Psychosocial treatment of the geropsychiatric patient

Abstract

SUMMARYAlthough clinicians believe strongly in the efficacy of various psychotherapeutic approaches to the geropsychiatric patient, to date there have been relatively few studies to validate these claims. We will selectively review some of the more clinically relevant studies concerning individual psychodynamic, cognitive, and behavioral psychotherapy, focusing on treatment of the depressed geriatric patient. Also reviewed are studies about the cost-effectiveness of psychiatric intervention, as well as innovative hospital-based treatment modalities. Although progress has been made, Rechtschaffen's succinct summary of the psychotherapy literature in 1959 is still pertinent today; 'As is true for psychotherapy as a whole, systematic, controlled studies of the effectiveness of various treatments of older people are still lacking. Ultimately, there must be empirical grounds for predicting which type of treatment will work best for which type of patient' (Rechtschaffen, 1959).KEY wows-Psychosocial, therapy, old age, dementia.We will review and critique germane studies of psychosocial treatment approaches with the elderly that have clinical relevance to the practising psychia trip!. The approaches considered are psychodynamic psychotherapy, cognitive and behavioral therapy, an innovative geriatric hospital unit, and a study utilizing statistical meta-analysis to examine the cost benefits of mental health treatment.Only within the last few decades have empirical studies been carried out concerning psychosocial treatment approaches with the geropsychiatric patient. These empirical studies were preceded by, and simultaneous to, an extensive literature by skilled clinicians who reported favourably upon the responsiveness of elderly patients to psychotherapy (

Geriatric Depression

“…44 Common issues for the geriatric patient involve grief, family and peer losses, assumption of new roles, and acceptance of mortality. These nonpharmacological therapies can improve self-esteem, reduce helplessness and anger, and can improve quality of life.…”

“…These nonpharmacological therapies can improve self-esteem, reduce helplessness and anger, and can improve quality of life. 44 Common issues for the geriatric patient involve grief, family and peer losses, assumption of new roles, and acceptance of mortality. Group therapy is especially effective in that it can provide an opportunity for mutual support as well as provide a mechanism for new friendships at a time when many long-term friends may have died.…”

The Difficult Elderly Patient: Curable Hostile Depression or Personality Disorder?

“…One is never too old to change (Weiss & Lazarus, 1993). New techniques in psychotherapy for older patients are available (Wayne & Myers, 1991).…”