Age cues in patients’ descriptions influence treatment attitudes

Abstract

Objectives: Ageism on the part of service providers has been widely cited as an important factor limiting access to and adequate quality of mental health services for old, especially very old adults. The objective of this study was to analyze how treatment attitudes depend on age cues in patients’ descriptions.

Method: A sample of psychotherapists-in-training (N = 114) responded to questions concerning a naturalistic case vignette of a male patient with symptoms of depression. Based on random assignment, participants either read the original (real-life) case description including very-old age cues (‘very-old patient condition’) or the manipulated case description (‘middle-aged patient condition’) which was identical with the exception that the most salient age cues were replaced by a younger chronological age of the patient (52 years) and age-neutral cues (e.g., “black hair” instead of “light grey hair”). All other aspects of the vignette including the patient’s psychological symptoms and medical conditions were kept constant.

Results: Participants showed less favorable attitudes towards the patient in the ‘very-old patient condition’ relative to the patient in the ‘middle-aged patient condition’, as indicated by more negative affect, less conviction in the treatability of the patient, a poorer prognosis, less interest in treatment provision as well as less subjective treatment competence.

Conclusion: Mental health care providers’ ‘age bias’ continues to be a problematic factor in psychotherapy with older adults. An “age-aware education” for psychotherapists is needed for better realizing the potentials of psychotherapy with older adults.

Keywords:

• Psychotherapy
• depression
• beliefs/attitudes
• mental health
• ageism

Acknowledgements

The authors wish to express their gratitude to the German Association for Behaviour Therapy (Berlin institute, especially Monika Basqué) for the valuable support of this study.

Disclosure statement

No conflict of interest. This study follows the principles of the Declaration of Helsinki.