Can Older Adults Benefit From Counseling?

Dear Dr. LeCrone:

I am a 75-year-old man who always believed that anyone seeking help from a “shrink” was either too dumb or too weak to handle his own problems.

After being told by my family doctor that I was depressed and needed counseling, I reluctantly sought help and now feel much better about my life. Please discuss counseling for older adults.
-A reader in Colorado

Dear Reader: Thank you for your request.

Counseling objectives for older individuals often involve dealing with such things as:

• Feelings of neglect, abandonment, manipulation or abuse.

• Grief over losses, including death of friends and family.

• Concerns dealing with disability, chronic pain or other health issues.

• Issues of perceived failures earlier in life and the guilt/depression that may relate to these issues.

• Concerns over relationships with adult children, especially those dealing with independence/dependence.

• Despair and frustration over unresolved conflicts from the past.

Counseling can consist of supportive psychotherapy aimed at helping people adjust to issues of health, a change in living environment and loss. Other therapies may be directed at helping change patterns of unhealthy thinking that may be interfering with someone’s perception of the past, present and future.

Pain, which accompanies many diseases of aging such as arthritis, can be treated successfully with psychological/behavioral therapies.

Life-review strategies often help older adults deal with their past and, in particular, unresolved conflicts. They are encouraged to deal with "unfinished business," which often means working through a process of self-forgiveness or forgiving others for real or perceived past transgressions.

An important aspect of life-review therapies is that they seem to help people realize that they are worthwhile because they have really done something significant in their lives and have had an impact on other people. Life-review therapies have been shown to be effective in increasing self-esteem and renewing interest in areas that once held meaning and satisfaction.

Reminiscence therapy encourages people to reminisce and reflect on various aspects of their life and during the process receive positive feedback from the therapist. The process also encourages the development of insight into positive areas of one's past, which may have been overlooked or temporarily forgotten.

These and other counseling techniques are not designed to help extend life, but are, instead, suggestions to improve the quality of life.