Psychotherapy with older adults: Ageism and the therapeutic process

ABSTRACT

Objective This study explores how ageism in therapists is manifested in psychotherapy with older adults and how therapists deal with its impact on their therapeutic work. Method: Semi-structured interviews were conducted with 14 therapists and analyzed using grounded theory methodology. Results: Findings clustered around two themes: (i) maintaining openness to change while acknowledging limitations; (ii) dealing with manifestations of ageism inside therapy by going beyond relating to older patients only in terms of their chronological age. Conclusions: Our findings indicate that while therapists maintain an optimistic view regarding the possibility of therapeutic change, the therapeutic encounter with older patients triggers certain ageist therapeutic biases and behaviors in therapists, even in experienced therapists who have competency in working with older adults. Our findings also indicate that dealing with therapists’ ageism in psychotherapy with older patients requires therapists not only to be aware in advance of their ageist attitudes but also to continuously engage in the management of the manifestations of ageism inside treatment. We use the conceptual framework of countertransference to suggest an understanding of the relationship between therapists’ ageism and the therapeutic process. Implications for training and practice are discussed.

KEYWORDS:

• psychotherapy with older adults
• ageism
• countertransference
• psychotherapy process research
• qualitative research methods

Acknowledgements

The authors wish to thank Orit Gazit-Lederman for her valuable comments on previous versions of this manuscript and Refael Yonatan-Leus for providing feedback on data analysis and for his insightful comments on previous versions of this manuscript.

Disclosure Statement

No potential conflict of interest was reported by the author(s).

Data Availability Statement

The data that support the findings of this study are available from the corresponding author, S. L., upon reasonable request.