Intervention, consultation, and other service provision: A foundational geropsychology knowledge competency.

Abstract

To address the shortage in geriatric behavioral health professionals, it is crucial for more psychologists to become competent in working with older adults. This article will provide an overview of foundational geropsychology knowledge regarding intervention, consultation, and related services. We will begin by reviewing general and specialized psychological interventions with older adults, as well as adaptations based on aging-related changes and diverse care settings. Next, we will review health and medical factors that can impact service delivery. We will highlight characteristics of different treatment settings and interdisciplinary collaboration in providing consultation services, as well as services such as health promotion and illness prevention. We will summarize administrative best practices when psychologists work with older clients, including documentation of medical necessity for psychological services, billing, and reimbursement procedures compliant with state and federal laws and regulations. Finally, we will end with a discussion of ethical and legal considerations such as informed consent, confidentiality, substitute or end-of-life decision-making and potential conflicts of interest, diminished capacities, and elder abuse and neglect. Public Health Significance StatementGiven the growing population of older adults aged 65 and older, there is a need for psychologists who are competent to provide psychological services to older adults. Psychologists who find themselves working with older adults are encouraged to enhance their knowledge and competencies specific to diverse older adult populations and treatment settings to ensure high quality care of older clients. The authors hope that information provided within this article will serve as a guide to providing foundational knowledge competencies related to providing interventions and consultation services with older adult clients.

Clinical practice: A foundational geropsychology knowledge competency.

“…There is wide variability between older adults, thus it is important to attend to modifications and adaptation that may be needed early on and across the course of therapy. Please see Lind et al (in press) article in this special edition for full review of this topic.…”

Knowledge of aging reduces risk of harm: Why you need to read this special issue.

“…Although a clinical psychologist's approach to treatment of depression might not vary based on age, the assessment and treatment plan likely need to be adjusted for the advancing age of the client. Furthermore, clinical services must be adjusted to accommodate the context in which services are delivered, a context shaped by the individual characteristics of the person being served, the community in which services are provided, and the role of the psychologist in the service delivery team (Lind et al, 2021). In short, later adulthood is a distinct period in the lifespan during which aging processes affect emotional, cognitive, social, developmental, and neuropsychological functioning in ways that need to be incorporated into assessment and treatment.…”

“…Furthermore, the research literature on what is distinct about the aging process and the later period of human life is proliferating rapidly. The documentation of cultural attitudes toward aging (Garrison-Diehn et al, 2021), distinctive symptom presentations of mental disorders late in life (Jacobs & Bamonti, 2021), and evidence-based treatments and practices (Jacobs & Bamonti, 2021; Lind et al, 2021) illustrate the growing scientific base for practice with older adults. The articles in this special issue do a remarkable job of summarizing what is now a vast literature on aging in a form that can be used by psychologists who do not intend to be experts in geropsychology, to ensure adequate understanding of the aging process to support effective health services for older adults.…”

“…Among the areas of competency that geropsychologists must develop are the role of psychologists in determinations of legal incapacity in particular domains and abuse/neglect reporting and evaluation. As noted by Lind and colleagues (2021), distinct ethical dilemmas arise from these complex contexts that psychologists are often best prepared to address. Some geropsychologists are lucky enough to be members of strong interprofessional teams that include social work, medicine, nursing, pharmacy, and rehabilitation professionals with whom to partner on complex cases, but in many practice environments, psychologists need to know the topography of the service contexts to help clients, patients, and their families navigate them.…”

“…For psychologists who work, in complex health care service systems, building professional consultation competencies enable them to participate in improving the lives of older adults through interprofessional partnerships (Lind et al, 2021). The nearly universal presence of chronic disease in the later decades of the lifespan offers opportunities for psychologists to practice in integrated care settings to address behavioral health concerns related disease prevention, management, and maintenance (Jacobs & Bamonti, 2021; Lind et al, 2021; Mast et al, 2021). Psychologists have long practiced in long-term care, especially nursing homes, but are far less often found tightly partnered with community agencies that focus on home health, hospice, senior housing, adult protective services, or legal services.…”