Training Guide Addresses Unfamiliar Turf

By Athan Bezaitis on May 28, 2009 7:26 AM

Twenty years from now, the number of people over the age of 65 in the United States will nearly double from 12 to 20 percent of the population. This group, predicted to have greater needs for psychological services than today’s older adults, faces a dearth of mental health professionals specially trained to meet its demands.

Workforce shortages for geriatric mental health care are expected. A 2002 American Psychological Association survey found that just 3 percent of psychologists devote “most” of their time to older clients.

“The profession of psychology as a whole is currently unprepared to deal with the mental health needs of the growing number of older adults,” said Bob Knight, the Merle H. Bensinger Professor of Gerontology and Clinical Psychology.

Considered one of the top clinical geropsychologists in the country, Knight is lead author of an article outlining a training model to provide optimal care for older adults and their families that appeared in an issue of American Psychologist.

The Pike’s Peak Model for Training in Geropsychology, described by Knight along with the article’s co-authors, was developed at the 2006 National Conference on Training in Professional Geropsychology in Pikes Peak, Colo., and is intended to facilitate an increased growth of resources and opportunities for quality training at multiple levels of professional development.

“A psychologist dealing with older adults must develop competencies in attitude, knowledge base and skills that allow for a more complete understanding of the mental health issues affecting individuals and the older population as a whole,” Knight said.

Attitudes, as defined in the Pike’s Peak model, include awareness not only of one’s own bias toward older clients, but also being mindful of how a patient’s diversity interacts with attitudes and beliefs about aging.

Knowledge-based competencies described in the model involve familiarity with adult development, aging and the older adult population, as well as understanding how psychological problems, their assessment and therapy change in older adult clients.

Necessary skills outlined in the model include the ability to assess, intervene, consult and deliver services to older persons.

“The Pike’s Peak model also outlines key steps for advanced training,” Knight said.

Among those steps are:

• education in the process of normal aging

• employing geropsychologists as supervisors in training programs to help students develop skills with older adults

• preparation for how personal bias affects responses to varying health status, individual identities and diverse cultural experiences

• experience working as part of a team and in diverse settings such as nursing homes, assisted living facilities, primary care medical practices, hospitals and clients’ homes.

• preparation for issues such as late-life decision-making, advance care planning, surrogate decision-making and communication with caregiving families in a manner that respects the confidentiality of the older client.

“We hope the model will inspire professional psychologists to expand their practices to include the underserved population of older persons in need of psychological services,” Knight said.

Co-authors included Michele J. Karel of the Department of Veterans Affairs, Boston Health Care System and Harvard Medical School; Gregory A. Hinrichsen of the Albert Einstein College of Medicine; American Psychological Association Congressional fellow Sara H. Qualls of the University of Colorado, Colorado Springs; and Michael Duffy of Texas A&M University.

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