The US Census estimates that in 2010, there were over 38 million people aged 65 and older living in the United States. As Baby Boomers continue to age, this number and the proportion of the population it represents will certainly grow. Despite these facts, many therapists out there (myself included) haven't been trained to and likely won't work directly with an elderly population. This can make test questions about working with the elderly tricky. Here's one way this topic can show up in a test item.
A 67 year-old woman approaches a therapist in a community center and requests treatment to address feelings of depression that have developed over the past year. Among other issues, she tells the therapist that shortly after retiring two years ago, her husband of 43 years passed away; she feels like "a third wheel" during social events, has stopped seeing many of her friends, and feels "useless" without a job. In order to help address these feelings, treatment objectives should include:
A. medical referral and referral to a support group for widows
B. life review and referral to a support group for widows
C. life review and medical referral
D. referral to a support group for widows and vocational counseling
So, what exactly is this "life review" thing? It's a process in which a person is encouraged to reminisce about their past in an effort to improve psychological health and come to terms with their life. A recent, relatively large randomly controlled trial showed that this intervention was quite effective in treating moderate depression symptoms in an elderly population (you can read about it here: http://www.ncbi.nlm.nih.gov/pubmed/21995889). It can include playing music that is meaningful to the client, looking at photographs or pictures, telling stories, and anything else that facilitates the sharing of memories and experiences.
The best answer to the question above is B. We can rule A and D, since they don't include the aforementioned life review technique. C is not the best answer because there isn't enough in the stem to indicate the need for a medical referral. If the client had presented with physical symptoms, such as sleeplessness, loss of appetite, weight loss, headaches, etc., then a medical referral would be justified, but there's not enough here. This doesn't mean that you wouldn't assess her for medical issues or ensure that she's seeing a healthcare provider appropriately, but the stem describes a psychosocial problem that needs a psychosocial answer. The support group referral will also help connect the client to other people with similar experiences, address feelings of isolation and potentially provide her with coping skills.
Coming up next week: Assessment
Think our straightforward, sensible approach could help you PASS your social work or MFT exam? If you're preparing for a social work exam, check out our Social Work Study Materials. If you're preparing for an MFT exam, check out our MFT Study Materials. Learn more about our offerings at The Therapist Development Center.
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