Psychological treatments.

Abstract

The emergence of psychiatry of old age as a speciality has been paralleled by a rapid growth in the application of psychological treatments for the elderly. This chapter offers guidance to adapting treatments to meet the particular needs of older people. While it is necessary to sound a note of caution in case the gains sought are too great, on the whole the problem is overcoming resistance, not least among older people themselves, to the idea that psychological treatments are relevant and effective. Practical applications In some cases a psychological treatment may be the treatment of choice and the only treatment required. More often older people, especially those with serious psychological disorders, have a number of current problems. Psychological treatment then involves working in an orchestrated way with several other professionals, whose skills are also required. This is not always quite as good for the therapist's kudos as playing the solo part, but is generally better at meeting the patient's needs. Psychological treatments may require adaptations for older clients (Box 17.1). Most of these are self-explanatory and allow for the effects of normal ageing and physical change. It is worth emphasising the importance of experience. The patient usually has more than the therapist! Rather than