Group Therapy with Older Adults
Over the years, there have been legislative amendments in Medical reimbursement that allows psychological services to older people with Medicare coverage. There’s since been an emerging niche in psychotherapy due to generational and legal changes. Baby Boomers are becoming older, and so does their demand for mental care. Demand for mental health services is likely to increase given the fact that the Baby Boomers have higher depression prevalence rates, including mental disorders compared to the GI Generation (Stoner, 2019). Therefore, the demand for mental care among older people is increasing because the Boomers are more psychologically oriented and generally consume higher mental health care services. Therefore, group therapy is ideal among the elderly, while therapeutic techniques are specified as per age groups.
Group sessions involve one or more therapists offering services to a group of patients at the same time. It involved a minimum of 4 patients and maximum of 12 patients who met once or twice a week for an hour or two to share their experiences to promote coping skills. According to Manor Oded (Handbook of Psychotherapy), there should be at least six patients per session and sessions may be closed or open (Stoner, 2019). Most elderly suffer interdependence due to loss of memory or limbs, among other emotional challenges. As such, their psychological demands are unique. The group session begins with pleasantries followed by reasons one was in the group (Initial stage), and it comprised 12 patients. However, the session was in the transition stage; this when members begin to share their experiences as the meeting proceeds. There’s no precise procedure as each session depends on the group’s goals as well as the style of therapy (Stoner, 2019).
Group therapy is often praised for treating depression, but some factors inhibit member’s participation, thus threatening its effectiveness. The session was mired with fear, insecurity, and prejudice. Almost 44% of adults in group therapy report significant improvements, while group therapy’s dropout rate is alarming. Due to lack of confidentiality, there’s the fear of prejudice, making 1 in every 5 patients drop out of group therapy (Stoner, 2019). Most elderly are also suicidal, making them a risk for group therapy. Most therapists face risk working with suicidal clients (Wheeler, 2014). Group therapy is mainly designed for specific issues such as depression, substance abuse, or panic disorders to help gain social and coping skills for anger and self-esteem management. As such, group therapy comprises different personalities leading to various challenges, especially personality clashes. Larger groups are likely to have personality clashes, and since no single patient is the sole focus, treatment is also likely to be diluted, thus longer recoveries (Wheeler, 2014). As such, psychologists use specific therapies on older patients.
Not all older people are prone to mental issues; while some experience mild mental decline, others may suffer dementia leading to impaired brain functions. The session mainly used behavioral therapies. In the U.S, 50-80% of all dementia cases are due to Alzheimer’s, a condition affecting mental functioning, while about 15% of those aged above 60 have mental impairment due to dementia (Stoner, 2019). Cognitive Behavioral Therapy (CBT) is often used to remedy mental issues due to dementia or difficulty with the aging transition. CBT believes that one’s perceptions and moods are based on their thoughts, and as such, its goal is to determine the negative thoughts and alter them with positivity (Wheeler, 2014). One may also use both or either validation and reminiscence therapies while incorporating family and psycho-dynamic therapies. Dialectical Behavioral Therapy (DBT), a combination of both behavioral and cognitive therapies, has proven helpful in stress management by enhancing coping skills (Stoner, 2019).
Based on the suicidal risk, I recommend psycho-education and pharmacotherapy. Psycho-education involves formal education meant to inform patients about their depression and the risk factors. It serves by empowering them to learn about risk factors and coping skills, including treatment options available for their disorder (Davidson et al. 2018). Mediation may also be incorporated with therapy. The use of serotonin and dopamine has proved effective in suicide prevention by elevating neurotransmitter levels to improve moods (Davidson et al. 2018).
In conclusion, group therapy mainly through the use of CBT is ideal for elderly patients, especially those suffering from depression due to physical or mental impairment. Even though most of the elderly are less suicidal, DBT, and family therapy is advised to ensure stress management while limiting dropouts and resistance. Despite patients sharing common experiences, group therapy’s effectiveness is archived when personality clashes and other challenges that may discourage the client’s participation are limited.
References
Davidson, J. E., Zisooks, S., Kirby, B., DeMichele, G., & Norcross, W. (2018). Suicide Prevention: a healer education for and referral program for nurses. JONA: The Journal of Nursing Administration, 48(2), 85-92
Stoner, C. (2019). Positive psychiatry/psychology for older adults: a new and important movement but robust methodology is essential. International psychiatrics, 31(2), 163-165
Wheeler, K. (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice. Springer Publishing Company. Chapter 18 Psycotherapy In Olderadults.