Individual psychotherapy with the institutionalized aged.

Abstract

Contrary to the predisposition of many mental health professionals, this paper contends that insight‐oriented, dynamically‐based, individual psychotherapy is an effective treatment modality with the institutionalized elderly. Issues such as dependency, transference and countertransference, contrasts to psychotherapy with younger patients, and methodological modifications are discussed, and clinical examples are offered.

Depression in Long-Term Care.

“…In some of the earliest, Goldfarb and Sheps (1954) and Goldfarb and Turner (1953) provided a series of case studies of LTC residents with a range of problems, including depression, who were treated successfully with a psychodynamically oriented approach aimed at improving self‐esteem through mastery. Ronch and Maizler (1977) and Semel (1986) reported success with similar, insight‐oriented psychodynamic methods. Applying these concepts in a group format, Meunier (1989) described an empowerment‐focused intervention that encourages residents to acknowledge their assets and set goals, however small.…”

Individual psychotherapy and the elderly.

“…The current generation of elderly have been referred to as having a "generational psyche" (Ronch & Maizler, 1977). Theirs is the experience of immigration, the great depression, two world wars, a bootstrap economy, and seniority experience being outstripped by technology.…”

“…Sharing information about common interests and feelings is an example of this giving process which takes on a symbolic but safe implication of intimacy. Cards, checkers, and an occasional brandy, if appropriate, are examples of behaviors which might be shared (Ronch & Maizler, 1977).…”

“…Laughter and tears shared in common are often important displays of interest and understanding. Do not hesitate to shake patients' hands, pat their shoulders, and gently touch their arms in demonstration of reassurance and support (Ronch & Maizler, 1977).…”

“…Create an atmosphere in therapy of independence for the patients whenever possible (Ronch & Maizler, 1977). This is done by avoiding a patronizing and condescending attitude at all costs.…”