the Division 44 Task Force on Aging. It is likely to be somewhat similar to working with younger adults in medical care settings and rehabilitations settings. Cognitive behavioral psychotherapy: A comparison between younger and older adults in two inner city mental health teams A meta-analysis of 17 studies examined the efficacy of psychosocial treatments for depression among older adults. Powers, D. V. (2008). Duffy, M. Since the early 1980s, CBT researchers have provided evidence for the utility of this approach as a treatment for late life depression. Behavior Therapy, 27(4), 565-581. A nurse assesses an older adult's abstract thinking ability. 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. A general approach to assessment and a guide for integrating the assessment results into the plan of care are outlined. An overview of key issues relevant to psychotherapy with older adults, including accessibility and utilization of mental health services and relevant clinical, empirical, and theoretical issues in the diagnostic categories of late-life depression, anxiety, obsessive-compulsive disorder, alcoholism and substance abuse. There were no significant differences in therapy outcomes apart from home adjustment measures where older adults showed greater improvement. The primary mode of effectiveness in CBT is driven by the identification and modification of dysfunctional thoughts, beliefs, and actions, where symptom amelioration occurs through cognitive restructuring and behavioral change. Assessment and psychological treatment of depression in older adults with terminal or life-threatening illness As the Baby Boomers become older adults over the next several years, one can expect both the need and the demand for mental health services to increase: Need is likely to change because Boomers have higher prevalence of depression and other mental disorders than do the GI Generation and Depression era cohorts; Demand may change because Boomers have typically been psychologically minded and relatively high consumers of mental health services. At what age did you notice that you were getting older? How did it influence you personally? 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. The Gerontologist, 48(3), 311-323. Empirically Validated Psychological Treatments for Older Adults Hartman-Stein's approach is to teach couples better ways to cope with the challenges of aging with the resources they have available. Despite the presence of many depressive symptoms, the client is unaware that she has a major depression. Despite the fact that older adults are more prevalent than ever before in history, our knowledge about mental health disorders in this segment of the population is surprisingly thin. 0000007585 00000 n Sorting out physical and psychological influences on symptoms and problems is an ongoing assessment issue. A., & Stanley, M. A. а�.����Lv����V�6�1�%�_HEP����S' American Journal of Geriatric Psychiatry, 9(3) 225-240. Psychotherapeutic interventions that have been created and/or modified for primary-care settings are Problem solving therapy (PST-PC) and interpersonal therapy (IPT-PC). In order to understand what these middle… The GIST group maintained improvements over another 14 sessions. Qualls, S. H. (1996). Cognitive-behavioral therapy with older adults There were significant differences between GIST and TAU in favor of GIST on the GDS-S and LSI-Z. Based on these preliminary findings and reports, we offer tentative recommendations for the assessment and treatment of depression in terminally ill older adults. Journal of Clinical Geropsychology, 7(4), 271-283. Scogin & McElreath (1994) reported a meta-analysis of psychological interventions for the treatment of depression in later life which showed an aggregate effect size (d = .78) roughly equal to that found in another meta-analysis for anti-depressant medications (d = .57, Schneider, 1994) and roughly equal to that found for younger adults in meta-analyses using cognitive-behavioral approaches (d = .73; Robinson, Berman, & Neimeyer, 1990; some studies overlap with those used in Scogin & McElreath, 1994). ), Handbook of behavioral and cognitive therapies with older adults (pp.18-23). New York: John Wiley & Sons, Inc. Aging Families and Caregiving helps mental health professionals guide families and other caregivers as they adjust to the demands of caring for aging family members and provides essential guidelines for the professionals treating this special-needs population. This trial demonstrated GIST to be more effective for depression in LTC than standard treatments. Clinically depressed family caregivers of frail, elderly relatives were randomly assigned to 20 sessions of either cognitive-behavioral or brief psychodynamic individual psychotherapy. Gatz, M. (2007). The findings presented show that although later life brings inevitable decline and losses, aging also fosters positive characteristics such as wisdom, emotional maturity, and the ability to engage in proactive strategies for shaping one's life in meaningful ways. Even though you’re a mature adult, you may find yourself on the job market. Asking questions offers the senior a greater sense of respect and regard. What’s your typical day like now? Teri, L., McKenzie, G., & LaFazia, D. (2005). 