Explore career as a geropsychologist
Aging brings unique changes to our bodies, changes that are not only physical, but cognitive as well. Disease and illness affect us more frequently, driving us to depressive thoughts. Retirement, deaths of loved ones, and physical limitations also contribute to negative reactions, and sometimes we need professional help to regain our lives.
Geropsychologists are clinical psychologists who focus on the unique problems older adults face every day. Through the use of therapy techniques, geropsychologists treat the depression and anxiety that afflict many older adults. (see Depression Treatments and Anxiety Treatments)
Geropsychology is a rapidly growing field. Adults are living longer, and more geropsychologists will be needed to assist older adults with aging problems. Adults over 65 represented 12.4% of the population in the year 2000, but are expected to encompass 19% of the population by 2030, according to the Administration on Aging.
To accommodate this population boom in older adults, the National Institute on Aging estimates that 5,000 doctoral-level geropsychologists will be needed by 2020. These geropsychologists will apply their expertise through comprehensive knowledge and understanding of aging-related research, assessment, and treatment.
Geropsychologists analyze research studies to employ treatment methods for older adults. Research studies on age-related disorders, caregiving, and approaches to therapy provide these professionals with guidelines and insight on how to best treat older adults suffering from depression (see Depression), anxiety (see Anxiety), addiction (see What is Drug Addiction?), or mental distress (see Mental Health Disorders).
American Psychological Association (APA) guidelines state that geropsychologists must familiarize themselves with the biological, social, and psychological aspects of aging to effectively treat older adults. A psychologist who understands difficulties that arise during the aging process will also gain a greater understanding of the available treatments and therapies that help patients through that process. Understanding different mental health disorders, their causes, and their effects on aging prepares geropsychologists to assess these disorders.
Anxiety and depression are integral research topics for geropsychologists because they are the most common mental disorders among older adults. Depression affects more than 6.5 million older Americans and has grave consequences if it remains untreated, according to the National Alliance on Mental Illness (NAMI). Physical health issues have been linked to depression, including increased heart attack risk, stroke, and cardiovascular disease. Geropsychologists must be familiar with reasons behind anxiety and depression, such as deteriorating health, financial concerns, housing issues, and loneliness.
Using knowledge they have gained from research studies, geropsychologists assess and diagnose mental health problems and disorders. Depression and anxiety are often mistaken to be normal reactions to the aging process, but this is simply not true. Older age often leads to physical limitations that some adults find hard to manage in healthy ways.
Geropsychologists employ their diagnostic abilities to help differentiate between serious mental illnesses and normal reactions to stress, such as the loss of a loved one, retirement, and housing problems. Sadness and grief are normal, temporary reactions to loss and hardships, according to NAMI. But when sadness and grief last for months, the services of a geropsychologist become necessary. Correct assessment of older adults leads to effective treatment.
One way that geropsychologists assess depression is through the Geriatric Depression Scale, a brief questionnaire that asks 15 questions regarding how an individual felt during the previous week. Depending on how many answers correlate with depressive symptoms, the geropsychologist will follow up, applying the appropriate interventions and treatments. Some of the questions include:
- Have you dropped many of your activities and interests?
- Are you afraid something bad is going to happen to you?
- Do you often feel helpless?
- Do you think it's wonderful to be alive now?
- Do you prefer to stay at home, rather than going out and doing new things?
To treat age-related mental disorders, geropsychologists apply psychological interventions. According to the APA, the most common interventions include cognitive behavioral, interpersonal, and psychodynamic psychotherapies.
Cognitive behavioral therapy
Cognitive behavioral therapy (see CBT) is a treatment that focuses on negative patterns of thinking that often afflict those with mental or physical disorders, or those who are undergoing hardships in life. CBT examines the fatigue, pain, and financial difficulties that feed these disorders, and works to shift negative thinking to positive thinking.
According to “Cognitive Behavioral Psychotherapy in Older Adults,” published by The San Francisco Treatment Research Center, psychologists Bob. G. Knight and Derek Satre state that CBT is effective at treating depression, anxiety, complications from chronic illness, alcoholism, and insomnia in older adults.
CBT restructures cognitions by examining underlying assumptions. For example, author and psychologist Renée R. Taylor states that patients with chronic illness often think in the following negative ways:
- “Sick people are a burden.”
- “No one wants to hear about another person's medical problems.”
- “If I ignore my symptoms, I won't be such a burden on others.”
- “I can tell they will be relieved when I am gone.”
Writing in Cognitive Behavioral Therapy for Chronic Illness and Disability, Taylor says these and other negative thoughts influence behaviors by causing the individual to not seek treatment, or tell his or her primary care doctor about depressive thoughts.
Those who suffer from mental health issues often feel overwhelmed by life's problems, so patients work with the geropsychologist to set manageable goals to help alleviate these problems. Geropsychologists give homework assignments to patients so they change their attitudes not only at therapy, but also outside of it. Homework assignments involve learning experiences where patients identify and monitor negative thoughts, and are taught to question the validity of those thoughts.
Geropsychologists help alleviate problems by acknowledging feelings of helplessness and guilt associated with disabilities and other life changes.
