Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-cd9895bd7-dzt6s Total loading time: 0 Render date: 2024-12-24T16:45:51.168Z Has data issue: false hasContentIssue false

Chapter 11 - Psychotherapy with Diverse Adults in Later Life

from Part 3 - Special Topics in Psychotherapy in Later Life

Published online by Cambridge University Press:  09 January 2020

By
Sarah A. Nguyen ,
Philip Blumenshine  and
Boski Patel
Edited by
Rajesh R. Tampi ,
Brandon Yarns ,
Kristina F. Zdanys  and
Deena J. Tampi
Rajesh R. Tampi
Affiliation:
Case Western Reserve University, Ohio
Brandon Yarns
Affiliation:
VA Greater Los Angeles Healthcare System
Kristina F. Zdanys
Affiliation:
University of Connecticut
Deena J. Tampi
Affiliation:
Diamond Healthcare Corporation
Get access

Summary

Culturally diverse populations now include groups defined by age, gender, gender identity, language, country of origin and acculturation, sexual orientation, socioeconomic status, religion/spirituality, and geographic location. In this chapter, we will explore issues that arise when performing psychotherapy with diverse older adults, including ethnic minorities, women, LGBTQ, and veterans. Although there is limited evidence on the efficacy of specific therapy modalities with diverse older adults, review of the current literature and clinical guidance on important challenges encountered is provided. For diverse older adults, common psychotherapeutic factors – the quality of the therapeutic alliance, the ability to express empathy, and the therapist’s competence and experience – may be more important than the specific therapy modality used.

