Psychotherapy

Psychotherapy involves individual or group meetings with a therapist trained to use various techniques to treat psychopathology. Psychiatrists, psychologists, nurses, social workers, and counselors can provide psychotherapy interventions to older adults with psychiatric disorders. Review of the literature suggests that psychotherapy is an effective treatment intervention, either alone or in conjunction with medication, for many psychological disorders in older adults.

Advanced age can be accompanied by bereavement, relationship conflicts (either marital or with adult children), or chronic or acute illness. Although such difficulties are more common among older adults than younger adults, the development of psychiatric symptoms as a response to life stress is never normal, and most older adults remain psychologically healthy in the face of difficult circumstances.

The normal aging process does provide challenges for therapists in adapting psychotherapy to older patients. Some types of cognitive function decrease in elderly persons, although the distribution of function is widely varied. Therapists may need to proceed through material at a slower pace, or in smaller units with more repetition. Memory aids, such as tape recordings of sessions, written notes, and reminders, can help patients recall information. Clearly defined goals and strategies, plus an agenda and structure for each session, are beneficial. Also, elderly patients are more likely to have loss in visual or auditory acuity or have coexisting medical problems, requiring adaptation of standard techniques.

Many elderly persons with medical problems take multiple medications, making it difficult for a psychiatrist to prescribe and manage additional medications. This makes psychotherapy an appealing option for older adults. Though research suggests the most promising treatment for late-life psychological disorders is combined medication and psychotherapy, psychotherapy alone is also an effective treatment option. Just as there is a myriad of medications for treating psychological disorders, psychotherapy options are quite varied as well, and depend upon structure, goals, and suitability to the problem of depression, anxiety, or dementia.