Psychotherapy in long-term care: A review

Area of Science:

• Gerontology
• Psychiatry
• Psychology

Background:

• Psychological distress is common in long-term care (LTC) settings, affecting residents across various diagnostic boundaries.
• Non-pharmacological therapeutic approaches are utilized by mental health professionals in LTC but are under-reported in literature.
• Existing research often lacks systematic investigation into these interventions.

Purpose of the Study:

• To review the evidence for "talk therapies" (psychotherapy) in treating depression and enhancing psychological well-being among LTC residents.
• To synthesize findings from controlled trials of psychotherapy published in English-language peer-reviewed journals.
• To identify the efficacy and limitations of psychotherapy interventions in the LTC population.

Main Methods:

• Systematic review of controlled trials of psychotherapy for LTC residents.
• Inclusion of studies published in English-language peer-reviewed journals.
• Exclusion of interventions for dementia-related behavioral disturbances and non-"talk therapy" psychosocial approaches.

Main Results:

• A majority of the 18 included studies reported significant short-term and some longer-term benefits.
• Positive effects were observed on measures of depression, hopelessness, self-esteem, and perceived control.
• Methodological limitations such as small sample sizes and short trial durations were noted across studies.

Conclusions:

• Psychotherapy demonstrates positive efficacy for psychological well-being in LTC residents, especially considering risks associated with pharmacotherapy in this population.
• Significant methodological limitations necessitate caution in interpreting current findings.
• There is a strong need for methodologically rigorous trials of psychotherapy in LTC settings, potentially in combination with pharmacotherapy.