Psychosocial Therapies

Introduction

Polypharmacy refers to the use of multiple drugs by a patient. This occurs when the patient uses too

many forms of medication or when the patient uses more drugs that are prescribed than needed. It also

occurs when all the medications to be used by the patient are clinically prescribed, but there are many

pills to take. It is also referred to as pill burden. Polypharmacy is most common in elderly people, and it

has adverse effects like reaction to drugs and increase in drug costs. Polypharmacy is common in elderly

people suffering from depression and anxiety. The effects of Polypharmacy have forced clinical officers to

provide alternative interventions to treat depression, and anxiety. An alternative intervention to treat

depression and anxiety among the elderly is psychosocial therapies. This paper analyzes if psychosocial

interventions are effective in treating anxiety and depression among the elderly.

Problem

Use of medication to treat patients suffering from depression has many side effects. The patient takes a

lot of pills that are not required. The patient also uses many forms of drugs. This causes adverse effects

like reaction to drugs and increase in cost of drugs. The medication is not effective like psychosocial

therapy as it does not address the main cause of the problem. Psychosocial interventions are more

effective in treating depression and anxiety among the elderly as they address the course of the problem

(Gabbard, Beck & Holmes, 2007).

Literature review

There are several articles that researchers have used to show how psychosocial therapies or intervention

are effective in treating depression among the elderly (Gabbard, Beck & Holmes, 2007).The research

question is in elderly patients with anxiety and depressions are psychosocial therapies effective in

treating the disorder than medication. The article used to carry the research is the Future of Psychosocial

Treatments for Elderly Patients.

Another article is a randomized trial of the effectiveness of cognitive-behavioral therapy and supportive

counseling for anxiety symptoms in older adults (Klausner & Alexopoulos, 1999). This article analyzes

whether existing knowledge about the use of psychosocial interventions among the elderly patients. It

also discusses directions for future practices that can help improve health care among the elderly.

Geriatric disorders occur as a result of several factors. They occur where the patient has mental illness,

disability or has no enough psychosocial therapies (Klausner & Alexopoulos, 1999). Most researchers

argue that, psychotherapy reduces psychopathology and physical complains. Psychotherapy is effective

in treatment of depression. Psychosocial interventions are expected to be more important in treatment

of psychiatric disorders like depression than medications.

Mental illness among elderly people increases the risk of psychopharmacotheraphy. This is either

directly or through interaction with drugs. It can also increase the risk of psychopharmacotheraphy when

the patient does not comply well. This reduces the effectiveness of the process. Psychosocial
interventions and psychotherapy can help elderly patients suffering from depression, and anxiety cope

with many situations. For example, psychosocial therapies can help the patient cope with stressors like

loss of loved ones (Klausner & Alexopoulos, 1999). Most elderly patients with depression and anxiety are

treated by primary care physicians. The primary care physicians help recognizes symptoms of depression

and anxiety. The primary care physician may not recognize the symptoms of the disorders as they are

complicated by attitude of the patients and other factors. Psychopathology interferes with the outcome

of medical illness. This is because it worsens the outcome, and encourages disability.

This makes recognition and treatment of mental disorders to have different outcomes. The impact of

psychopathology should be addressed by delivering psychotherapy in primary environment. This will

provide information for designing good health care system for old people in the community. The study

carried out in the article shows that psychosocial intervention is effective in treating elderly patients with

depression and anxiety. Different types of psychosocial therapies were used to carry out the study. The

psychosocial interventions were more effective in treating depression and anxiety than medication

(Sable1 & Jeste1, 2001).Researchers have found five psychosocial interventions effective in treating

depression and anxiety among the elderly. The psychosocial therapies include cognitive behavioral

therapy and brief psychodynamic therapy.

Other psychosocial interventions include interpersonal therapy, reminiscence therapy and psycho

education therapy (Sable1 & Jeste1, 2001). Cognitive behavioral therapy is aimed at changing the

patient’s thoughts and skills. It also helps modify the emotional state of the patient. Psycho education

interventions are administered in group formats (Gabbard, Beck & Holmes, 2007). The interventions are

aimed at reducing symptoms of depression among the elderly patients. In the study, the elderly patients
were administered psycho education therapy in groups. The interventions helped reduce the symptoms

of depression among the patients. Depressed adults were assigned to get cognitive therapy and

alprazolam. The researchers combined cognitive group therapy and placebo and used placebo alone

(Gabbard, Beck & Holmes, 2007). The interventions given to the group gave different results.

For example, the group that received cognitive therapy showed greater improvement. The therapy

helped the adults improve the mood and sleep efficiency. The group showed high sleep efficiency and

better mood. The group that received placebo alone and Alprazolam alone did not show good results.

The cognitive behavioral therapy was also used to treat other disorders like anxiety among the elderly

patients and it had good results. The anxiety level among the patients went down. This showed that

cognitive behavioral therapy can reduce stress among the patients instead of using medication (Gabbard,

Beck & Holmes, 2007).Another psychosocial intervention that was used in the research is problem

solving therapy.

Problem solving therapy focuses on solving family problems. The therapy is different from other

therapies in that it emphasizes on the social situation of peoples problem. The therapy believes that

people develop problems as a response to their social surrounding. In problem solving therapy, the

therapist is required to solve one problem at a time. The therapist uses techniques that are specific to

the situations. This makes it easy for the therapist to solve problems among the elderly patients

(Gabbard, Beck & Holmes, 2007). The main objective of problem solving therapy is to solve problems

and change the behavior of the patient. The therapist studies the symptoms of the patient and decides

the technique to use to solve the problems. Behavioral solving therapy is aimed at changing the social

situation of the person so as to bring change.

