Psychotherapies and Non-pharmacological Interventions
This chapter provides an overview of therapeutic modalities that may be useful for geriatric patients within inpatient settings including, but not limited to, medical units, skilled nursing facilities, and acute psychiatric units. Despite the time and resource limitations inherent in each of these settings, there are psychotherapeutic approaches that may be adapted to the environmental and staffing resources while also being individualized for the patient. Several approaches discussed here may be also used in groups. Inpatient settings also offer the opportunity for team members to make direct interventions throughout the day, which can facilitate early readjustments based on each patient’s needs, potentially accelerating improvement. Team members of various experience levels can undergo training in specific therapeutic modalities and coordinate appropriate interventions with the primary or consulting psychiatrist. Despite the logistical and environmental challenges to implementation, the targeted use of a thoughtfully chosen psychotherapeutic approach has the potential to not only improve the patient’s mental health but also enable him/her to participate more fully in medical care, with better treatment outcomes and quality of life.
KeywordsCognitive behavioral therapy (CBT) Psychotherapy Geriatrics Inpatient Problem-solving therapy (PST) Competitive memory training (CMT) Reminiscence group therapy (RGT) Problem adaptation therapy (PAT) Mindfulness-oriented intervention (MOI) Behavioral activation (BA) Acceptance and commitment therapy (ACT) Social problem-solving therapy (SPST) Reminiscence therapy and life review (RT & LR) Group psychotherapy Art Music Exercise
- 7.Wilson KC, Mottram PG, Vassilas CA. Psychotherapeutic treatments for older depressed people. Cochrane Database Syst Rev. 2008;1:CD004853.Google Scholar
- 10.Hummel J, Weisbrod C, Boesch L, Himpler K, Hauer K, Hautzinger M, et al. AIDE-acute illness and depression in elderly patients. Cognitive behavioral group psychotherapy in geriatric patients with comorbid depression: a randomized, controlled trial. J Am Med Dir Assoc. 2017;18(4):341–9.CrossRefPubMedCentralGoogle Scholar
- 12.Schore AN. Affect regulation and the repair of the self. New York: W.W. Norton; 2003.Google Scholar
- 36.Chan SCC, Chan CCH, Derbie AY, Hui I, Tan DGH, Pang MYC, et al. Chinese calligraphy writing for augmenting attentional control and working memory of older adults at risk of mild cognitive impairment: a randomized controlled trial. J Alzheimers Dis. 2017;58(3):735–46.CrossRefPubMedCentralGoogle Scholar