Counseling the Elderly and their Families GERO 522
Spring Semester, 2008
Bob Knight, Ph.D.
Overview of course: This course provides a didactic background in counseling older adults and their families. The first part of the course provides basic information on common mental health problems of later life and how to assess them. The second part introduces the student to basic knowledge about counseling theories and their application to problems in later life including grief and adjustment to chronic illness. This section concludes with a discussion of evaluating the effectiveness of psychological interventions with older adults. The remainder of the course covers counseling in the family system, applying counseling theory and interventions in organizational settings like nursing homes, and ethical issues with older adults.
As one of the skills courses in gerontology, the course is intended to introduce students to counseling skills that can be used in a wide variety of human services jobs in the aging services network. The class can also provide gerontological counseling knowledge for persons in other programs which prepare the student for a counseling career such as social work, counseling psychology, clinical psychology, and so on.
Knight, B.G. (2004). Psychotherapy with older adults, 3rd edition. Thousand Oaks (CA): Sage Publications.
Qualls, S.H. & Knight, B.G. (2006). Psychotherapy for depression in older
adults. Hoboken, NJ: Wiley.
Whitbourne, S.K. Psychopathology in later adulthood. New York: Wiley.
Other readings: On electronic reserve
Contact Info: Phone: 213-740-1373 (ofc; voice mail)
Office hours: Thursdays 2 to 4 pm
January 15 Ethical Issues in Counseling Older Adults
Reading. Knight Chapter 11
January 22 Counseling as Applied Gerontology: The Contextual, Cohort-based,
Maturity, Specific Challenge Model
Readings: Knight Chapters 1 and 2
Qualls & Knight Chapter 1
January 29 Dementia and Delirium in the Elderly
Exercise: Introduction to Assessment of Dementia
Reading: Whitbourne, Chapters 3 and 9
Knight, Chapter 8
Internet: Images of brains with various dementing illnesses and other damage: http://medlib.med.utah.edu/WebPath/TUTORIAL/CNS/CNSDG.html
diagnostic criteria for dementia, delirium: see www.mentalhealth.com for all diagnostic criteria assignments. Take a look at both American (DSM) and European (ICD) criteria for each disorder
February 5 Anxiety, Depression & Suicide in Older Adults
Exercise: Depression Inventories & Suicide Assessment
Internet: Diagnostic criteria for depression, DSM-IV and ICD-10
Readings: Knight Chapter 5;
Whitbourne, Chapters 5, 6, and 10
Qualls & Knight, Chapters 2 and 3
February 12 Serious Mental Illness: Paranoia, Schizophrenia, and Paraphrenia
Internet: see diagnostic criteria for DSM-IV and ICD-10. Check sites for info and support related to these disorders
Readings: Whitbourne Chapter 8
February 19 Substance Abuse: Alcohol, Prescription Medications, other
Whitbourne Chapter 11
Satre, D. D., Mertens, J., Areán, P. A., & Weisner, C. (2003). Contrasting outcomes of older versus middle-aged and younger adult chemical dependency patients in a managed care program. Journal of Studies on Alcohol, 64, 520-530.
February 26 Life Review and Interpersonal Psychotherapy
Reading: Knight Chapters 3, 10
Qualls & Knight, Chapter 5
Essay due March 4: Write 6 to 8 pages reviewing your own life from the standpoint of developmental stages, cohort effects, age-graded social roles, and family roles, context effects. When you get to the age you are now, try to project into the future, using these concepts and what you know about gerontology.
First paper due. Interview with older adult
March 4 Topics in Counseling the Elderly: Death and Dying
Discussion: Personal Experiences with Death and Funerals;
Attitudes toward Death & Dying
Readings: Knight Chapter 6
Schut, H., Stroebe, M.S., Van Den Bout, J, & Terheggen, M. (2001). The efficacy of bereavement interventions: Determining who benefits. In M.S. Stroebe et al. (Eds.), Handbook of bereavement research : Consequences, coping, and care. Washington, D.C. American Psychological Association.
March 11 Transference and Countertransference with older adults
Readings: Knight (1996) Chapter 4
Altschuler, J. & Katz, A. (1999). Methodology for discovering and teaching countertransference toward elderly clients. Journal of Gerontological Social Work, 32,
Assignment due next class period: Complete the Altschuler & Katz questions
March 18 Spring Break--No Class
March 25 Cognitive Behavioral Approaches to Illness & Disability in Later Life
Reading: Qualls & Knight Chapter 4
Knight Chapter 7
Satre, D.D., Knight, B.G., & David, S. (2006). Cognitive behavioural interventions with older adults: Integrating clinical and gerontological research. Professional Psychology: Research and Practice, 37, 489-498.