The researchers used the behavioral solving therapy to help elderly patients with stress and depression.

The therapists studied depression symptoms among the patient. The symptoms made it easy for the

therapists to use the right technique to treat depression. Behavioral solving therapy helped eliminate

family problems and other stressors. It also helped the elderly change their behavior. This reduced the

symptoms of stress and anxiety among the patients.The problem solving therapy assumes that lack of

skills in social problem solving increases the susceptibility of depression among the elderly people in the

society. Improving problem solving skills make elderly patients better, and it helps them cope with

dificuity situations (Klausner & Alexopoulos, 1999).. This prevents them from developing

psychopathology. Problem solving is effective in treating depression among patients with dispersion.

Patients who have participated in problem solving therapy have reduced levels of depression.

This is because problem solving therapy helps eliminate symptoms of depression. The elderly patients

showed better results than the patients who did not. Problem solving is effective in controlling

depression and anxiety among the elderly patients as the patients are taught how to cope with

problems. Thus, it is clear that psychosocial therapy is more effective in treating depression and anxiety

than medication (Feldman & Christensen, 2003).Interpersonal psychotherapy also helps treat depression

and anxiety among the elderly. Interpersonal psychotherapy mainly focuses on interpersonal content. It

also focuses on developing interpersonal skills. Interpersonal psychotherapy assumes that interpersonal

factors lead to development of psychological problems. The therapy is different from other therapies in

that it emphasizes on interpersonal. It helps change a patient’s behavior so as to help him adapt to

current roles and situation.

Most elderly people develop mental illness like depression due to isolation (Feldman & Christensen,

2003). Change of roles and interpersonal deficits. The interpersonal therapy is important as it helps

eliminate such problems. Interpersonal psychotherapy is an important treatment for patients with late

life depression. Late life depression can be linked to losses and social isolation (Feldman & Christensen,

2003).Studies have shown that interpersonal psychotherapy alone is effective in treating acute and

continuation depression among elderly patients. It is also effective in treating elderly patients when

combined with pharmacotherapy. In the study, interpersonal psychotherapy was used alone and it

showed effective results. This is because it reduced the level of depression among g elderly patients. It

also reduced the level of anxiety (Feldman & Christensen, 2003).

Then interpersonal psychotherapy was used with psycho education therapy and the outcome was good.

The two therapies were able to reduce the level of depression among g elderly patients. It also helped in

managing depression among elderly people. The study was also carried out using placebo and the

results were not effective. The placebo did not treat depression in the positions effectively. Some

patients still showed symptoms of depression even after being given placebo. Thus, the placebo was not

effective in treating depression among the elderly people like interpersonal psychotherapy. The study

shows that psychosocial therapies are more effective in treating depression and anxiety among elderly

patients than medical interventions (Feldman & Christensen, 2003).The researcher also used

psychodynamic psychotherapy to treat patients with depression. The objectives of psychodynamic

psychotherapy vary from one patient to another. They depend on the medical health of the patient.

It is used on all elderly patients suffering from depression and anxiety. In patients without disability,

psychodynamic psychotherapy aims at resolving interpersonal conflicts. It also helps solve

disappointments and resolve patient’s achievements. In addition, psychodynamic therapy helps a patient

cope with looses and other stressors. For patients who are not very old, psychodynamic psychotherapy

helps the patient accept his or her physical limitations (Feldman & Christensen, 2003). It also helps

eliminate fear of dependency by encouraging the patient to cope with the situation. Moreover,

psychodynamic psychotherapy helps the patient t overcome interpersonal difficulties. Psychodynamic

psychotherapy helped elderly patients with anxiety, and depression. It gave good results like behavioral

therapies, and cognitive therapy.

It also proved more effective than medications used to treat depression and anxiety.Another

psychosocial therapy that was used in the research is reminiscence therapy. Reminiscence therapy was

invented as treatment for depression, and anxiety among the elderly people. The therapy was based on

the assumption that reflection of positive experiences in a patients life helps eliminate depression and

lose of hope. It also assumes that reflections of negative experiences helps control depression and lose

of hope. Reminiscence therapy reduces symptoms of depression among elderly patients (Feldman &

Christensen, 2003). Most researchers have found the method effective in controlling depression among

elderly patients. This is because it helps the patient eliminate symptoms of depression by reflecting on

positive and negative experiences. Though, the method proved effective in controlling depression, it did

not prove effective like behavioral therapy and other therapies.

This is because patients showed some symptoms of depression after some time. The method was

considered effective than medication used to treat depression and anxiety. In addition to being effective

than medication, the method was better than lack of treatment. It helped the elderly patients have a

renewed life. They managed to cope with stressors like bereavement and isolation (Feldman &
Christensen, 2003).The content of the article supports the idea that psychosocial interventions are more

effective in treating depression and anxiety among the elderly than medication. This is because the

psychosocial interventions used are aimed at helping the patient change his or behavior and help him

cope with stressors. The interventions have no negative effects like medications used to treat depression

and anxiety. Thus, they are more effective than medication (American Psychiatric Association, 2000).

King, B, C ., & Colville J, et al. (2001). A randomized trial of the effectiveness of cognitive-behavioral

therapy and supportive counseling for anxiety symptoms in older adults. J Consult Clin Psychol. Vol 69,

page756–62.

Klausner, E,J.,& Alexopoulos,G,S.(1999).The Future of Psychosocial Treatments for Elderly Patients

.American Psychiatric Association

Sable1, J, A .,& Jeste1,D,A.(2001) Anxiety disorders in older adults. Current Medicine Group LLC.Vol 3,

Issue No. 4, Pages302-307