Feature

By 2030, 20 percent of Americans will be age 65 or older, says the U.S. Department of Health and Human Services--a dramatic increase over the 13 percent of older Americans in 2005.

Yet many psychology practitioners could be better prepared to meet the needs of older adults. In fact, although 70 percent of psychologists have older adults as clients, only 3 percent of these practitioners have formal geropsychology training, according to a 2002 survey published in Professional Psychology: Research and Practice (Vol. 33, No. 5).

"Of course we assume that generalists can see older adults very successfully, because most older adults need the same things other people need," says study author Sara Qualls, PhD, a psychology professor at the University of Colorado at Colorado Springs.

But there are some challenges common to older adults that generalists may not know how to respond to, such as bereavement, chronic illness, cognitive impairment or the effects of medication on psychological wellbeing, notes Qualls.

Learning how to address such issues is critical for psychology to stay relevant in the coming decades, believes APA President Sharon Stephens Brehm, PhD, who this year convened the APA Presidential Task Force on Integrative Health Care for an Aging Population (IHAP). The group's report--Blueprint for Change: Achieving Integrated Health Care for an Aging Population, due out next year--will focus on the ways psychologists can collaborate with other healthcare professionals to ensure effective health care for older adults.

Meanwhile, psychologists who want to sharpen their geropsychology knowledge can take advantage of new continuing education opportunities offered by APA and affiliated organizations.

Assess thyself

At a time when even graduate courses focused on geropsychology are the exception rather than the norm, there are even fewer options for practitioners with established careers, says Qualls. Regional workshops are offered infrequently, and the expense and time required to attend national conferences can be prohibitive to psychologists in private practice.

Many groups are working to change that, says Deborah DiGilio, director of APA's Office on Aging. "Increasing opportunities for continuing education in geropsychology for all psychologists is an ongoing initiative of APA's Committee on Aging, and several divisions," says DiGilio.

To that end, Divisions 12/Section II (Clinical Geropsychology) and 20 (Adult Development and Aging) joined forces with APA's Practice Directorate to publish the "Guidelines for Psychological Practice with Older Adults." The guidelines are a self-study tool that psychologists can use to evaluate their readiness for working with older adults. They also recommend education and training to increase knowledge, skills and experience in this area of practice. In addition, the APA Psychotherapy Video Series offers seven videos that teach psychology students and practitioners how to work with older adults on common concerns such as caregiving. APA's Continuing Education Office also offers independent study programs on end-of-life care, interpersonal psychotherapy for depressed older adults and neuropsychological assessment of dementia and depression in older adults.

APA's materials and IHAP's forthcoming Blueprint provide a solid knowledge base, but regional workshops offer the benefit of visiting experts and active learning, says Qualls. And they are easier to get to than national conferences, she notes.

"The cost of leaving home to go to a training...involves not only the travel and training costs, but also the loss of practice time," she says.

At the state level, the Maryland Psychological Association (MPA) recently rose to the challenge of providing regional continuing education in geropsychology. Private practitioner EddaWeisberg, PhD, coordinated an eightsession geropsychology lecture series in Baltimore. Participants could attend as many or as few as desired and earned continuing education credits. Weisberg sought out aging experts such as Antonette Zeiss, PhD, who spoke on sexuality and older adults, and Gregory Hinrichsen, PhD, who led a day-long workshop on interpersonal psychotherapy and older adults.

"If you attended all the workshops, you would get a wonderful breadth about this issue and the challenges and rewards of working with older adults," Hinrichsen says. "The series was exemplary and unusual."

Though Weisberg has no immediate plans to repeat the workshops, she encourages interested psychologists to e-mail the MPA's public relations office.

"Future workshops all depend on demand," she says. "We were very happy with the program, the people who spoke were happy and willing to come again and we still have more issues we'd like to cover."

Practitioners in Colorado--or those willing to travel there--can attend the National Clinical Geropsychology Conference in Colorado Springs (www.uccs.edu/~geropsy), a program Qualls developed. Held each summer for the past three years, the fourday gatherings draw 60 to 80 participants who receive 15 continuing education credits through Div. 20. Next year's theme is "Grief, Bereavement and End-of-Life Care."

Psychologists can also get geropsychology training through the several continuing-education opportunities APA offers at its Annual Convention. Past sessions have covered capacity assessment in older adults, insomnia treatment, positive aging and psychosocial issues near the end of life.

Supervision: the missing link

Each of these continuing-education venues is valuable for increasing knowledge and skills, but they provide only part of the solution, say experts.

If practitioners have little experience working with older adults, it's important for their work to be observed by more seasoned geropsychologists, says Michelle Karel, PhD, co-chair of the National Conference on Training in Professional Geropsychology and a staff psychologist at the Veterans Affairs Boston Healthcare System.

"We all need antennae for the subtle changes that are harbingers of underlying, unfolding pathology," adds Qualls. "Working with a new population, one usually picks up those antennae through some kind of clinical supervision consultative relationship, and that's not very easy to get post licensure."

Karel suggests contacting an experienced geropsychologist and arranging for mentoring or consultation, which can even happen long distance through the use of video and audio tapes.

Practitioners who want to move into geropsychology do have options, but experts agree that they currently have to forge their own path.

"I think people are getting this training in informal ways, but we need something that's more systematic," notes Qualls.