Department of Clinical Psychology, Goethe University, Frankfurt, Hessen, Germany.
Frankfurt Forum for Interdisciplinary Ageing Research (FFIA), Goethe University, Frankfurt, Hessen, Germany.
Gerontologist. 2024 Nov 1;64(11). doi: 10.1093/geront/gnae130.
The lack of psychotherapy in nursing homes can be explained by organizational obstacles but also by practitioners' reservations about this patient group and setting. This study aimed to inform practice by qualitatively exploring the experiences of psychotherapists delivering cognitive behavioral therapy to residents of nursing homes diagnosed with depression.
Semistructured interviews with 6 psychotherapists, who had delivered treatment within the DAVOS project (Depression in the nursing home: a cluster-randomized stepped-wedge collaborative case management approach to improve treatment) were recorded, transcribed, and analyzed using a deductive-inductive content analysis.
Therapists experienced various difficulties, including practical (e.g., multiprofessional collaboration) and existential issues (e.g., confrontation with their own mortality). Participants described correcting some stereotypical images of older people (in need of care) through their work within the DAVOS project. However, evidence of ageism was still included in their reports. In the interviews, psychotherapists more experienced with older patients addressed more existential issues, whereas more novice therapists tended to focus more on practical difficulties.
To ensure a more effective implementation of psychotherapeutic treatment in nursing homes, it appears necessary to address important contextual factors that facilitate interdisciplinary collaboration, interference-free treatment rooms, and tele-assisted sessions. Further, more setting-specific training, targeted supervision regarding death and suicide, and interventions that address stereotypical images of age and older people in residential care are needed.
DRKS00015686.
养老院中缺乏心理治疗可以用组织障碍来解释，但也可以用从业者对该患者群体和环境的保留来解释。本研究旨在通过定性探索为养老院中被诊断患有抑郁症的居民提供认知行为疗法的治疗师的经验，为实践提供信息。
对 6 名治疗师进行了半结构化访谈，这些治疗师曾参与 DAVOS 项目（养老院中的抑郁：一种集群随机分步式协作案例管理方法，以改善治疗）提供治疗，使用演绎归纳内容分析对访谈进行记录、转录和分析。
治疗师遇到了各种困难，包括实践方面的（例如，多专业合作）和存在主义方面的问题（例如，面对自己的死亡）。参与者通过参与 DAVOS 项目，描述了纠正一些关于老年人（需要照顾）的刻板印象。然而，他们的报告中仍包含年龄歧视的证据。在访谈中，更有经验的老年患者的治疗师更能处理存在主义问题，而经验较少的治疗师则更倾向于关注实际困难。
为了确保在养老院中更有效地实施心理治疗，似乎有必要解决促进跨学科合作、无干扰治疗室和远程协助治疗的重要环境因素。此外，还需要进行更针对特定环境的培训、针对死亡和自杀的针对性监督，以及解决对年龄和养老院中老年人的刻板印象的干预措施。
DRKS00015686。
