Diagnoses Assigned and Issues Brought Up in Therapy by Older Adults Receiving Outpatients Treatment

Abstract

An archival study was conducted on the case records of 298 clients, aged 60 to 98, treated by a community mental health center program which offered a full range of psychotherapeutic services and an active outreach program to elders. Data were collected on the clients' diagnoses and the specific issues raised during therapy. The majority (81.1%) of the clients were classified into only four DSM-III categories: adjustment disorders, affective disorders, organic brain disorders, and conditions not attributable to a mental disorder. Clients residing in long-term care facilities showed a higher incidence of organic brain disorders and schizophrenia but were as likely as community-residents to be diagnosed with emotion-based problems. Three types of issues predominated among the aged clients in therapy: family conflicts, poor physical health, and the feeling they were not in control of events in their lives. The pattern of issues addressed by clients in the two residential groups showed strong similarities, although community-residents more frequently reported family problems while long-term care residents were more worried about cognitive losses. Women were more concerned with aches and pains while men were more concerned with loss of work role.