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Geriatric Psychiatry pp 177–200Cite as

Psychotherapy in Late Life

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Abstract

Older individuals face an increasing complexity of challenges such as physical limitations and changes in roles and environment that can add to latent, unresolved psychological conflicts. Even though physicians often think of biological treatment options first, we need to remember that many psychotherapies have been adapted for older patients and are effective in reducing depression and anxiety, decreasing isolation, and improving function and general well-being. This chapter provides an overview of psychotherapies with an emphasis on the relationship between the patient and the therapist (the alliance), which constitutes a fundamental common factor for all therapies. Two cases will illustrate the evolution of psychotherapeutic encounters with older patients in order to facilitate the mastery of the psychotherapy principles at any training level.

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Notes

  1. 1.

    The words “therapy” and “psychotherapy” are considered equivalent in the context of this chapter (unless stated otherwise); hence, both will be used interchangeably. The same applies to “therapist” and “psychotherapist.”

  2. 2.

    Up until the French Revolution (late 1700s), psychiatrically ill persons were treated as criminals, shuttered away in dungeons, and chained to their cells in abominable conditions. Philippe Pinel, known to many as the first to remove chains from the “insane,” laid the groundwork for humanitarian treatment (“traitement moral”). His publications assured him the honorific title, “father of psychiatry” [2].

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Author information

Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, University of California Davis Medical Center, Sacramento, CA, USA

    Caroline Giroux MD

  2. Department of Psychiatry, Saint John Regional Hospital, Dalhousie University Memorial University, Saint John, NB, Canada

    W. Edwin Smith

Authors
  1. Caroline Giroux MD
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  2. W. Edwin Smith
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Corresponding author

Correspondence to Caroline Giroux MD .

Editor information

Editors and Affiliations

  1. Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada

    Ana Hategan

  2. Baylor Scott and White Department of Psychiatry, Texas A&M University College of Medicine, Temple, Texas, USA

    James A. Bourgeois

  3. Division of General Medicine, University of California Davis Medical Center, Sacramento, California, USA

    Calvin H. Hirsch

  4. Department of Psychiatry and Behavioral Sciences, University of California Davis Medical Center, Sacramento, California, USA

    Caroline Giroux

Appendix

Appendix

In his book The Gift of Therapy, Irvin Yalom addresses core themes in therapy divided in 85 short chapters. The title for each chapter could be used as helpful guidelines easy to memorize. Here are some examples:

  • Remove the Obstacles to Growth

  • Avoid Diagnosis (Except for Insurance Companies)

  • Therapist and Patient as “Fellow Travelers”

  • Let the Patient Matter to You

  • Acknowledge Your Errors

  • Create a New Therapy for Each Patient

  • The Here-and-Now—Use It, Use It, Use It

  • Blank Screen? Forget It! Be Real

  • Encourage Self-Monitoring

  • Give Yourself Time Between Patients

  • Express Your Dilemmas Openly

  • Never Be Sexual with Your Patient

  • Look for Anniversary and Life-Stage Issues

  • Dreams—Use Them, Use Them, Use Them

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Giroux, C., Edwin Smith, W. (2018). Psychotherapy in Late Life. In: Hategan, A., Bourgeois, J., Hirsch, C., Giroux, C. (eds) Geriatric Psychiatry. Springer, Cham. https://doi.org/10.1007/978-3-319-67555-8_8

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  • DOI: https://doi.org/10.1007/978-3-319-67555-8_8

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-67554-1

  • Online ISBN: 978-3-319-67555-8

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