Integrative Care Models

Chapter 7 discusses integrative care models within geropsychology, including how mental disorders, including depression, anxiety, and substance abuse, frequently co-occur with physical illnesses, either as precipitating or exacerbating factors, and are associated with increased risk of multiple physical health problems and mortality in older adults. It also discusses the Integrated Health Care for an Aging Population (IHCAP) report of 2008, competencies related to integrated care, interprofessional healthcare teams, team development, and the role of the psychologist in integrated care.

Applying the Pikes Peak Model of Treatment Competency to the Use of Cognitive-Behavioral Therapies with Older Adults

Chapter 6 examines specifically the application of Beck’s cognitive-behavioral therapy (CBT) and problem-solving therapy (PST), an adaptation of cognitive-behavioral techniques, with the older adult population. It also uses the Pikes Peak Model to identify the focal areas needed for competent delivery of these treatments with older adults. It also covers the Pikes Peak Model, which outlines six areas to be considered in the competent application of treatment: applying interventions with appropriate modifications, using evidence-based treatments, developing appropriate treatments when there is a lack of evidence available, proficiently employing common late-life intervention, using interventions to enhance the health of diverse elderly persons, and intervening across settings.

Interpersonal Psychotherapy and Psychodynamic Psychotherapy

Chapter 5 reviews two psychotherapeutic approaches that have been adapted or developed for use with older adults: interpersonal psychotherapy (IPT) and psychodynamic psychotherapy. It also discusses the elements of these psychotherapeutic interventions, needed adaptations for older adults, and evidence of their efficacy, and is mindful of competencies outlined in the Pikes Peak Model.

Teaching, Supervision, and the Business of Geropsychology

Chapter 10 covers the enormous attention given to the multiple training and employment opportunities, including research, clinical practice, teaching, and services targeted at the elderly. It also addresses the need for competent geropsychologists with a commitment to teaching and supervision, and how these individuals must be skilled in providing appropriate training for those interested in learning about older adults, whether on an applied or professional level, at a place of business or an academic institution. It covers the Pike’s Peak Model, an aspirational competency-based approach to professional psychology, including aspects of teaching, supervision, and business, offered for those at any stage of their training, to further support the needed skills in geropsychology.

Older Adult Assessment Issues and Strategies

The purpose of the present chapter is to provide some of the basic assessment-related knowledge that would be expected of a psychologist who is preparing to work with older adults, and to provide suggestions for addressing some of the challenges of assessing older adults. The chapter was prepared with the assumption that clinicians at the novice and intermediate levels would particularly benefit from the information.

Individual and Cultural Diversity Considerations in Geropsychology

Chapter 8 discusses individual and cultural diversity considerations in geropsychology, including how diversity is a broader concept when considered at the individual and cultural levels. It addresses how diversity encompasses ethnicity and race as well as age, gender, income, education, location of residence, national origin (US-born, foreign-born, immigrant status), language, family composition, disability (physical, cognitive, emotional), religion/spirituality, and sexual orientation. It covers the need for the conceptualization of geropsychology to encompass diversity as a foundational competence, and to provide for the ability to meet the needs of today’s changing demographic, of committing the profession to social responsibility, and of ensuring that core practices of assessment, intervention, and consultation will remain innovative and relevant for the needs of older adults.

Conceptual and Scientific Foundations

This chapter is meant to provide a comprehensive overview of the aging process, including descriptions of the physical, psychological, social, and environmental challenges that can accompany later life. The processes described in this chapter are associated with normative aging . Nevertheless, it is important to recognize the great diversity in this age group, an understanding critical to an informed geropsychological practice.

Professional Identification

Chapter 1 discusses the history and evolution of geropsychology, including the identification of the core corpus of geropsychology knowledge, the development of training curricula, and the recruitment of new students to the field. It also covers the Omnibus Budget Reconciliation Act (OBRA), which permitted Medicare to directly compensate licensed psychologists for supplying mental health services to older patients in a variety of settings, the launch of Division 12, Section 2 (today called the Society of Clinical Geropsychology), the APA-affiliated group, Psychologists in Long Term Care (PLTC), the Committee on Aging (CONA), and the Council of Geropsychology Training Programs (CoPGTP).

The Field of Geropsychology

The development of competencies in geropsychology represents another key step in the maturation of the professional practice of psychology with older adults. The science and practice of psychology related to aging expanded rapidly in the second half of the 20th century, marking several other key steps of maturation, all of which readied the field to define the competencies needed to practice in this discipline. This chapter identifies the discipline of geropsychology (The Psychology of Aging) as a distinct discipline in research and practice, articulates central tenets of the theoretical framework, and explores overlaps with related disciplines.

Ethics

Chapter 9 has three broad aims. Firstly it provides a detailed review of the foundational competencies for ethical geropsychology practice, including the fundamental tension between the values of respecting the autonomy versus protecting the safety of an older adult; the concept of decision-making capacity; the challenges of surrogate decision making; and legal, clinical, and social tools central to working with vulnerable older adults. It then covers specific ethical issues that can arise in psychological assessment, intervention, consultation, and research with older adults or care systems are identified, followed by a model for ethical decision making in geriatric care.