Keywords

race and ethnicitycross-culturalLGBTQwomenveterans
Type
Chapter
Information
Psychotherapy in Later Life , pp. 158 - 166
Publisher: Cambridge University Press
Print publication year: 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Blazer, DG, Steffens, DC. Treatment of seniors. In: Hales, RE, Yudofsky, SC, Roberts, LW, editors. Textbook of psychiatry. 6th ed. Arlington, VA: American Psychiatric Publishing; 2014. p. 1233–1262.Google Scholar
Lu, FG, Lewis-Fernandez, R, Primm, AB, Lim, RF, Aggarwal, NK. Treatment of culturally diverse populations. In: Hales, RE, Yudofsky, SC, Roberts, LW, editors. Textbook of psychiatry. 6th ed. Arlington, VA: American Psychiatric Publishing; 2014. p. 1263–1292.Google Scholar
Passel, J, Livingston, G, Cohn, D. Explaining why minority births now outnumber white births. Pew Social and Demographic Trends. Pew Research Center; 2012. Retrieved from: www.pewsocialtrends.org/2012/05/17/explaining-why-minority-births-now-outnumber-white-births (November 2018).Google Scholar
American Psychiatric Association DSM-5 Cultural Formulation Interview (CFI); 2013. Retrieved from: www.psychiatry.org/File%20Library/Psychiatrists/Practice/DSM/APA_DSM5_Cultural-Formulation-Interview.pdf (December 2018).Google Scholar
Falicov, CJ. Changing constructions of machismo for Latino men in therapy: “the devil never sleeps.” Family Process. 2010;49(3):309–329.Google Scholar
Paniagua, FA, Yamada, AM, editors. Handbook of multicultural mental health: assessment and treatment of diverse populations. 2nd ed. San Diego, CA: Elsevier; 2013.Google Scholar
Leong, FT, Lee, SH. A cultural accommodation model for cross-cultural psychotherapy: illustrated with the case of Asian Americans. Psychotherapy: Theory, Research, Practice, Training. 2006;43(4):410–423.Google Scholar
Ryder, NB. The cohort as a concept in the study of social change. Am Sociol Rev. 1965;30(6):843–861.CrossRefGoogle Scholar
Pan, D, Huey, SJ Jr, Hernandez, D. Culturally adapted versus standard exposure treatment for phobic Asian Americans: treatment efficacy, moderators, and predictors. Cultur Divers Ethnic Minor Psychol. 2011;17(1):11–22.CrossRefGoogle ScholarPubMed
Karlsson, R. Ethnic matching between therapist and patient in psychotherapy: an overview of findings, together with methodological and conceptual issues. Cultur Divers Ethnic Minor Psychol. 2005;11:113–129.CrossRefGoogle ScholarPubMed
Cabral, RR, Smith, TB. Racial/ethnic matching of clients and therapists in mental health services: a meta-analytic review of preferences, perceptions, and outcomes. J Couns Psychol. 2011;58(4):537–554.Google Scholar
Presnell, A, Harris, G, Scogin, F. Therapist and client race/ethnicity match: an examination of treatment outcomes and process with rural older adults in the Deep South. Psychother Res. 2012;22(4):458–463.CrossRefGoogle Scholar
Meghani, SH, Brooks, JM, Gipson-Jones, T, et al. Patient–provider race-concordance: does it matter in improving minority patients’ health outcomes? Ethn Health. 2009;14(1):107–130.CrossRefGoogle ScholarPubMed
Roland, A. Across civilizations: psychoanalytic therapy with Asians and Asian Americans. Psychotherapy: Theory, Research, Practice, Training. 2006;43(4):454–463.Google Scholar
Benish, SG, Quintana, S, Wampold, BE. Culturally adapted psychotherapy and the legitimacy of myth: a direct-comparison meta-analysis.J Couns Psychol. 2011;58(3):279–289.Google Scholar
Hwang, WC. The psychotherapy adaptation and modification framework. Application to Asian Americans. American Psychologist. 2006;61(7):702–715.Google Scholar
Jimenez, DE, Bartels, SJ, Cardenas, V, Dhaliwal, SS, Alegria, M. Cultural beliefs and mental health treatment preferences of ethnically diverse older adult consumers in primary care. Am J Geriatr Psychiatry. 2012;20(6):533–542.Google Scholar
Comas-Diaz, L, Jacobsen, FM. Ethnocultural transference and countertransference in the therapeutic dyad. Am J Orthopsychial. 1991; 61(3):392–402.Google Scholar
Santiago-Rivera, A, Kanter, J, Benson, G, et al. Behavioral activation as an alternative treatment approach for Latinos with depression. Psychotherapy: Theory, Research, Practice, Training. 2008;45(2):173–185.Google Scholar
Comas-Diaz, L. The future of psychotherapy with ethnic minorities. Psychotherapy Theory Research & Practice. 1992;29(1):88–94.Google Scholar
Hays, PA. Multicultural applications of cognitive-behavior therapy. Professional Psychology: Research and Practice. 1995;26(3):309–315.Google Scholar
Sue, S. Psychotherapeutic services for ethnic minorities: two decades of research findings. American Psychologist. 1988;43(4):301–308.Google Scholar
Thorn, GR, Sarata, BP. Psychotherapy with African American men: what we know and what we need to know. J Multicult Couns Devel. 1998;26(4):240–253.Google Scholar
Thompson, VLS, Bazile, A, Akbar, M. African Americans’ perceptions of psychotherapy and psychotherapists. Prof Psychol Res Pr. 2004;35(1):19–26.Google Scholar
Conner, KO, Copeland, VC, Grote, NK, et al. Barriers to treatment and culturally endorsed coping strategies among depressed African-American older adults. Aging Ment Health. 2010;14(8):971–983.Google Scholar
Alvidrez, J, Areán, PA, Stewart, AL. Psychoeducation to increase psychotherapy entry for older African Americans. Am J Geriatr Psychiatry. 2005;13(7):554–561.CrossRefGoogle ScholarPubMed
Reynolds, CF 3rd, Thomas, SB, Morse, JQ, et al. Early interventions to preempt major depression among older black and white adults. Psychiatric Services. 2014;65(6):765–773.Google Scholar
