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There will be an increased need for psychologists to provide mental health services in residential aged care facilities. Experience while training is invaluable to improving both confidence and interest in working in this area. Awareness of potential barriers and ethical situations that may impede good mental health care is necessary when providing supervision. This paper reviews issues that supervisors need to be aware of when working with students in this clinical space. Barriers and enablers of clinical placements in residential aged care settings are discussed. Models of care, ethical considerations relating to risk, consent and working systemically, multiple clients, practical difficulties of being off-site and clinical aspects of adapting therapy to residential care settings are identified as key issues related to supervising students. Potential solutions, resources and practical approaches to these issues are also highlighted. A positive approach to the complexities of working in residential aged care settings can lead to quality supervision and clinical care in this much needed area. What is already known about this topic: There is a high degree of mental health issues amongst older adults living in residential aged care. Concerns have been raised about how clinical psychologists will meet future workforce demands. There is a lack of supervisors with experience in providing clinical guidance in this area. What this topic adds: Supervising in residential aged care has been enabled by an increased level of funded psychological services available to aged care residents in Australia. Several unique ethical issues can arise within supervision in residential aged care contexts that need to be discussed with students to improve their competence. There are practical approaches to adapting clinical interventions and working systemically that serve to facilitate a student's placement journey in residential aged care. [ABSTRACT FROM AUTHOR]

The Mini-Mental State Examination (MMSE) is one of the most commonly used instruments to screen for cognitive deficits within the hospital setting. However training in how to administer this widely used tool is scarce with little, if any, formal training for nursing staff. Scores are also often misused with over reliance on results and cut-offs to support a diagnosis of dementia within the acute and sub-acute aged care context. The present study assessed the level of training and accuracy in administering the MMSE within a geriatric in-patient rehabilitation ward. Ratings of the level of knowledge, training and confidence in administering the MMSE were obtained from 16 registered nurses and two medical officers before and after an education session on the uses of the MMSE and correct administration. Objective assessment of competencies in administration was also obtained with interrater reliability scores demonstrating high accuracy in the use of this screening instrument. Knowledge improved following the training session, but confidence scores remained unchanged. Results also indicated limited knowledge regarding the necessity for cognitive screening in an aged care setting. Inconsistency in administration of certain items was also identified as a concern. Strategies for improving the quality of administration are identified and discussed.

Despite the growing number of older adults that implies an increasing need for psychological services, few psychologists choose to specialize in working with older clients. The present cross-sectional research examined predictors of student interest in working with older clients in an effort to understand factors that may influence future psychologists to work in this area. The targeted sample consisted of Australian postgraduate psychology students whose course coordinators responded to a request to participate in this national survey. Four hundred and thirty-one postgraduate trainee psychology students completed the survey that examined training, contact, and attitudinal variables. This represents a 45.3% response rate from surveys being distributed by course coordinators. Having undergone or intending to do a placement within an aged care setting was the most powerful predictor of interest, with confidence in working with the elderly, and positively anticipating old age being attitudinal factors related to increased interest. Amount or quality of contact with older adults and formal education through aging-related coursework failed to predict interest, based on hierarchical regression analysis. Implications for future training of psychologists highlight the importance of quality clinical experiences with older clients during training as opposed to pure coursework. (Contains 3 tables.)

Despite increasing numbers of older people in most global populations and increasing evidence of the efficacy of psychological therapy in older clinical populations, few psychologists work with older clients as compared with other clinical groups. In the present research, the authors examine potential influences on psychologists choosing to specialize in working in the field of aging. The authors surveyed 1,498 psychologists Australia-wide to examine which factors exerted the most influence on choosing to specialize in clinical work with older clients. Clinical exposure to older clients and age-related course content within training programs, together with further education external to formal training, were significantly correlated with specializing in aged care. Holding a more negative attitude toward one's own aging was another predictor of specialist category membership, with interest in working with older clients also being a significant factor based on direct logistic regression analysis. In contrast to previous work, amount or quality of contact with older persons did not appear to relate to working with older adults. These findings highlight the importance of quality training experiences in influencing attitudes toward working with older adults. Keywords: clinical training, older adults, contact hypothesis, ageism, geropsychology

