Psychotherapeutic Interventions

Psychotherapeutic strategies need to adapt to the geriatric patient, rather than the other way around. In the United States, the population of adults aged 65 and older is projected to increase from 40.3 million to 72.1 million from 2010 to 2030. Older adults with mental health conditions and major neurocognitive disorder (MNCD) contribute disproportionately to rising healthcare costs. Yet, the number of geriatric mental health specialists is inadequate (Institute of Medicine, The mental health and substance use workforce for older adults. In: Whose hands? Washington, DC: The National Academies Press, 2012), making alternative treatment models a necessity. This chapter reviews common psychotherapeutic strategies which provide alternatives to excessive medication treatment or unnecessary interventions: Psychotherapies for older adults need to accommodate to different social-environmental contexts, rather than only to the older age of the patients (Knight BG, Psychotherapy with older adults, 3rd ed., 2004). Older adults have shown a preference for self-management strategies that fit with their lived experiences, such as increasing their socialization or prayer, but also express willingness to consider professional services like psychotherapy in more severe cases (Nair et al., Gerontologist 60:e93–e104, 2020). Older adults living in the community rated combination (therapy + medication) as more acceptable and preferable over medication alone (Hanson and Scogin, J Gerontol B Psychol Sci Soc Sci 63:P245–P248, 2008). Psychological treatments that are effective in young adults are equally effective in older adults (Scogin and McElreath, J Consult Clin Psychol 62:69–74, 1994). There is a need to foster greater participation, access, and better outcomes for the growing proportion of aging individuals.