Gitlin, LN, Szanton, SL, Huang, J, Roth, DL. Factors mediating the effects of a depression intervention on functional disability in older African Americans. J Am Geriatr Soc. 2014;62(12):2280–2287.Google Scholar
Kim, BJ, Sangalang, CC, Kihl, T. Effects of acculturation and social network support on depression among elderly Korean immigrants. Aging Ment Health. 2012;16(6):787–794.Google Scholar
Paniagua, FA, editor. Handbook of multicultural mental health: assessment and treatment of diverse populations. San Diego, CA: Elsevier; 2000.Google Scholar
Cardemil, EV, Battle, CL. Guess who’s coming to therapy? Getting comfortable with conversations about race and ethnicity in psychotherapy. Prof Psychol Res Pr. 2003;34(3):278–286.Google Scholar
Ortman, JM, Velkoff, VA, Hogan, H. An aging nation: the older population in the United States. US Census Bureau Current Population Reports; 2014.Google Scholar
Hare-Mustin, RT. An appraisal of the relationship between women and psychotherapy. 80 years after the case of Dora. Am Psychol. 1983;38(5):593–601.Google Scholar
Trotman, FK, Brody, C, with contributors. Psychotherapy and counseling with older women, cross-cultural, family, and end-of-life issues. New York: Springer; 2002.Google Scholar
Ogrodniczuk, JS, Piper, WE, Joyce, AS, McCallum, M. Effect of gender on outcome in two forms of short term individual psychotherapy. J Psychother Pract Res. 2001;10:69–78.Google ScholarPubMed
Ogrodniczuk, JS. Men, women, and their outcome in psychotherapy. Psychother Res. 2006;16:453–462.Google Scholar
Parker, G, Blanch, B, Crawford, J. Does gender influence response to differing psychotherapies by those with unipolar depression? J Affect Disord. 2011;130:17–20.Google Scholar
Staczan, P, Schmuecker, R, Koehler, M, et al. Effects of sex and gender in ten types of psychotherapy. Psychother Res. 2017;27(1):74–88.Google Scholar
Steuer, JL. Psychotherapy with older women: ageism and sexism in traditional practice. Psychotherapy: Theory, Research, and Practice. 1982;19(4):429–436.Google Scholar
Mlambo-Ngcuka, P. Challenges facing older women: the feminization of aging. Women’s UN Report Network; 2017. Retrieved from: wunrn.com/2017/02/challenges-facing-older-women-the-feminization-of-aging/ (October 2018).Google Scholar
World Population Data Population Reference Bureau; 2018. Retrieved from: www.worldpopdata.org/ (October 2018).Google Scholar
Brown, JE, Rhee, N, Saad-Lessler, J, Oakley, D. Shortchanged in retirement: continuing challenges to women’s financial retirement. National Institute on Retirement Security; 2016. Retrieved from: www.nirsonline.org/wp-content/uploads/2017/06/final_shortchanged_retirement_report_2016.pdf (October 2018).Google Scholar
Grant, JM, Kosovich, G, Frazer, MS, Bjerk, S, SAGE. Outing age 2010: public policy issues affecting gay, lesbian, bisexual and transgender elders. 2010. Retrieved from: www.thetaskforce.org/downloads/reports/reports/outingage_final.pdf (November 2018).Google Scholar
Hash, KM, Rogers, A. Clinical practice with older LGBT clients: overcoming lifelong stigma through strength and resilience. Clin Soc Work J. 2013;41:249–257.Google Scholar
Steven, D, Cernin, PA. Psychotherapy with lesbian, gay, bisexual, and transgender older adults. J Gay Lesbian Soc Serv. 2008;20:31–49.Google Scholar
Hinrichs, KLM, Donaldson, W. Recommendations for use of affirmative psychotherapy with LGBT older adults. J Clin Psychol. 2017;73:945–953.Google Scholar
Fredriksen-Goldsen, KI, Hoy-Ellis, CP, Goldsen, J, Emlet, CA, Hooyman, NR. Creating a vision for the future: key competencies and strategies for culturally competent practice with lesbian, gay, bisexual, and transgender (LGBT) older adults in the health and human services. J Gerontol Soc Work. 2014;57(24):80–107.Google Scholar
Management of MDD Working Group. VA/DoD clinical practice guideline for management of major depressive disorder (MDD). Washington, DC: Department of Defense, Department of Veterans Affairs; 2016. Retrieved from: www.healthquality.va.gov/guidelines/MH/mdd/VADoDMDDCPGFINAL82916.pdf (October 2018).Google Scholar
The Management of Post-Traumatic Stress Working Group. VA/DoD clinical practice guideline for management of post-traumatic stress. Washington, DC: Department of Defense, Department of Veterans Affairs; 2017. Retrieved from: www.healthquality.va.gov/guidelines/MH/ptsd/VADoDPTSDCPGFinal012418.pdf (October 2018).Google Scholar
Thorp, SR, Stein, MB, Jeste, DV, Patterson, TL, Wetherell, JL. Prolonged exposure therapy for older veterans with posttraumatic stress disorder: a pilot study. Am J Geriatr Psychiatry. 2012;20(3):276–280.Google Scholar
Schonfeld, L, Dupree, LW, Dickson-Fuhrmann, E, et al. Cognitive-behavioral treatment of older veterans with substance abuse problems. J Geriatr Psychiatry Neurol. 2000;13(3):124–129.Google Scholar
Management of Substance Use Disorders Working Group. VA/DoD clinical practice guideline for management of substance use disorders (SUD). Washington, DC: Department of Defense, Department of Veterans Affairs; 2015. Retrieved from: www.healthquality.va.gov/guidelines/MH/sud/VADODSUDCPGRevised22216.pdf (October 2018).Google Scholar
Egede, LE, Acierno, R, Knapp, RG, et al. Psychotherapy for depression in older veterans via telemedicine: a randomised, open-label, non-inferiority trial. The Lancet Psychiatry. 2015;2(8):693–701.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×