Treatment - Psychotherapy
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Choice of treatment when the depression is; less severe, less chronic, non psychotic, prior positive response, person has a higher level of ego strength and self motivated, the treatment is available and funds available to pay the cost, medical contraindication to medication, patient preference. | |
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Generally there is a 6-12 week trial of psychotherapy to identify whether it is treatment of choice, duration is based on individual. Crisis intervention terminates within 6-8 visits or approximately 2 months. | |
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Short-term therapy lasts from 2 months to 1 year. | |
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Long-term therapy continues for 1 year or more. | |
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Therapy should begin with education about depression as a disease, nature of depression explained. | |
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Goal is for the resolution of the conflict, understanding the person as they are now, setting and achieving relatively short-term and specific goals, understanding the social context within which the elder lives. | |
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Focus usually is on resolution of present conflicts vs. reconstructive change. | |
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Grief work focus’ on recognizing the specificity and meaning of the loss, restructuring losses into challenges, overcoming the loss and finally to optimize functioning after the loss, through insight-oriented or supportive therapy. | |
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The use of anxiety is utilized differently in each type of therapy. The insight-oriented mode utilizes anxiety to understand the nature of the emotional conflicts, recognize the reactions that are utilized in dealing with them and to facilitate a corrective emotional experience. The goal of supportive therapy is to contain or suppress anxiety, and to support the person’s strengths (ego). | |
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Some therapies are more directive, others are more process and analytical oriented. |
