Age Stereotypes in the Therapeutic Setting: What it Means for Older Clients
As the global population aged 65 years and above is increasing, a growing number of older adults will seek psychotherapy. It is important that we recognize potential challenges in the therapeutic process with older clients – one of them being unconscious age stereotypes held by psychotherapists. Read more about how age stereotypes can shape the therapeutic process and what can be done to prevent and manage their impact.
Age Stereotypes Among Psychotherapists
One common ageist stereotype in the therapeutic context is the assumption that older clients are less likely to benefit from therapy due to supposedly lower cognitive flexibility. Such stereotypes can influence therapists’ perceptions of their clients and, in turn, influence their behaviors towards them, affecting the whole therapy process:
- Provision of Assessment Services: Research shows that psychotherapists with little formal training or practical experience with older adults more often show ageist stereotypes and attitudes (Burnes et al., 2019) and are less likely to conduct psychological assessments with older clients (Qualls et al., 2002). Such assessments – including diagnostic tests – are crucial for gathering the necessary information to provide effective treatment from the beginning. This is especially important, as mental disorders are expected to be very likely in older age (Andreas et al., 2017), but often go unrecognized (Gundersen & Bensadon, 2023; Risch & Wilz, 2015).
- Therapeutic Goal Setting: At the start of therapy, when psychotherapists still have little information about their clients, psychotherapists presumably rely more on stereotypes and biases (Kite & Johnson, 1988, as cited in Kessler & Bowen, 2015). As a result, therapeutic goals set early in the therapeutic process might not adequately reflect the needs of older clients, potentially affecting the course of therapy negatively.
- Therapeutic Treatment and Techniques: Research shows that psychotherapists-in-training are more likely to indicate shorter therapy to older clients (e.g., 25 sessions compared to 45 sessions) and are less likely to use certain therapeutic techniques, such as the so-called “motivational clarification” with older clients (Kessler & Schneider, 2019). These biases might stem from the ageist assumption that older clients are less able or willing to reflect on the motivational aspects of their experiences.
- Practitioner and Client Dynamic: In therapy, every psychotherapist reacts to their clients by having certain thoughts and feelings or behaving in a certain way, presumably due to unresolved, subconscious conflicts. This also happens with older clients and is believed to stem from psychotherapists’ own unresolved fears of aging. As a result, psychotherapists might build certain misconceptions of their older clients, such as perceiving them as a distinctive, frail group. Or they might distance themselves from older clients by overlooking certain aspects, such as their sexuality (Lederman & Shefler, 2023) or ignoring their emotions whilst focusing only on the topic, changing the topic or creating long silences (Bandura et al., 1960, as cited in Hayes et al., 2011).
What Can Therapists Do to Counteract Age Bias?
- Invest in Specialized Training: To prevent or reduce unconscious ageist stereotypes and attitudes in the first place, psychotherapists can benefit from formal training. This may include internships to enhance practical experience and to engage in intergenerational contact, as well as specialized courses in gerontopsychology – the field of psychology focusing on older adults and their well-being.
- Self-Reflection on Age Biases: Tools the Age Implicit Association Test can help psychotherapists to become more aware of their unconscious biases. It can also be valuable to reflect on past therapeutic decisions and consider whether implicit age associations may have played a role in shaping those choices.
- Engage in Supervision: Regular discussions with colleagues and supervisors to explore and manage the above-mentioned unconscious reactions should be considered. By talking about these thoughts, feelings and reactions, psychotherapists can learn to use them constructively instead of letting them negatively influence therapy.
In Conclusion
Age stereotypes can subtly influence key aspects of the therapeutic process, from assessment to goal setting, treatment planning, and client-practitioner dynamics. With appropriate training, self-reflection and supervision, psychotherapists can learn to manage the impact of these biases, ensuring that all clients receive the most effective and respectful care possible.
About the Author
Angela Kolb is a Master’s student of psychology with a focus on clinical psychology. She is working as a research assistant at the University of Zurich in the Department of Gerontopsychology. She supports the project “Jedes Alter zählt” (“Every age counts”).
References
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