The role of the clinical psychologist

Abstract

The clinical psychologist brings to the practice of mental health care of older people knowledge-based psychological skills in relation to people, ageing and disease. Key areas for the use of these skills include the disturbances of cognition, including memory, mood and behaviour. This includes assessment and diagnosis, the delivery of psychological treatment, teaching and training, research audit and clinical management. Psychological tests are increasingly available with appropriate norms into advanced age and can help distinguish early cognitive decline from age-related changes. They are particularly useful in atypical cases and where premorbid features may influence presentation. They are also helpful in assessing mental capacity, and the clinical psychologist has core skills relevant to this. As well as assessment of mood, psychological approaches are also important in the treatment of mood disorders using individual and systemic approaches. The evidence base indicates that psychological treatment should be combined with pharmacological treatment. Psychoeducation programmes are also effective in reducing carer strain. The clinical psychologist can contribute to the training and supervision of other staff in the practice of psychological treatments. This includes the management of challenging behaviour using psychological approaches. The key outcomes in old age psychiatry include psychological variables such as quality of life. The clinical psychologist can make a major contribution to audit and service evaluation, and there are several areas where assistant psychologists can give additional support. The clinical psychologist has skills relevant to the support, facilitation and management of clinical teams