The Efficacy of Individual Psychological Interventions With Non-Clinical Older Adults

Abstract. A number of reviews and meta-analyses have consistently documented the positive effect of individual psychological intervention with clinical older adults suffering from late-life depression, anxiety disorders, or other mental illnesses. However, many older adults without clinical disorders might seek and benefit from individual psychological interventions too. Given the aging populations across the globe, knowing the potential efficacy of individual psychological interventions with non-clinical older adults therefore is important. However, the research on this topic has not been reviewed systematically. This was the primary aim of the present review. Secondarily, we wanted to find out how many of these studies were conducted in a European context. A systematic literature search identified nine eligible studies yielding an aggregated sample size of 983. Two of these were European. Eight of the nine studies (including one European) reported significant positive effects of individual psychological interventions, that is, increases in psychological well-being and decreases in depression symptoms and distress. Effect sizes were extracted or calculated when possible to estimate the magnitude of the intervention effects. These effect sizes varied across studies and ranged from trivial in size to large and even very large, the median being a medium effect size. The results from the present review suggest that non-clinical older adults benefit from individual psychological interventions. However, the limited number of studies available for review precludes conclusions regarding the comparative efficacy of different types of psychological interventions in this population. Directions for future research are discussed.

Older Adults Seeking Mental Health Counseling in a NORC

The authors used the Andersen model to compare older adults’ help seeking from clergy to help seeking from other sources of formal mental health services. Data were from the Naturally Occurring Retirement Community Demonstration Project. Multinomial logistic regression was used to compare sources from which help was sought.The results indicate that older adults sought help from clergy more frequently than from other formal sources. Increased stress levels, higher intrinsic religiosity, and being younger were related to seeking help from clergy. Greater stress and attendance at religious services were related to help seeking from other sources. Only greater frequency of attending religious services was associated with a greater likelihood of seeking help from clergy versus other formal providers.The increasing elderly population and the attendant crisis in mental health services might best be addressed through public-private partnerships in which mental health professionals assist clergy in identifying problems and making appropriate referrals.

Clergy as mental health service providers to older adults

Older adults tend to seek help for emotional problems from clergy at greater rates than they do from other sources. However, their help-seeking from clergy is largely understudied. We used data from the Naturally Occurring Retirement Community (NORC) Demonstration Project to examine older adults' patterns of help-seeking from clergy. We studied a sample of adults aged 65 or older (n = 317) to determine which factors were related to help-seeking from a religious leader. This study was framed within the Behavioral Model of Health Services Utilization. Results of hierarchical logistic regression analyses indicated that having less social support and greater frequency of attendance at religious services was related to help-seeking from clergy for this sample, while other predisposing, enabling, need and religiosity variables were not found to be related to help-seeking from clergy. Discussion focuses on the need for mental health workers to be aware of the important role that clergy play in service provision and to find ways to leverage knowledge and skills to enhance provider-clergy relationships in order to improve services that older adults receive.

The impact of religiousness, spirituality, and social support on psychological well-being among older adults in rural areas

This paper presents the results of a study on the impact of spirituality, religiousness, and social support on the psychological well-being among rural elderly. With a rural community sample of 215 older adults, hierarchical regression analyses found significant associations between dimensions of spirituality/religiousness, social support, and psychological well-being, with spirituality/religiousness inversely related to depression and social support, positively related to life satisfaction. Findings of this study suggest that practitioners need to develop programs or services that are congruent with religious/spiritual beliefs and practices in order to better enhance the psychosocial well-being and improve the quality of life among older persons in rural areas.

The relationship of religiosity to older adults' mental health service use

This article uses data from the Naturally Occurring Retirement Community (NORC) Demonstration Project (N = 326) to examine older adults' utilization of mental health services. This study is guided by the behavioral model of health service utilization and helps to fill gaps in the literature by including religious affiliation, religiosity, and interaction terms as variables in regression models. These variables are important, as religion is more important in the lives of older adults than in the lives of their younger counterparts. This study found the rate of use of mental health services during the previous six months to be 19.0%, and those with higher levels of private religious activity and higher levels of intrinsic religiosity are more likely to have accessed some form of mental health service. However, frequency of attendance at religious services is not associated with the use or non-use of services. Information from this study suggests that more research is needed to specify the manner in which religious affiliation and religiosity work to affect the use of mental health services, and future studies must include religious variables in order for models of service use to be complete.