Assignments: Track mood and pleasants events
Thought tracking record
April 1 Sexuality in Later Life
Exercise: The ASKAS questions
Hillman J. (2000). Clinical perspectives on elderly sexuality. New York: Kluwer. Chapters 2 and 3.
Crowther, M.R. & Zeiss, A.M. (1999). Cognitive behavioral therapy in older adults: A case involving sexual functioning. Journal of Clinical Psychology: In Session, 55, 961-976.
Garnets, L. & Peplau, L.A. (2006). Sexuality in the lives of aging lesbian and bisexual women. In D. Kimmel, T. Rose, & S. David (Eds), Lesbian, gays, bisexual, and transgender aging: Research and clinical perspectives. (pp. 70-90). New York: Columbia University Press.
Wierzalis, E.A., Barret, B., Pope, M., & Rankins, M. (2006). Gay men and aging: Sex and intimacy. In D. Kimmel, T. Rose, & S. David (Eds), Lesbian, gays, bisexual, and transgender aging: Research and clinical perspectives. (pp. 91-109). New York: Columbia University Press.
Paper on counseling intervention with older adult interviewee due.
April 8 Evaluating Therapy with Older Adults
Qualls & Knight Chapter 7
Also, read one or more articles from the Special Section on this topic in Spring, 2007, Psychology and Aging
April 15 Family Systems Viewpoints and Counseling the Elderly
Exercise: Family role play in class
Knight, B.G. & McCallum, T.J. (1998). Family therapy with older clients: The contextual, cohort-based, maturity/specific challenge model. In I.H. Nordhus, G. VandenBos, S. Berg, & P. Fromholt, Clinical Geropsychology. (pp. 313-328). Washington, D.C.: American Psychological Association.
Additional readings to be assigned.
April 22 Services for Families of the Demented Elderly
Readings: Knight, Chapter 9
Assignment: Stress monitoring
April 29 Psychological Interventions in the Nursing Home Setting
Qualls & Knight Chapter 9
Additional readings to be assigned.
Major assignments and grading policy:
Class assignments. The personal life review counts for 15% of the course grade. Due Mar 4.
Participation. Being present, prepared, completing questions and self-monitoring assignments, and participating in class discussions, and counts for 10% of the course grade.
Course paper: Much of the grade depends upon a developing course paper, composed of 3 parts as follows. For the second and third parts, please turn in prior sections with any corrections/additions you want to make, as well as the new parts. Clarity of discussion, logic of discussion, and use of references additional to assigned readings (20% of each paper grade).
Interview paper. Interview an older adult not related to you; Give Folstein MMSE and the CES-D and score. Discuss a current or past problem and how they have tried to handle it. Get some history of the problem and their lives. [8 to 10 pages, double-spaced] Due Feb 26. 20% of course grade.
Counseling theory paper. Discuss and interpret the person that you interviewed earlier and their problems within the context of a counseling theory. End with discussion of what you would try to do with this person in a counseling context. Your understanding of the person and the problem should be different than the individual's own perception and clearly derived from the therapy system selected. [8-12 double-spaced pages]. Due April 1 25% of course grade.
Final paper (1) Adding on to your paper in progress, discuss interviewee’s problem from family systems viewpoint (50%).
(2) Add a discussion section that addresses what changes in therapy approach are required for work with elderly and the strengths of this system in working with elderly (50%)
[8 to 10 pages, double-spaced.] Due April 29 30% of course grade.
Timeliness: Papers are expected to be on time. Arrangements to turn in a paper after the due date must be made in advance. Medical emergencies should be reported by voice mail or e-mail, both of which are time and date labeled. Late papers without prior arrangement will not be accepted or graded.
Academic integrity. With regard to the course papers, academic integrity violations include plagiarism, turning in purchased papers, turning in papers written by someone else, turning in papers written for another class. See SCampus for more information on academic integrity. The Office of Student Conduct also has a Guide to Avoiding Plagiarism (X 06666 or on-line at www.usc.edu/dept/student-affairs/student conduct)