Despite the global trends of Population Ageing, the development and use of psychotherapeutic interventions in the treatment of the elderly, it is significantly underrepresented. Knowledge of skills and emotional readiness are key to working with older people. Many elderly patients seeking treatment struggle with problems that threaten mental well-being at any age: with chronic illness, disability, or the death of loved ones. These problems are not specific to older age, but are more likely in old age. In addition, old age is not spared the usual inconveniences that occur during life: quarrels with family members, disappointments in love, failure to achieve one's own goals, etc. Finally, many people who have struggled with depression, anxiety, substance abuse or psychosis all their lives, and when they get older, have to deal with the same problems.
The specific nature of these problems is important in use psychotherapy in the elderly. Specific problems require special knowledge from the therapist working with the elderly, for example, knowledge of how illness and treatment affect their feelings or behaviors in old age and, conversely, how feelings or behaviors affect illness and treatment. For older adults who face many changes and losses, including increased addiction and fear of addiction to other and physical illnesses, the psychotherapy process can offer a secure and confidential relationship in which these most difficult feelings can be reconsidered. One of the final tasks of old age is the retrospection of life's achievements. People who feel they have led a happy, productive life will develop feelings of satisfaction and wholeness. But those who look at life through disappointments and unrealized goals can develop feelings of despair and depression, as well as loss of self-esteem.
Self-esteem is often one of the main themes during psychotherapy with the elderly. The therapist's job is to try to understand how the patient manages to maintain self-esteem through biopsychosocial losses with aging. It is important to understand that older patients often seek approval and support from therapists which helps them gain a more positive view of themselves. Nor should the inevitability of impending death be overlooked. Psychotherapeutic work should facilitate natural processes, and the weight of these relationships should not (nor is it possible) assume.