Cognitive behavioral therapy (CBT) for depression and anxiety for older adults living in residential aged care facilities (RACFs) needs to accommodate the care needs of residents and the circumstances of RACFs. This systematic review examines the delivery and content characteristics of these interventions, in relation to participant satisfaction, staff appraisal, uptake rate, attrition rate, and treatment effectiveness. Such a review could provide important information for the development of future CBT-based interventions. Studies that examined the application of CBT for depression or anxiety in RACFs were identified by systematically searching a number of relevant databases. Reference lists of all included studies were examined, and citation searches on the Web of Science were conducted. Two independent reviewers were involved in screening articles and in extracting data and assessing methodological quality of the selected studies. Across the 18 studies included in this review, the most common therapeutic strategy was pleasant activities scheduling. Studies varied on treatment duration (2–24 weeks), number of sessions (6–24), and length of sessions (10–120 min). Residents and staff members were satisfied with the CBT interventions. The average uptake rate was 72.9%. The average attrition rate was 19.9%. Statistically significant results were reported in 8 of the 12 randomized controlled trials (RCTs). In these eight RCTs, CBT was characterized by psychoeducation, behavioral activation, and problem-solving techniques; further, the therapists in six of these studies had training in psychology. CBT interventions for depression and anxiety are acceptable to RACF residents and judged positively by staff members. Effective studies differed from non-effective studies on content and training characteristics, but not on other delivery features. [ABSTRACT FROM AUTHOR]

There is a push to change the focus of mental health delivery from symptom reduction to recovery orientation where self-determination and choice are central to programmes. Whilst there is a robust literature on recovery definition, assessment and training, this has not been matched with studies of recovery with older adult consumers or staff working in older adult settings. The purpose of this sequential explanatory study was to identify the recovery attitudes and practices of the staff from the Sydney Local Health District Specialist Mental Health Service for Older People (SMHSOP), Australia. Fourteen members of staff completed two self-report recovery measures and subsequently took part in focus group interviews. Results of this mixed methods study suggested that whilst mental health staff in this sample supported the self-definition and individuality aspects within the recovery model, risk management remains problematic with this population. Clinical experience mediated the extent of knowledge and practices within a recovery framework. Barriers to implementing recovery oriented practice included client incapacity and the expectation of consumers. The suitability of current recovery concepts and measures to older populations is discussed. [ABSTRACT FROM AUTHOR]

It is well-documented that the population of much of the developed world is aging. On the one hand, this represents a success story in terms of reducing deaths from infectious and a number of systemic diseases, most notably cardiovascular disease. On the other hand, it also presents a challenge to provide adequate health services to a population with rapidly increasing longevity, as well as an opportunity to develop policies that can assist in promoting good physical and mental health. A number of authors have asked whether we are ready to meet the challenges of an aging population (Doyle et al., 2009; Connolly, 2012). Over the years, prominent psychologists have suggested that clinical psychology could play a greater role in the provision of services for older adults, and lamented the apparent lack of enthusiasm on the part of psychologists to work with this group (e.g. Karel et al., 2012). In this paper, we examine a range of questions pertinent to this theme: where are the psychologists in the provision of mental health services to older adults? What contribution can psychologists make to improve the mental health of this growing sector of the population? How can we encourage more psychologists to specialize in working with older adults? [ABSTRACT FROM PUBLISHER]

Patients admitted for rehabilitation can display behaviours that challenge professional caregivers. Whether this is a direct consequence of the primary medical condition (for example, closed head injury) or other comorbidity (dementia) or a manifestation of adjustment difficulties faced by patients, a cooperative approach to the psychosocial management of behaviours such as aggression can be highly effective. Little has been reported in the scientific literature regarding the recommendations of direct care nursing staff on the management of challenging behaviours in rehabilitation settings. Often a consultancy model is used, with nurses simply requiring to follow a programme of strategies that may not always be implemented. The present quality improvement project describes an investigation into nursing recommendations regarding preferred practice in managing challenging behaviours in an in-patient aged care rehabilitation unit. Focus groups and the results of a survey highlighted the importance of clear communication and direct involvement of nursing staff as key elements of success in implementing strategies to manage behaviourally disturbed patients. The issue of autonomy also featured in results. The survey confirmed the significant stress on nursing staff when caring for a patient with challenging behaviours. The presence of a list of behavioural strategies in a patient's file does not always equate to these actually being carried out. This study highlights the relationship between the level of direct involvement of nursing staff in the development of management suggestions and their actual implementation. [ABSTRACT FROM AUTHOR]

Presents a correction to the article "Cognitive Therapy for Depression in the Elderly" which was previously published in the 1996 issue of the "International Journal of Geriatric Psychiatry."