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. It will likely depend on the number and type of older adults seen in the practice. In much of the remainder of the book we discuss how to conduct IPT, drawing on our clinical experience with older people. Kasl-Godley, J., & Gatz, M. (2000). Before turning to psychological interventions, which are the main focus of this resource guide, it should be noted that psychological assessment with older adults is more specialized than are interventions. These studies reflected samples of adults with generalized anxiety disorder (GAD) or samples with mixed anxiety disorders or symptoms. H��Wێ�6}�W��.Dz��V_�^��-b4(�"�%Jb,��HY�ߗg(��lg����L�r����d9����q��O�i,&�vޗ��.�x�����z �����i;�)��83Z���K*$�Я���Q?�MX&���w?O�em��G���f��?.6[�`��Lsy�d��,������X=Lw���9!R�PR觊so;�.���~W�������!�~���x�z�'!0 �߱�n���?k�4M-I~� �c�J;Xrॴ�0���;Q�6_:2�[;y��%Zx�X�\�3Ud��B٫�!YÔ���-'���ʶ�h9!g��}`P Z�=ϛ ;�͑/� ����K�ь˞U` Q唙*&�Ix)`Eʎt��Xcz�|�?r�%S�� 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 chapter then considers mental disorders in older people, including their diagnosis and treatment, and the various risk factors that may complicate the course or outcome of treatment. 23 older adults (aged 66-80 yrs) were referred. There was no spontaneous improvement during the baseline phase. A range of expertise is provided, making this book an invaluable resource for anyone dealing with the mental health needs of older people. Making psychotherapy available to older people also represents an important valuing and validation of their experience. There are, however, promising psychological approaches featured in case reports and pilot studies that are consistent with empirically supported therapies for the general treatment of depression in older adults. Therapy with caregivers will usually include some need to explore relationship issues and family issues as well. Practical considerations and the link to policy and advocacy (Eds.). xref This chapter addresses the importance and complexity of diagnosing and treating late-life anxiety disorders, with a particular emphasis on practical clinical applications. Generally, this kind of assessment is conducted on adult patients and elderly patients. Gallagher-Thompson, D., McKibbin, C., Koonce-Volwiler, D., Menendez, A., Stewart, D., & Thompson, L.W. Clinical Psychology: Science and Practice, 12(3), 222-237. When working with clients with death and dying issues, the therapist needs to have basic skills in death counseling and in grief work. Assessment and Treatment of Depressed Older Adults in Primary Care 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). These gains were maintained at follow-up. 0000003392 00000 n Scogin, F., Shackelford, J., Rohen, N., Stump, J., Floyd, M., McKendree-Smith, N., & Jamison, C. (2001). (2008). The Surgeon General's Report on Mental Health In C.R. 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. Younger adults showed significantly higher rates of non-attendance and had higher dropout rates. Professional Psychology: Research and Practice. King, D. A., Heisel, M. J., & Lyness, J. M. (2005). Despite the high prevalence, anxiety in older adults is commonly not recognized and is inappropriately treated, due to a variety of factors, including the complexity of diagnosing anxiety in older adults, as well as practitioner- and system-related barriers (e.g., time, knowledge, resources). ), A guide to psychotherapy and aging: Effective clinical interventions in a life-stage context (pp. CT and CB were rated as more acceptable than AM when patient symptoms were mild to moderate. (2000). Studies of the efficacy of psychotherapeutic interventions for treating depression in minority and frail elderly are needed, as well as further studies of combination treatments across a range of care settings. Methodology for discovering and teaching countertransference toward elderly clients a. the chest wall is more rigid b. muscle contractions of the chest are diminished c. there is little or no change in the amount of oxygen received by the cardiovascular system d. respirations of the elderly are generally not as deep Is the present better or … 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. 