Academic journal article Journal of Cognitive Psychotherapy

Personal Construct Therapy for the Elderly

Academic journal article Journal of Cognitive Psychotherapy

Personal Construct Therapy for the Elderly

Article excerpt

Personal construct theory has provided a model of psychosocial functioning in the elderly. This model analyzes the changing events construed by the elderly, the content of their constructs, the forms of their construing, and the outcomes of these changes for them. Personal construct theory has also provided a model of psychotherapy, describing the roles of the client and therapist, as well as the therapeutic relationship between them. This model has identified the major therapeutic movements that can occur for elderly clients. The two models and the therapeutic movements are illustrated here in a case study.

The need for psychotherapy programs developed specifically for use with the elderly is apparent (Butler & Lewis, 1977). Few such programs have, however, been developed (Levy, Derogatis, Gallagher, & Gatz, 1980; Myers & Salmon, 1984), and those that have, have tended to focus on particular "symptoms," such as depression. When we were funded to establish and evaluate short-term psychotherapy for the elderly, we selected personal construct theory as a conceptual framework for our short-term psychotherapy. The theory provided a model of psychosocial functioning in the elderly which enabled us to articulate our therapeutic goals and also how they could be achieved. It also provided a model of the psychotherapy process, as well as identification of the therapeutic movements to be encouraged. The models of psychosocial functioning in the elderly and of the psychotherapy process, and descriptions of their therapeutic movements, are reported here, together with an illustrative case study. Evaluations of the efficacy of this therapy have been provided elsewhere (Viney, Benjamin, & Preston, 1988; 1989).

PERSONAL CONSTRUCT MODEL OF PSYCHOSOCIAL FUNCTIONING IN THE ELDERLY

This presentation of our model begins with an analysis of the assumptions underlying it. Then follows a discussion of the role of transitions in the model, together with the related concepts of validation and invalidation of the construct systems of elderly people. The content of their constructs is next explored, together with their forms of construing. Finally, the possible outcomes of these transitional processes for the elderly are examined as a basis for identifying appropriate psychotherapeutic goals for the elderly.

The first of the four assumptions basic to our model is one that it holds in common with personal construct theory (Kelly, 1955). It is that people try to make sense of what is happening to them now and what will happen in the future. They do so by building up a system of constructs, on the basis of their past experiences, through which they interpret their own behavior and that of others. This assumption is as true of the elderly as it is of other age groups. The next assumption is about the processes of development throughout the life span. Itis that developmental psychology is a psychology of changing experiences (Viney, 1987a). The subjective rather than the objective perspective is taken. The third assumption follows from the first two assumptions. It is that development occurs where people interpret and reinterpret their experiences, in a process that can be described as serial reconstruction (Bannister & Fransella, 1986). The fourth assumption is that the integration of these reinterpretations is the primary characteristic of development (Hildebrand, 1982). This is especially important for more central, core constructs about oneself, and less so for more peripheral constructs.

Figure 1 provides a schematic account of this model of development for the elderly. It is a complex model, following in the tradition of Erikson (1959) and Jung (1954). The ongoing series of transitions which it represents are set off by events that invalidate some of the constructs of elderly people; that is, they disconfirm their expectations. The events most likely to do this for the elderly fall into four categories. …

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