Academic journal article Journal of Counseling and Development : JCD

Evidence-Based Effective Practices with Older Adults

Academic journal article Journal of Counseling and Development : JCD

Evidence-Based Effective Practices with Older Adults

Article excerpt

Older adults (persons over age 65) constitute a unique population that has been underserved in the area of counseling services (Myers & Schwiebert, 1996). An estimated one third of individuals in this population have mental health problems for which professional intervention is needed, including anxiety, depression, and other diagnosable mental disorders (Smyer & Qualls, 1999), but this estimate fails to incorporate normative developmental issues such as the transition to retirement, grandparenthood, and second careers. When developmental issues are included, clearly the incidence of mental health needs among the older population increases. Given the changes in the demographic structure of society in the United States, specifically the dramatic increase in the numbers of older persons, it is highly likely that professional counselors will encounter older persons and their families as clients (Myers, 1995). As a consequence, counselors' repertoire of knowledge and skills should include strategies for assessment and intervention to address both the common mental health concerns of persons in later life and the normative issues of aging.

Although persons over the age of 60 make up almost 13% of the total United States population (AARP, 2000), they represent only 6% to 8% of persons seen in community mental health clinics and outpatient mental health settings and an even smaller percentage of clients seen by private counseling practitioners (Smyer & Qualls, 1999). Barriers to the use of these services by this population include bias toward older persons among service providers and reluctance of older persons to seek counseling, as well as a lack of adequate training and supervised clinical practice with this population that would allow counselors to be both comfortable with and effective in service to older clients (Nordhus & VandenBos, 1998). Such training requires an understanding of effective intervention practices.

In this article, we provide a brief overview of the older population and describe several important differences in counseling with older and younger persons. We review and discuss outcome studies that reveal effective strategies and best practices for counseling with older persons. We accessed these studies from reviews of PsycINFO, the ERIC database, and counseling journals. We also consider implications for clinical practice, counselor training, and needed research.

THE OLDER POPULATION: DEMOGRAPHICS, COUNSELING NEEDS, AND COUNSELING CHALLENGES

Professional counselors working with older persons need to understand how those in this population are like persons of other ages and how they differ. A brief review of key demographic indicators provides information on some risk factors in later life, such as gender, ethnicity, and income. Commonly experienced circumstances in later life create counseling needs, and the higher incidence of mental health concerns combined with these needs contributes to challenges for counselors working with older clients. It is important to note that, although traditional, stereotypical views of aging present a negative perspective dominated by poor health, disability, functional limitations, and increasing mental illness, recent research on later life reveals that older persons typically age well (Myers, 2003); are resilient in responding to stress, transitions, and change (Myers & Schwiebert, 1996); and experience a lower incidence of mental illness than do persons of younger ages (Smyer & Quails, 1999).

Demographics

The total population of older persons in the United States numbered 34.5 million in 1999, representing 1 in every 8 persons--an 11-fold increase during the twentieth century (AARP, 2000). Life expectancy increased from 47 years in 1900 to 76.7 years in 1998. The total older population is expected to increase to 20% of the population by 2030, with significant increases in older minority populations. …

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