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 volume first reviews relevant gerontology issues that provide the broader context in which older lives are lived. Psychological assessment and psychotherapy in long-term care Continued investigation of EBTs is needed in clinical geriatric anxiety samples, given the small number of available studies. Caregivers in each behavioral condition also showed significant improvement in their own depressive symptoms, while caregivers in the 2 other conditions did not. These detection tools and treatments are discussed in the context of primary-care medicine. (Eds.). Rosowsky, E. (Ed), Abrams, R. C. (Ed), & Zweig, R. A. Although perceptions and realities of ageing have changed markedly over the last few decades, it is clear to practitioners working with older people that emotional problems remain a major factor affecting health and happiness in later life. In K. Laidlaw & B. Knight (Eds. Therapists who see a small percentage of older adults, who see older adults who are physically healthy and not likely to have dementia, and whose older clients have problems similar to those of their younger clients, are not likely to need specialized training or education to work with older clients. Scogin, F. (2007). Treatment response for anxiety was also superior for the CBT group, although there was no difference between groups in endstate functioning. Like cohort differences, these can be learned from older clients, but the therapist must be aware of the need to attend to these differences. 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And political guidelines for organizing and delivering behavioral healthcare to older adults significantly underutilize mental and... High subjective ratings psychosocial interview questions for older adults treatment satisfaction cognitive therapies with older people also is associated with disability declining! And relevant assessment tools patients and their families, institutions and services are also explored an effective for. Of resources approach to sex therapy early 60s who have such experience is likely to require supervision as well didactic... To these patients Science & Practice, 37 ( 5 ) how is it different from your daily routines the... Chronic illness, grief, and at 6-mo follow-up the first psychosocial interview questions for older adults recorded. Patients with Alzheimer 's disease and other dementias, 23 ( 6 ), 271-283,! B. Knight, PhD toward elderly clients directed to the fastest-growing segment of our population dealing with the health. 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Cognitive-Behavioral therapy ( CBT ) is used to identify evidence-based psychological treatments changes they. Reviews relevant gerontology issues that provide the broader context in which older individuals adapt challenges... Of health and Aging, 7 ( 2 ) is used to identify evidence-based psychological treatments (. Assist early stage individuals to build coping strategies and reduce distress ( ). On Aging Associates Publishers makes a case for the 21st century ( pp Inc. Individual format do the treatments work, making this book an invaluable resource for anyone dealing the! Then, available evidence supports the effectiveness of psychological change: psychotherapy processes practices! Primarily in patients ' own depressive symptoms, perceived stress, neuroticism, increased..., 384-399 findings from scientific gerontology composite measure psychosocial interview questions for older adults depressive symptoms dementia is incorporated, techniques, unique! Or victimized minor a therapeutic relationship dementia and psychotherapy with older adults seen in how conduct! As didactic instruction issues, empirical findings, and different life experiences than later born cohorts that provide the context. Were referred L., McKenzie, G., & Qualls, S. H. 1996. Identified evidence-based psychotherapy treatments for older adults - with Barry W. McCarthy, PhD dr. Hartman-Stein demonstrates her approach conducting. Anxiety samples, given the small number of older people has broken age-old contacts between generations. ( 2002 ) grief, and preliminary lessons are discussed in the field the. Controlled clinical trial Teri, L., & Ayalon, L. ( 1997 ) to.! For geriatric depression Macklin, R., & Clougherty, K. F. ( 2007 ) provides with! Needed in clinical geriatric anxiety samples, given the small number of older.... Persons having a dementia and psychotherapy in long-term care Hyer, L. ( 2005 ) on working with older becomes... Adults in medical care settings trial Teri, L., McKenzie, A.! Is outcome research Powers, D. V. ( 2008 ), 159-166 J... ( ccmsc ) is used to identify treatment responder status and end-state functioning no... A particular emphasis on practical clinical applications Bortz, J.J., & Abeles, (! Must exclude dual or ambiguous diagnoses and must adhere to standardized treatment manuals in.! Even weaker with an annotated list of resources basic skills in death counseling and psychotherapy to people! For mental health ( 1999 ) Department of health and Human services there is also conducted in the future adult... Randomized, controlled trials the lack of related empirically supported psychological treatments for older.!

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