Psychotherapies with older people: an overview

Abstract

Psychotherapies with older people have been slow to develop, both theoretically and operationally, in the UK. This is due to ageism and the predominance of models of psychological development relevant to children and younger adults. Despite this, many have applied their practice and skills to psychological work in old age psychiatry, countering the dominance of the 'organic' model. An evidence and practice base exists to suggest that cognitive-behavioural therapy, interpersonal therapy, cognitive analytic therapy, psychodynamic and systemic approaches can help in a range of psychiatric problems in older people, including affective disorders, personality disorders and dementia. The inclusion of older people in existing psychotherapy services and the development of networks of practitioners whose support and supervision are encouraged are likely to be positive ways forward.Jason Hepple is a consultant psychiatrist and Medical Director of Somerset Partnership NHS and Social Care Trust (Magnolia House, 56 Preston Road, Yeovil, Somerset BA20 2BN, UK. E-mail: jason.hepple@sompar.nhs.uk). He is a clinical research fellow of the Peninsula Medical School and is a cognitive analytic therapy practitioner and supervisor.

Computerised cognitive‐behaviour therapy (cCBT) and older people: A pilot study to determine factors that influence willingness to engage with cCBT

“…The postal response rate alone was high at 58.5%. Such willingness to participate in research should be noted, given Hepple's (2004) observation that older people tend to be excluded from research. Since nearly half of the respondents said they would be interested in using computerised therapy, we might infer that a considerable proportion of older people with mild to moderate anxiety and/or depression may be willing to engage with cCBT.…”

“…Due to the absence of older people in the cCBT research, it is not yet clear what adaptations, if any, should be made in order for older people to benefit from it. Research shows that some adaptations should be made when using CBT with older people (Hepple, ). Future cCBT research ought to consider the impact of variables pertinent to older people, such as benign memory loss, bereavement, stroke, chronic pain, and arthritis.…”

Cognitive behavioural therapy for older adults with depression: a review

“…Ageism, or the discrimination against people on the grounds of age alone, has been slow to gain public awareness in Western society, which has been a significant hindrance to development of expertise, research, and services (Hepple, 2004). In addition, potential barriers to older adults receiving CBT may include invalid beliefs that older adults are unlikely to benefit from psychotherapy (Laidlaw et al, 2008).…”

Crossing Age and Generational Boundaries: Exploring Intergenerational Research Encounters

“…Insights from psychodynamic work on aging (Garner, 2002; Hepple, 2004) suggest that feelings and emotions brought into the intergenerational exchange may blur age and generational boundaries. While not all issues in late life are related to aging (Kaufman, 1986), the issues of incurable illness, long‐term impairment, death of loved ones and long‐term caregiving often experienced in late life, bring specific challenges (Grenier & Leonard, 2006).…”