Psychotherapeutic Treatment of Psychotic Disorders in Later Life

Abstract

Older adults exhibit psychotic symptoms for various reasons. Treatment may require medical and psychiatric intervention, family support, community services, etc. The role of psychotherapy, however, has received little attention. This article describes a psychotherapeutic approach to treating older adults with psychotic symptoms based on the literature and the authors’ own experience. The approach includes reaching out to identify individuals in need of help; clinical engagement to develop a working relationship; linkage with needed services; and helping individuals reduce the link between triggers and psychotic symptoms. Differences between treating a person with delusional disorder versus schizophrenia are discussed.

Innovating to meet the needs of our aging population.

“…Practitioners should be knowledgeable regarding research on treatment, therapeutic interventions, and the efficacy of such interventions for practice with older adults. A broad literature exists that demonstrates the effectiveness of psychotherapeutic treatments of this population for anxiety and depression (Bains, Scott, Kellett, & Saxon, 2014), posttraumatic stress disorder (Dinnen, Simiola, & Cook, 2015), as well as adjustment disorders, personality disorders, substance abuse and dependence, and mood disorders (Roseborough, Luptak, McLeod, & Bradshaw, 2013), psychotic disorders (Yang, Garis, & Lowe, 2015), and insomnia (Edinger & Sampson, 2003), among others. Further, a wide range of treatment approaches have been found to be effective with older adults to include cognitive behavior therapy, problem-solving therapy, interpersonal therapy, and psychodynamic psychotherapy (Hinrichsen, 2011; McGovern, Kiosses, Raue, Wilkins, & Alexopoulos, 2014) as well as for psychotherapies provided to individuals, groups, and through telehealth (Bains et al, 2014; Lichstein et al, 2013).…”