Therapy With Older Clients: Key Strategies for Success

"Dr. Marc Agronin takes us on a thoughtful journey through the many facets of aging. Along the way he provides a wealth of information about interventions with older clients, and the ways in which we can educate and assist their caretakers and family members. Therapy with Older Clients is a useful and comprehensive guide for beginning therapists, an informative overview for medical professionals. and a valuable reference for anyone who sees an occasional older client."-Louis Cozolino, PHD, author, The Healthy Aging Brain: Sustaining Attachment, Attaining Wisdom

"Therapy with Older Cheat, is an excellent resource to help the practicing professional work optimally with an aging clientele. Comprehensive in its scope yet immensely readable, in it Agronin uses plenty of ease vignettes and real-life examples to not only clarify important conceptual points, but introduce innovative ideas that can be directly applied to therapy. New clinicians who want to learn effective intervention strategies will find it particularly useful, but its also an essential resource for any professional on how to effectively address the psychological needs older adults."uRobert D. Hull, PhD, Professor. Educational Psychology, University of Utah, and author, Positive Aging

"This book must become required reading for any professional working with an older population. Its direct and clear style and vivid clarifying case vignettes make it equally suitable for therapists, regardless of their population, as well as nonprofessional caretakers, perhaps a family member. While the author makes a persuasive case that everyone, even the deeply impaired can benefit from an attuned and attentive relationship, he is never unrealistic in his goals. Dr. Agronin feels we need curiosity, caring and courage to work with the aged and the book itself reflects such a humanistic approach."-Sophie Freud, Msw, PhD, Professor Emerita of Social Work, Simmons College

What is it like to be 106 years old? What are the mental health needs of someone this old, and for that matter, all elderly? Can we, as clinicians and caregivers, ever really understand old age and provide for their needs adequately? How can we prevent the physical problems they face from overwhelming the patience and care that we give? What are the most effective therapeutic tools that underlie all successful therapy work with older clients?

Whether you are a caregiver or a professional mental health clinician, caring for the elderly is complex, challenging work. Often they are wrestling with a unique set of medical, psychiatric, and social challenges, all set against the backdrop of their approaching mortality. The therapist's jobueven those who aren't accustomed to working with this client populationuis to successfully navigate these challenges without dwelling on the inevitability of physical decline, and to provide the most compassionate, valuable treatment possible.

It is with this guiding principle in mind that Marc Agronin, a dedicated geriatric clinician with years of on-the-ground experience, offers a sensitively-written and eminently practical guide that addresses the therapeutic challenges, and uncovers the top strategies for compassionate and effective work with the elderly.

Therapy with older clients, Agronin argues, requires a sensitivity to the tension between the body's physical decline and its simultaneous capacity for mental growth and maturation. Therapists must learn to handle these seemingly opposing forces with varying client types and in different settings, and reconcile their own fears of aging, disability, and death. At times this therapeutic relationship can be difficult: medications are often not as effective as they are in younger clients, and the elderly often view change at such a late stage of life as pointless. However, Agronin encourages therapists to work with creativity and passion, persisting in their efforts by retooling their approaches, shoring up patience, and remembering that the very presence of a caring listener can bring a spectacular transformation to even the most debilitated individuals.

An understanding of aging alone does not make an effective therapist, and Agronin offers key strategiesuillustrated through real-life case examplesufor dealing with countertransference, performing age-guided evaluation, working with caregivers, and handling end-of-life issues. He explains the impact of aging on the major psychiatric disorders, providing direction on how to cultivate empathy and understanding for a range of age-specific challenges.

Therapy with Older Clients is not a hard-and-fast prescription for effective therapeutic work. On the contrary, Agronin offers a compassionate, insightful narrative that explores the nuances of successful rapport-building and problem-solving that can enrich the lives of the elderly. In doing so, he gives readers a better understanding of what it means to grow old, and how cultivating a respectful, productive relationshipuone that is inspired with curiosity and energized with creativityucan bring joy and affirmation to older clients.

Marc E. Agronin, MD, is the Medical Director for Mental Health and Clinical Research at the Miami Jewish Health Systems and an Affiliate Associate Professor of Psychiatry at the University of Miami Miller School of Medicine. In 2008 he was named Clinician of the Year by the American Association for Geriatric Psychiatry.