Helping Relationships With Older Adults. Adelle M. Williams

has relied on Erikson’s final stage of development: integrity versus despair. However, developing interventions to successfully resolve this stage has not been a priority in the counseling field.

      Developing New Perspectives, Attitudes, and Knowledge

      Changing demographics are encouraging counselors to seek answers to support the older population. As a person ages, psychological issues increase in breadth and depth. They broaden to include physical health, economic factors, familial loss, decrease in independence, and many more. Issues deepen from the perspective that any psychological problems that remained unresolved earlier in the life span will increase in intensity when facing the issue of mortality. Working in the preventative mode, counselors are provided the opportunity to offer the older client a variety of intrapersonal and network interventions. Locating, exploring, and using available outside networks are perhaps the most essential interventions a counselor can offer to the older client.

      Another component of the changing perspective of the counseling field is the growing age of counselors themselves. Not only are counselors presented with issues of the older client, but they are facing their own changing demographics. The majority of university counselor educators who joined the field in the early to mid-1960s and who currently train and lead the profession are growing older. In looking toward retirement, these counselors are developing a deeper empathy with the older generation and a vested interest in supporting their needs.

      As members of the baby boomer generation move beyond 65, much of what mental health professionals know about how to treat their concerns become obsolete (American Psychological Association [APA], 2003; Langer, 2009). A survey by the American Psychological Association (2004) found that almost 70% of psychologists work with adults over 65, but only 30% received graduate training for this demographic, and only 20% worked with older adults in a practicum or internship setting. Therefore, these individuals as well as students and early-career professionals are urged to take the necessary steps to prepare themselves to work with this population. Mental health counselors have a responsibility to acknowledge stereotypes and validate older adults’ experiences, but they must also be able to provide accurate information about normative development so that older adults can base their self-assessments on facts rather than myths or unrealistic expectations (Walters & Boyd, 2009).

      When working with older adults, mental health counselors are in a unique position to foster positive expressions in their clients. Physiological, psychological, and social/relational factors are all important dimensions of the aging process. Lack of knowledge about normative physiological changes that accompany aging, combined with stereotypes may cause older adults to feel abnormal and internalize feelings of inferiority that will negatively impact the helping relationship. Helping professionals need to address clients in an unbiased and nondiscriminatory manner, allowing older adults a comfortable environment to express their concerns.

      It is important for counselors to continue to develop their knowledge, attitude, and skills including self-awareness, so that they can counsel older adults on a variety of issues. Staying aware of the older adult client as a unique individual with a combination of racial, ethnic, gender, sexual orientation, cultural, religious, and socioeconomic identities will prevent professional and emerging practitioners from viewing the client primarily in terms of age (Zeiss & Kasl-Godley, 2001). This awareness will further develop the client–counselor relationship.

      Many factors, such as coping mechanisms, influence how older persons address changes in later life. Coping has been defined as a person’s “cognitive and behavioral efforts to manage (reduce, minimize, master, or tolerate) the internal and external demands of the person—environment transaction that is appraised as taxing or exceeding the resources of the person” (Folkman, Lazarus, Gruen, & DeLongis, 1986, p. 572). Adaptive coping, or managing the demands of life relatively well, is at the heart of achieving and maintaining optimal health and wellness. This is certainly true at any age, but perhaps even more so in old age, when the threat of overtaxed resources and the need to tolerate limitations become inevitable. Life involves gains and losses; it is naïve to assume that everyone can and will maintain a high quality of life right up to their death. On the other hand, unnecessarily pessimistic views of old age, fueled by negative stereotypes of the elderly, restrict the ways people choose to adapt to aging and limit their sense of control over their lives.

      Helpers who are knowledgeable about and skilled in understanding coping mechanisms can promote healthy adaptation, regardless of client age. Sources of concrete information about how to cope with getting older, how to understand the perspective of elders (Pipher, 1999), and how to deal with dementia can help clinicians build their foundations of knowledge. Whitbourne (1989) summarizes the task:

      The main point that a clinician must keep foremost in mind, when working with an aging client, is the need to be flexible. The aging process involves multiple physical, psychological, and social demands that can all potentially impact on the individual’s ability to function. Clinicians may be called upon to perform advocacy services, environmental interventions, and interdisciplinary consultations, which they would not ordinarily regard as falling within the domain of “psychotherapy.” It is only by maintaining an open approach to the multiple needs of the aged client that the clinician can hope to bring about successful change. Helping professionals assume multiple roles when working with older clients and should remain open and flexible in their encounters. (p. 168)

      Remaining Flexible and Open

      Stereotypes, myths, and erroneous information regarding aging and the abilities of older adults is pervasive within the American culture. Henderson, Xiao, Siegloff, Kelton, and Peterson (2008) found that first year nursing students’ attitudes toward aging tended to be positive; however, the students did not aspire to work with geriatric patients. The reasons for not wanting to work with older adults were difficulty in relating or communicating with older people, feelings of the work being boring, and inexperience in caring for older people. However, students who had previously worked with elderly patients reported more positive attitudes, suggesting that positive exposure to such persons diminished negative feelings about aging.

      Similarly, social work students’ negative attitudes toward older adults regarding their productivity, adaptation, independence, and optimism were a result of little previous contact with elderly individuals and minimal knowledge about aging prior to graduate school (Gellis, Sherman, & Lawrence, 2003). While Gellis and colleagues (2003) did not find experiences to predict attitudes toward older people among nursing, gerontology, and health science students, attitudes toward elderly adults changed as a result of ongoing exposure to and meaningful intergenerational exchanges with such persons (Butler & Baghi, 2008).

      Older clients are capable of personal growth in the latter stage of life, unless there exists diseases that negatively impact their cognitions. While an individual’s basic personality is usually formed by around age 30, personality traits of older men and women take on a different pattern. For example, in later life, women may become more assertive and aggressive (when needed), and older men may become more nurturing. Therefore, the idea of being inflexible and rigid is questionable, at best. Both the older client and helping professional need to maintain openness to what can be accomplished within the therapeutic encounter.

      Counselors help people with issues of career and sexual development well before they are fully active in these areas. Similarly, work to promote successful aging must begin before old age. Successful aging can involve adjusting to life transitions (such as from work to retirement), which can be thought of as turning points that occur between periods of stability within one’s life (Goodman, Schlossberg, & Anderson, 2006). Transitions often require a person to journey into the unknown, take risks, adapt, and cope with fears. They can therefore be challenging times in one’s life, often experienced as a crisis. Transitions can also create opportunities for personal discovery, renewal, and transcendence to heightened levels of existence.

      Promoting Successful Aging

      The process of helping to promote successful aging can be implemented by counselors in individual counseling, group counseling, workshops, or courses. The underlying philosophy or theme