Does therapy work with older adults?
Before turning to psychological interventions, which are the main focus of this resource guide, it should be noted that psychological assessment with older adults is more specialized than are interventions. The higher prevalence of the dementias in late life make some level of neuropsychological screening essential. The higher prevalence of medical disorders makes attention to physical causes of symptoms and to iatrogenic effects of medications as causes of symptoms highly important as well. For more on geropsychological assessment see Lichtenberg (1999).
Gatz et al. (1998) reported that behavioral and environmental interventions for older adults with dementia met the standards proposed at that time for well-established empirically supported therapy. Probably efficacious therapies for the older adult included cognitive behavioral treatment of sleep disorders and psychodynamic, cognitive, and behavioral treatments for clinical depression. For nonsyndromal problems of aging, memory retraining and cognitive training are probably efficacious in slowing cognitive decline. Life review and reminiscence are probably efficacious in improvement of depressive symptoms or in producing higher life satisfaction. Scogin & McElreath (1994) reported a meta-analysis of psychological interventions for the treatment of depression in later life which showed an aggregate effect size (d = .78) roughly equal to that found in another meta-analysis for anti-depressant medications (d = .57, Schneider, 1994) and roughly equal to that found for younger adults in meta-analyses using cognitive-behavioral approaches (d = .73; Robinson, Berman, & Neimeyer, 1990; some studies overlap with those used in Scogin & McElreath, 1994). In general, then, available evidence supports the effectiveness of psychological interventions with older adults, for those interventions that have been studied.