How young psychotherapists experience working with older patients.

Abstract

Preliminarily findings from experimental and survey research suggests that psychotherapy with older adults is an area of practice in which psychotherapists do not feel positive and confident. This qualitative study is the first to explore how young psychotherapists experience and perceive their therapeutic work with older patients. To do so, we provide an in-depth perspective of how young (aged 27-35) psychotherapists experience providing psychotherapeutic treatment for older patients (aged over 65). Semistructured interviews were conducted with 20 psychotherapists in training (14 women, six men). They were recruited via psychotherapeutic training institutions and geropsychiatry clinics in Germany. The grounded theory approach was used to analyze the data. We found that the participants had various attitudes toward older adults (respectful/admiring, caring/supportive, doubtful, and open) that were related to individual social and biographic experiences with older adults. The participants' attitudes and personal experiences were also found again in their reported therapeutic behavior toward older patients. The finding further showed that the treatment setting (inpatient vs. outpatient) had an additional impact on the participants' perception of and therapeutic behavior toward older patients. Our findings demonstrated that the participants experienced various challenges and particularities when working with older patients. Young psychotherapists who work with older patients should be supported by psychotherapeutic training institutions through supervision and guidance on how to deal with clinical challenges. Furthermore, it can be valuable for young psychotherapists to critically reflect their attitudes toward older adults and personal motives for their therapeutic behavior toward older patients. Public Significance StatementThis study provides an initial insight into young psychotherapists' perceptions of and experiences with older patients, including several particularities and clinical challenges that the work with older patients might pose for young psychotherapists. A detailed insight into how young psychotherapists experience working with older patients can also be useful for the training and education of young health care providers who work with older adults.

Psychotherapists’ experiences providing at-home psychotherapy for home-living older adults with long-term care needs and depression.

“…We identified three specific areas of tension: (a) pushing for change versus acknowledging limitations , (b) providing help versus maintaining boundaries , and (c) behaving as a guest versus host of a psychotherapy session. These three dilemmas add to the limited body of evidence on psychotherapists’ clinical and ethical experiences of conducting psychotherapy with older adults (Boschann et al, 2022; Jones & Knowles, 2021; Lederman & Shefler, 2022, 2023) and outreach treatment with (older) adults in particular (Knapp & Slattery, 2004; Maxfield & Segal, 2008; Yang et al, 2009). In line with previous research, our analysis identified maintaining professional boundaries as a central challenge.…”

“…We considered professional experience as a selection characteristic based on Rønnestad et al (2016), who demonstrated the relevance of psychotherapists’ professional experience for their role perception (experienced psychotherapists achieve a deeper integration of their personal and professional qualities than their colleagues with less experience). We considered age and professional activity as selection characteristics based on Boschann et al (2022), who found that psychotherapists’ age and the treatment setting impacted their self-perceptions of treating older patients. We thus selected the sample to include psychotherapists who differed with regard to age, level of professional experience, and psychotherapists who worked in both inpatient and outpatient settings.…”

“…less confrontational (Boschann et al, 2022). Anecdotal evidence (Knapp & Slattery, 2004;Yang et al, 2009) and a clinical case study (Maxfield & Segal, 2008) identified maintaining professional roles, managing interruptions, and specific transference and countertransference phenomena as challenges associated with conducting specifically at-home psychotherapy (with older adults), and faster relationship building and better insight into the patient's life, including the opportunity to establish contact with family members and professionals, as some of its potentials.…”

“…A recent interview study found that young psychotherapists (27–35 years) had four attitudes toward older patients (65+ years): respectful/admiring, caring/supportive, doubtful, and open. Psychotherapists’ attitudes were related to their social and biographic experiences with older adults and reflected in their self-reported therapeutic behavior toward older patients; in addition, young psychotherapists experienced themselves as friendlier and less confrontational (Boschann et al, 2022). Anecdotal evidence (Knapp & Slattery, 2004; Yang et al, 2009) and a clinical case study (Maxfield & Segal, 2008) identified maintaining professional roles, managing interruptions, and specific transference and countertransference phenomena as challenges associated with conducting specifically at-home psychotherapy (with older adults), and faster relationship building and better insight into the patient’s life, including the opportunity to establish contact with family members and professionals, as some of its potentials.…”

Training in Aging as a Diversity Factor: Education, Knowledge, and Attitudes Amongst Psychology Doctoral Students

“…Education and training in the care of older adults is important to enhance a sense of competence as well as to address negative attitudes (Levy & Macdonald, 2016;Lytle & Levy, 2019) and foster interest (Merz et al, 2017). Though there are unique challenges to working with older adult clients, particularly amongst young psychotherapists, supportive training and supervision may help to facilitate increased competence and comfort working with this population (Boschann et al, 2022). Educational interventions are often geared toward improving attitudes toward older adults, with positive clinical interactions seemingly the most influential (see systematic reviews by Chonody, 2015;Ross et al, 2018).…”