Mental Health and Psychosocial Treatments in the Nursing Home
What are Psychosocial Treatments?
Affiliated COUNSELING
AND REFERRAL SERVICES (ACRS)
DR. Michael Shery, clinical
psychology
2615
Three Oaks Rd, Ste 2A,
Cary, IL 60013
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1976, state-of-the-art counseling which treats the problem, not just the symptom…”
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Mental Health and Psychosocial Treatments in the Nursing Home
What are Psychosocial Treatments?
Written by: Dr Mike Shery
Psychosocial treatments, an important form of mental health intervention includes certain forms of psychotherapy (often called
talk therapy) and social skills training. They are helpful in providing support, education, and guidance to emotionally troubled residents and
their families. Studies tell us that psychosocial treatments can help residents keep their moods more stable, stay out of the hospital, and
generally function better.
A licensed psychologist, social worker, or counselor typically provides these therapies. The therapist and a psychiatrist may work together as
the psychiatrist prescribes medications and the therapist treats the resident and monitors his/her progress.
The number, frequency, and type of psychotherapy sessions a resident has should be based on his or her individual
needs. As with medication, it is important to follow the treatment plan for psychosocial treatments to gain the greatest benefit.
Individual Psychotherapy
Individual psychotherapy involves regularly scheduled sessions between the patient and a mental health professional such as a psychologist,
psychiatric social worker, or psychiatric nurse. The goal of this treatment is to help residents understand why they are acting and thinking in
ways that are troubling or dangerous to themselves or others so they have more control over their behaviors and can correct them.
Talk-therapy sessions may focus on a residents current or past problems, experiences, thoughts, feelings, or relationships. By sharing
experiences with a trained, knowledgeable, and understanding person--by talking about his/her world with someone outside it--people with
emotional disorders may gradually understand more about themselves and their problems.
Individual psychotherapy is used successfully to treat emotional, behavioral, and social problems in residents with schizophrenia, bipolar
disorder, attention-deficit/hyperactivity disorder, depression, eating disorders, and anxiety disorders among many others.
Psycho-education
Psycho-education involves teaching residents about their illness, how to treat it, and how to recognize signs of relapse so that they can ask for
necessary treatment before their symptoms worsen. Family psycho-education includes teaching coping strategies and problem-solving skills to
families of residents with psychiatric dysfunctions to help them deal more effectively with their troubled family member. Family psycho-education
reduces distress, confusion, and anxieties within the family, which may help the resident, recover faster.
Psycho-education in combination with medication has been used successfully to treat people with schizophrenia, bipolar disorder,
attention-deficit/hyperactivity disorder (ADHD) and depression as well as to help their loved ones.
What are examples of specific
psychotherapies?
Mental health therapists offer several different types of psychotherapy. In general no one type of therapy is necessarily better than another
type.
When deciding which therapy (or therapies) will likely be the most successful treatment option for an individual resident, a psychotherapist
considers the nature of the problem to be treated and the consumer's personality, cultural and family background, and personal experiences. Note
that a psychiatrist or psychotherapist (or both) may offer each of the following therapies to an individual, family, couple, or group.
Interpersonal Therapy
Interpersonal therapy focuses on the relationships a resident has with others. The goal of interpersonal therapy is, of course, to improve
interpersonal skills. The therapist actively teaches residents to evaluate their interactions with others and to become aware of self-isolation
and difficulties getting along with, relating to or understanding others. He or she also offers advice and helps residents make decisions about
the best way to deal with others.
Interpersonal therapy is a relatively new psychosocial mental health treatment used most frequently to help residents with bipolar disorder,
attention-deficit/hyperactivity disorder (ADHD), depression, eating disorders, and generalized anxiety disorder.
Cognitive Behavioral Therapy
Cognitive behavioral therapy (CBT) helps residents learn to change inappropriate or negative thought patterns and behaviors associated with their
illness. The goal is to recognize negative thoughts or mind-sets (mental processes such as perceiving, remembering, reasoning, decision making,
and problem solving) and replace them with positive thoughts, which will lead to more appropriate and beneficial behavior.
For instance, cognitive behavioral therapy tries to replace thoughts that lead to low self-esteem (I can't do
anything right) with positive expectations (I can do this correctly). Combined with effective medication, CBT can successfully treat residents
with schizophrenia, bipolar disorder, ADHD, depression, eating disorders, generalized anxiety disorder and panic disorder.
Exposure Therapy
A type of behavioral therapy known as exposure therapy or exposure and response prevention is very useful for treating obsessive compulsive
disorder (OCD) and post-traumatic stress disorder (PTSD). During exposure therapy, a resident is deliberately exposed to whatever triggers the
obsessive thoughts or reaction to a previous traumatic experience under controlled conditions. S/he is then taught techniques to avoid performing
the compulsive rituals or to work through the trauma.
Dialectical Behavior Therapy (DBT)
Dialectical behavior therapy (DBT) was developed to treat chronically suicidal individuals, but it has evolved into a treatment for
multi-disordered residents with borderline personality disorder (BPD) as one of their diagnoses. DBT has also been adapted for behavioral
disorders involving emotion dysfunction (such as substance dependence in individuals with BPD and binge eating) and for treating people with
severe depression and suicidal thoughts.
DBT combines the basic strategies of behavior therapy with a philosophy that focuses on the idea that opposites
may really not be opposite when looked at differently.
As a comprehensive mental health treatment, DBT:
• improves destructive behaviors,
• improves motivation to change (by modifying inhibitions and providing positive reinforcement,
• ensures that new capabilities generalize to the natural environment
• provides a treatment environment that emphasizes what patients and therapist are best at when working together
• enhances the therapists motivation and ability to treat patients effectively.
In standard DBT, different types of mental health and psychosocial therapies--including individual psychotherapy, group skills training, and even
phone consultations--are used.
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About The Author
Dr. Mike Shery is a licensed clinical psychologist and is affiliated with almost all health plans, including: ValueOptions, Medicare, Cigna, Cigna Behavioral Health, United Health Care, Aetna, First
Health, Healthstar, Blue Cross Blue Shield of Illinois, ComPsych, Magellan Health, HFN, Tricare, Humana, most union local
plans, most school district plans, Unicare, ChoiceCare, CAPP, Multiplan, Mental Health Network, Managed Health Network,
United Behavioral Health, PPONext, Private Health Care Systems, Humana-Military and Beech Street .
He has practiced clinical psychology for approximately 24 years and is board certified as a specialist in professional counseling by the International Academy of Behavioral Medicine, Counseling and Psychotherapy. He is the director of Affiliated
Counseling and Referral Services and is a member of the American Counseling
Association.
The office is located in Cary, IL and in select cases phone consultations are
available for those who don’t live locally> Telephone Counseling.
To make an appointment> New Patient Registrationor to learn more about the psychological services he
providescall him at 1-847-516-0899 (24 Hrs).
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For more information on nursing home psychological
services,
Click: NURSING HOME MANAGERS: Drug-Free Ways to Eliminate Resident
Depression
To return to: Articles:
Eliminate Depression in your Nursing Home Residents
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