Developmental Issues in Therapy
Assuming that Juan is assessed properly and is found to have a mental disorder, what next? How can he be helped? Therapy for mental disorders generally involves two approaches (Qualls & Layton, 2009): medical treatment and psychotherapy. Medical treatment most often involves the use of various medications, which are based on the underlying physiological causes of the disorders. Psychotherapy usually involves talking to a clinician or participating in a group. In either case, it is essential to take into account developmental differences in people as they age.
As we saw in Chapter 3, the ways in which medications work change with age. The effective dosage of a specific medication may be very different for younger, middle-aged, and older adults. In some cases, medications that work in one age group do not work for others.
In terms of psychotherapy, adults of different ages deal with different major developmental issues as they grow older (Zarit & Zarit, 2006). As we saw in Chapter 9, various hypotheses suggest that as adults age, different life issues become central. For example, according to Erikson (1982) young adults deal with forming intimate relationships with others, middle-aged adults grapple with passing on their experience to younger generations, and older adults struggle with the meaning of their lives. Such
issues often are the major issue when people enter therapy. Thus to make sense of their problems clinicians must be sensitive to the primary developmental issues facing people of different ages.
Another major issue in psychotherapy is establishing whether a particular therapeutic approach is effective, based on research and clinical evidence. Major professional associations provide guidelines in their respective fields; for example, the American Medical Association provides evidence – based approaches to medical therapy (American Medical Association, 2009), and the American Psychological Association has developed a set of criteria for evidence-based psychotherapy (American Psychological Association, 2005). The therapeutic approaches that meet the standard for adult therapy appear to be effective for a wide range of ages and are generally the therapies of choice. As we consider specific disorders, we will focus on evidence-based approaches to therapy.
1. What are the major areas of thorough clinical assessment?
2. What factors must be considered in conducting clinical assessment?
3. What are the major clinical assessment techniques?
4. What developmental factors must be considered in therapy?