Despite the global trends of population aging, the development and use of psychotherapeutic interventions in the treatment of the elderly is significantly underrepresented. Knowledge of skills and emotional readiness are key to working with older people. Many elderly patients who seek help in therapy struggle with problems that threaten psychological well-being at any age: with chronic illness, disability or the death of loved ones. These problems are not specific to old age, but are more likely in old age. In addition, old age is not spared from the usual inconveniences that occur during life: quarrels with family members, disappointments in love, failure to achieve one’s goals, etc. Finally, many people who have struggled with depression, anxiety, abuse of psychoactive substances or with psychosis, and when they get old, they have to deal with the same problems.

The specific nature of these problems is important in the application of psychotherapy in the elderly. Certain problems require special knowledge of the therapist working with the elderly, for example, knowledge of how illness and treatment affect their feelings or behavior in old age and, conversely, how feelings or behavior affect illness and treatment. For older adults who are dealing with many changes and losses, including increased dependence and fear of dependence on others and physical illness, the process of psychotherapy can offer a safe and confidential relationship in which these most difficult feelings can be revisited. 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 develop a sense of contentment and wholeness. But those people who look at life through disappointments and unfulfilled goals can develop feelings of despair and depression, as well as loss of self-esteem.

Self-esteem is often one of the main topics 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 realize that older patients often seek approval and support from therapists which helps them gain a more positive view of themselves. The inevitability of impending death should not be ignored either. Psychotherapeutic work should facilitate natural processes, and the weight of these relationships should not (nor is it possible) to be assumed.

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