Mental Health and Psychosocial Treatments in the Nursing Home

Psychosocial treatments, an important form of mentalInterpersonal Therapy
health intervention includes certain forms ofInterpersonal therapy focuses on the relationships a
psychotherapy (often called talk therapy) and socialresident has with others. The goal of interpersonal
skills training. They are helpful in providing support,therapy is, of course, to improve interpersonal skills.
education, and guidance to emotionally troubledThe therapist actively teaches residents to evaluate
residents and their families. Studies tell us thattheir interactions with others and to become aware of
psychosocial treatments can help residents keep theirself-isolation and difficulties getting along with, relating to
moods more stable, stay out of the hospital, andor understanding others. He or she also offers advice
generally function better.and helps residents make decisions about the best
A licensed psychologist, social worker, or counselorway to deal with others.
typically provides these therapies. The therapist and aInterpersonal therapy is a relatively new psychosocial
psychiatrist may work together as the psychiatristmental health treatment used most frequently to help
prescribes medications and the therapist treats theresidents with bipolar disorder, attention-deficit
resident and monitors his/her progress.hyperactivity disorder (ADHD), depression, eating
The number, frequency, and type of psychotherapydisorders, and generalized anxiety disorder.
sessions a resident has should be based on his or herCognitive Behavioral Therapy
individual needs. As with medication, it is important toCognitive behavioral therapy (CBT) helps residents
follow the treatment plan for psychosocial treatmentslearn to change inappropriate or negative thought
to gain the greatest benefit.patterns and behaviors associated with their illness.
Individual PsychotherapyThe goal is to recognize negative thoughts or
Individual psychotherapy involves regularly scheduledmind-sets (mental processes such as perceiving,
sessions between the patient and a mental healthremembering, reasoning, decision making, and problem
professional such as a psychologist, psychiatric socialsolving) and replace them with positive thoughts, which
worker, or psychiatric nurse. The goal of this treatmentwill lead to more appropriate and beneficial behavior.
is to help residents understand why they are actingFor instance, cognitive behavioral therapy tries to
and thinking in ways that are troubling or dangerous toreplace thoughts that lead to low self-esteem (I can't
themselves or others so they have more control overdo anything right) with positive expectations (I can do
their behaviors and can correct them.this correctly). Combined with effective medication,
Talk-therapy sessions may focus on a residentsCBT can successfully treat residents with
current or past problems, experiences, thoughts,schizophrenia, bipolar disorder, ADHD, depression,
feelings, or relationships. By sharing experiences with aeating disorders, generalized anxiety disorder and panic
trained, knowledgeable, and understanding person--bydisorder.
talking about his/her world with someone outsideExposure Therapy
it--people with emotional disorders may graduallyA type of behavioral therapy known as exposure
understand more about themselves and their problems.therapy or exposure and response prevention is very
Individual psychotherapy is used successfully to treatuseful for treating obsessive compulsive disorder
emotional, behavioral, and social problems in residents(OCD) and post-traumatic stress disorder (PTSD).
with schizophrenia, bipolar disorder, attention-deficitDuring exposure therapy, a resident is deliberately
hyperactivity disorder, depression, eating disorders, andexposed to whatever triggers the obsessive thoughts
anxiety disorders among many others.or reaction to a previous traumatic experience under
Psycho-educationcontrolled conditions. S/he is then taught techniques to
Psycho-education involves teaching residents aboutavoid performing the compulsive rituals or to work
their illness, how to treat it, and how to recognize signsthrough the trauma.
of relapse so that they can ask for necessaryDialectical Behavior Therapy (DBT)
treatment before their symptoms worsen. FamilyDialectical behavior therapy (DBT) was developed to
psycho-education includes teaching coping strategiestreat chronically suicidal individuals, but it has evolved
and problem-solving skills to families of residents withinto a treatment for multi-disordered residents with
psychiatric dysfunctions to help them deal moreborderline personality disorder (BPD) as one of their
effectively with their troubled family member. Familydiagnoses. DBT has also been adapted for behavioral
psycho-education reduces distress, confusion, anddisorders involving emotion dysfunction (such as
anxieties within the family, which may help the resident,substance dependence in individuals with BPD and
recover faster.binge eating) and for treating people with severe
Psycho-education in combination with medication hasdepression and suicidal thoughts.
been used successfully to treat people withDBT combines the basic strategies of behavior
schizophrenia, bipolar disorder, attention-deficittherapy with a philosophy that focuses on the idea
hyperactivity disorder (ADHD) and depression as wellthat opposites may really not be opposite when looked
as to help their loved ones.at differently.
What are examples of specific psychotherapies?As a comprehensive mental health treatment,
Mental health therapists offer several different typesDBT:improves destructive behaviors,improves
of psychotherapy. In general no one type of therapy ismotivation to change (by modifying inhibitions and
necessarily better than another type.providing positive reinforcement,ensures that new
When deciding which therapy (or therapies) will likelycapabilities generalize to the natural
be the most successful treatment option for anenvironmentprovides a treatment environment that
individual resident, a psychotherapist considers theemphasizes what patients and therapist are best at
nature of the problem to be treated and thewhen working togetherenhances the therapists
consumer's personality, cultural and family background,motivation and ability to treat patients effectively.
and personal experiences. Note that a psychiatrist orIn standard DBT, different types of mental health and
psychotherapist (or both) may offer each of thepsychosocial therapies--including individual
following therapies to an individual, family, couple, orpsychotherapy, group skills training, and even phone
group.consultations--are used.