According to “Cognitive Behavioral Principles in Managing Chronic Disease” by psychologist Craig A. White, some of the common questions geropsychologists pose to depressed older adults include:
- “What experiences have you had that have shown you this thought is not completely true?”
- “Do you think about things this way when you are feeling less distressed? How do you think about things at these times?”
- “Might you be underestimating the chances of your being able to do something to lessen your distress?”
- “What is the evidence to support your distressing thought? Is this the only way of looking at things?”
Interpersonal psychotherapy focuses on negative feelings about relationships split into four areas: role transition, grief, interpersonal deficit, and role dispute.
Role transition. During role transition, the geropsychologist helps the patient give up an old role in order take on a new one. Older adults who retire, experience the death of a spouse, or move to a new location often become depressed and anxious about giving up an old role, and must develop new skills or thoughts. Geropsychologists teach skills that assist patients in identifying new roles, which also helps them manage depression.
Grief. Interpersonal psychotherapy also has treatment options for older adults who are grieving the death of a loved one. Deaths occur more regularly with older age, and geropsychologists assist older adults by guiding them through the mourning process, reestablishing relationships, and engaging in activities that distract them from their losses. As therapy concludes, geropsychologists help reinforce the patient's self confidence to cope independently.
Interpersonal deficit. Older adults often have feelings of interpersonal deficit, or social isolation, leading geropsychologists to focus on reconnecting the patient with family or friends. Geropsychologists examine past relationships the patient has had, and look for communication problems in those relationships. Geropsychologists the help patients re-examine those past relationships, remembering positive aspects of them, and increasing their confidence in making new friends. To increase interpersonal communication skills, geropsychologists encourage older adults to increase social interactions, either through group meetings, clubs, or other activities.
Role dispute. Changing roles in interpersonal relationships, or role disputes, are often attributed to marital or family problems, where the older adult is demoralized by the relationship, and it is contributing to depression. Geropsychologists work with patients to identify problems that caused disputes, help patients change their behaviors toward others, and reassess expectations of relationships.
Psychodynamic psychotherapy examines the unconscious mind to identify problems that might negatively affect day to day life. Empathic listening, exploratory inquiry, and interpretation of experiences make up the bulk of psychodynamic therapy, according to “Psychodynamic Psychotherapy with Older Adults,” published in Practical Geriatrics. The author, Dr. Alexander Morgan states that psychodynamic therapy is beneficial for older adults, allowing them to reminisce about the past and deepening their self knowledge.
Older adults focus on the past naturally, so this therapy gives them an opportunity to examine how a lifetime of experiences affects their current behaviors.
For example, according to “Psychodynamic Work and Older Adults,” published in Advances in Psychiatric Treatment, author Jane Garner states that how an older adult reacts to dependence in later life is correlated to how the adult viewed dependence in early life.
By identifying past complications, the geropsychologist assists the patient in resolving these issues, relieving anxiety or depression.
Morgan explains one of the challenges in using therapy with older adults is that many are unwilling to seek treatment. Older adults are more likely to believe that by visiting a therapist, they might be viewed as “crazy.” Transportation issues and financial difficulties also hinder many older adults from seeking treatment.
How Do I Become a Geropsychologist?
Geropsychology is a clinically-based field that typically requires a median of seven years of education, training, and internships past the undergraduate level. A strong dedication to advancing older adult issues, and finding new solutions to age-related mental disorders is required of geropsychologists.
To learn more about age-related work in the field of Psychology, request information from schools offering gerontology degree programs.
Meeting the demand for geropsychologists
The baby boomers are set to make more waves in the coming years, as the generation begins to impact the population of older adults in America. In 2001, older adults in America numbered 35 million, and by 2030, that number is expected to double to 70 million. A number of psychologists are working with older adults, but don't receive enough training to treat their unique issues.
“In Psychologists in Practice with Older Adults: Current Patterns, Sources of Training, and Need for Continuing Education,” published in Professional Psychology: Research and Practice, it's predicted that the psychology field isn't producing enough geropsychologists to meet rising demand. The study, conducted by a group of researchers from major universities and the American Psychological Association (APA) examines the lack of psychologists specializing in older adult care, and suggests remedies for the shortage. The APA predicts 5,000 doctoral-level geropsychologists will be needed to work full-time with older adults by 2020.
The study yielded survey results from 1,227 psychologists, and 69% reported they currently provided care to older adults, mostly in the form of psychotherapy. But the majority of responders indicated that their experience with older adults came mostly from informal on-the-job training, rather than formal studies at a university. In fact, only 3% of responders reported geropsychology as their career focus, furthering a need for more psychologists to concentrate in the area.
The study offers two solutions to the apparent shortage of geropsychologists. First, the study recommends increasing opportunities through increased internship funding for students to gain experience in the field of Geropsychology. The study indicated students who worked with older adults in an internship were more likely to offer services to older adults in a professional setting.
It also recommends placing emphasis on continued education for psychologists who wish to gain more knowledge about the aging process. The study showed psychologists were most interested in learning more about the problems older adults face, including:
- Adjusting to medical illness
- Caregiver Stress
The estimated demand for geropsychologists in the future will outnumber the actual amount of geropsychologists available, making career opportunities in the area very strong.