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Book Review   |    
Handbook of Counseling and Psychotherapy With Older Adults
Richard Zweig, Ph.D.; Eileen Rosendahl, Ph.D.
Psychiatric Services 2000; doi: 10.1176/appi.ps.51.11.1462
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edited by Michael Duffy, Ph.D.; New York City, John Wiley & Sons, 1999, 721 pages, $85

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Despite the growing numbers of older adults, evidence of their neglected mental health needs, and empirical support for their responsiveness to psychotherapy, older adults continue to encounter barriers to obtaining psychotherapeutic treatments. Whether because of ageist or misinformed attitudes of practitioners, limited training opportunities in geriatric psychiatry and psychology, or the youth-oriented culture in which we live, mental health clinicians have been slow to recognize that—quoting Longfellow— "age is opportunity no less than youth" in relation to psychotherapeutic potential.

The Handbook of Counseling and Psychotherapy With Older Adults challenges such barriers by presenting one of the most comprehensive volumes to date of psychosocial interventions applicable to older people. Written "for practitioners . . . by practitioners," with a decided emphasis on treatment rather than on diagnostic issues, the book assembles some of the most distinguished voices in clinical gerontology. Edited by Michael Duffy, a leading authority on counseling and psychotherapy with the elderly, and consisting of 39 chapters by more than 50 authors, it addresses a broad range of treatment issues and interventions. Perhaps owing to the editor's integrative and humanistic orientation, it presents an unbiased sampling of state-of-the-art psychosocial interventions, favors descriptions of therapeutic process rather than outcome studies, and emphasizes specific and practical psychotherapeutic techniques illustrated with rich case examples.

More than half the volume is devoted to various modalities of psychosocial intervention, ranging from individual psychotherapy to group and expressive therapies, couples and family therapies, and community and preventive interventions. The rest focuses on psychotherapeutic strategies for specific psychological problems of older adults and includes mood, anxiety, and personality disorders and dementia among its many topics.

The contributors provide excellent reviews of psychodynamic, interpersonal, cognitive-behavioral, and reminiscence techniques; all are well written and well referenced. The broadening scope of psychosocial interventions for the elderly is compellingly illustrated by superb chapters on couples therapy, interdisciplinary approaches to treating sexual dysfunction, and the dynamics and treatment of narcissism in later life. Particularly unusual is inclusion of topics rarely covered in standard texts, such as family system reorganization when an elderly member is impaired, existential issues in psychotherapy with the aged, and nonverbal strategies to "reach the person behind the dementia." Throughout, the authors present strong support, grounded in phenomenological case description, for the broad utility of psychosocial techniques for addressing psychological problems in older adults.

Of course, any such edited textbook has chapters of variable quality and omits topics of interest to some readers. Most authors, for example, draw on their experience in outpatient settings or nursing homes, although increasing numbers of practitioners treat elderly persons in acute care, rehabilitation, day hospital, or hospice settings and may need to tailor psychotherapeutic techniques to the setting as well as to the client. Nonetheless, because of its comprehensive scope and unique focus on practice techniques, the Handbook of Counseling and Psychotherapy With Older Adults will be of great interest and value to all mental health practitioners seeking to expand their knowledge and to unlock the potential of their elderly clients.

Dr. Zweig and Dr. Rosendahl are senior staff psychologists in the geriatric psychiatry division of Hillside Hospital of the North Shore-Long Island Jewish Health System in Glen Oaks, New York, and are assistant professors of psychiatry at Albert Einstein College of Medicine.




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