Counseling Psychologists’ Competence with Older Adult Clients

Research suggests that mental health clinicians are less likely to diagnose and recommend treatment for older adults, possibly in part due to clinician attitudes toward aging and older adults. For example, some studies have found that the identical set of symptoms is likely to be judged as less severe when experienced by an older client. Further studies have found that physicians believed that older adults at risk for suicide were less likely to be helped by interventions, despite evidence to the contrary. A forthcoming article in Aging & Mental Health examines the influence of characteristics and attitudes on the part of counseling psychologists on their attitudes toward older adults.

The researchers administered a questionnaire and a hypothetical vignette about a 70-year-old woman to a national sample of 364 counseling psychologists. The questionnaire included scales, chosen based on previous research on mental health professionals’ attitudes toward older adults, to assess characteristics that may be predictive of views of older adults, such as fear of death, multicultural competence, and training and experience with older adults. Participants were also given a scale directly designed to measure attitudes toward older adults. Demographic data was also collected, including age and gender. The clinicians were presented with the case vignette, which described symptoms that meet the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) criteria for clinical depression, and asked to give their clinical judgment.

In this national sample of counseling psychologists, older clinicians demonstrated less bias toward the hypothetical client. Contrary to previous findings on age bias among mental health clinicians, the men in the sample had more favorable attitudes toward older adults, but the authors point out that this may be influenced by the use of a woman’s case in the vignette (some findings suggest that men may view older women more favorably than older men). Most participants reported little to no formal education on aging issues. At the same time, within this sample, training and experience had no relationship with attitude toward older adults. The authors note that, overall, participants held favorable views of older adults. Other than practitioner age, the only significant predictor of diagnostic bias was multicultural competence; self-perceived multicultural competence was a predictor of a more accurate diagnosis.


Tomko JK and Munley PH. Predicting counseling psychologists attitudes and clinical judgments with respect to older adults. Aging & Mental Health (2012). DOI:10.1080/ 13607863.2012.715141.


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