Week 10: Psychotherapy With Older Adults
According to the Institute of Medicine, more than 20% of the growing older adult population has a mental health disorder (IOM, 2012). In the past, many older adults avoided psychotherapy because of the associated social stigma, but with the growing acceptance of therapy and awareness of mental health issues, more of this population is seeking the help they need. In your role, as the psychiatric mental health nurse practitioner, you have the opportunity to help these older adult clients overcome challenges that may have plagued them for a lifetime.

This week, as you explore psychotherapy with older adults, you assess clients and consider the appropriateness of various therapeutic approaches.

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Learning Resources
Required Readings
Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company.

Chapter 18, “Psychotherapy With Older Adults” (pp. 625–660)
Chapter 20, “Termination and Outcome Evaluation” (pp. 693–712)
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

McGuire, J. (2009). Ethical considerations when working with older adults in psychology. Ethics & Behavior, 19(2), 112–128. doi:10.1080/10508420902772702

Swift, J. K., & Greenberg, R. P. (2015). What is premature termination, and why does it occur? In Premature termination in psychotherapy: Strategies for engaging clients and improving outcomes (pp. 11–31). Washington, DC: American Psychological Association. doi:10.1037/14469-002

Document: Week 10 Case Study (PDF)

Discussion: Therapy with Older Adults
Clients who are older have often times been dealing with their mental health disorder their entire lives, whiles other disorders may be brought on through the aging process or the trauma of losing a lifelong partner. Treatment can be challenging for both the client and the therapist. For this Discussion, you will focus on therapeutic approaches for an older adult presented in a case study.
Learning Objectives
Students will:
Assess clients presenting with depression
Analyze therapeutic approaches for treating clients presenting with depression
Evaluate outcomes for clients presenting with depression
To prepare:·

Download and review the Week 10: Case Study from this week’s Learning Resources.
Review this week’s Learning Resources and reflect on the insights they provide.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click Submit, you cannot delete or edit your own posts, and cannot post anonymously. Please check your post carefully before clicking Submit!

By Day 3
Post a treatment plan for the older adult client in the Week 10: Case Study found in this week’s Learning Resources. Be sure to address the following in your post:

Which diagnosis should be considered?
What is the DSM-V Coding for the diagnosis you are considering?
What is your rationale for the diagnosis? Be sure and link the client’s signs and symptoms to the DSM-V diagnostic criteria to support your diagnosis.
What tests or tools should be considered to help identify the correct diagnosis?
What differential diagnosis should be considered?
What Treatment Strategy would you recommend?
What treatment would you prescribe and what is the rationale?
Safety
Psychopharmacology
Diagnostic Tests
Psychotherapy
Psychoeducation
What standard guidelines would you use to treat or assess this patient?
Clinical Note: Is depression a normal part of aging?
Support your approach with evidence-based literature.

Read a selection of your colleagues’ responses.

By Day 6
Respond to at least two of your colleagues by providing one alternative therapeutic approach. Explain why you suggest this alternative and support your suggestion with evidence-based literature

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