Psychological Treatment of Older Adults ― A Holistic Model

"This is one of the best mental health and aging books I have ever read. [It] is one that I will turn to often in my teaching of doctoral students, and in my work with older adults. One of the phenomenal aspects of this book is the research reviews; which are in-depth and broad in their scope. It is clear that Lee Hyer is an exceptional scholar-clinician and geropsychologist.."—Peter A. Lichtenberg, PhD

Drawing from current research and clinical practice, this text espouses a unique interdisciplinary approach to the assessment and treatment of psychosocial impairment in older adults. This approach, called "Watch and Wait," is grounded in a "whole person" model of care rather than one that addresses symptoms or syndromes in isolation. This model advocates relationship building, prevention, psychoeducation, multipronged interventions for comorbid problems, and communication. It does so in the context of a multidisciplinary health care team, the patient, and family.

The model encompasses five core factors of psychosocial impairment in older adults: depression, anxiety, cognitive deficits, adjustment or life problems, and health issues. Considered together, they provide an integrated understanding of the older adult that is more likely than single-disorder models to facilitate successful outcomes for common psychosocial difficulties that occur in later life. The book describes in depth the unique components and complex interactive influences of these five factors as they apply to older adults seeking mental health treatment. A cornerstone of the author's approach is treatment based on stringent care-based assessment and thorough monitoring of empirically supported interventions. Each factor is considered individually from its empirically supported basis as well as its interaction with the other factors. Distinct treatment modules are isolated for each factor and assembled to provide the optimal pathway for clinical treatment.

The text also addresses the unique difficulties of diagnosing the aging population, the pitfalls of existing treatments, and the need for brain-based models for care.

• Advocates for integrative, interdisciplinary care and primary care involvement for the older adult
• Emphasizes core components of care: depression, anxiety, cognition, pain/sleep/health issues, adjustment in the community
• Demonstrates how a single-problem approach for older adults with psychiatric problems is not effective or efficient care
• Espouses a "Watch and Wait" paradigm of care, based on person-centered diagnosis and careful monitoring of treatment
• Translates and integrates current research findings with clarity
• Covers use of SSRIs and other medications, suicide, subsyndromal states, issues involving cost of care for the older patient, among other topics
• Plentiful case examples