Older Adults Prefer Psychotherapy to Pharmacology for Anxiety Treatment

Symptoms of anxiety can often first appear in the later years of life. “Twelve-month prevalence of anxiety disorders in late life has been estimated at 7%; however, a far greater number experience impairing anxiety symptoms, with estimates ranging from 15– 45%,” said Jan Mohlman of Rutgers University, and lead author of a new study identifying which type of anxiety treatment older adults prefer. “First, and contrary to the widespread assumption that older adults prefer pharmacological interventions, psychotherapies (cognitive and behavioral therapies in particular) are more acceptable, credible, and appealing to older patients than pharmacological treatment for depression.” Additionally, she found that older adults prefer to receive treatment in settings that are familiar, such as their primary care offices, rather than community mental health settings. Mohlman said, “Most primary care settings do not offer psychotherapy as part of the services available to the elderly, giving rise to a mismatch between preferred modality and setting.”

For her study, Mohlman interviewed 14 adults between the ages of 69 and 91, none of whom had symptoms of anxiety. They were asked to imagine they had anxiety severe enough to interfere with their daily lives so that they had been referred for treatment. They were then instructed to choose the type of treatment they would prefer, and the setting in which to receive it. “The community sample overwhelmingly preferred psychotherapy to pharmacotherapy, which replicates findings obtained from primary care samples and younger adults,” said Mohlman. “This preference for psychotherapy was apparent across age group cohorts, which is a new finding.” She added, “Perhaps the most important message found here is that mental health professionals must increase efforts to disseminate information on psychotherapy (e.g., where to obtain it, the various ways in which it can be administered) in more innovative ways, given that older adults are likely to have particular preferences when presented with a range of available options.”

Reference:
Mohlman, J. (2011, April 4). A Community Based Survey of Older Adults’ Preferences for Treatment of Anxiety. Psychology and Aging. Advance online publication. doi: 10.1037/a0023126

© Copyright 2011 by By Noah Rubinstein, LMFT, LMHC, therapist in Olympia, Washington. All Rights Reserved. Permission to publish granted to GoodTherapy.org.

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • molly

    molly

    October 18th, 2011 at 4:32 PM

    Really? I work with older patients all of the time and in my experience they are all wanting drugs.

  • Kayla

    Kayla

    October 19th, 2011 at 4:22 AM

    I would hope that with this finding that there will now be more therapists focusing on geriatric issues and that this will lead to better treatment options for an older adult population. But now we have to get the general doctors on board to make those referrals instead of always just trying to dispense meds first, particularly if the patient is indeed looking for other alternatives.

  • gerrard

    gerrard

    October 19th, 2011 at 11:31 AM

    @molly:please remember that many older people have one disorder or another and these drugs may have side effects or may even be out-of-bounds for them due to their pre-existing disorder.so psychology seems like the to-get option.

  • Anna J

    Anna J

    October 19th, 2011 at 11:37 AM

    I think it’s a bit logical, drugs might work well and take care of the problem for a while, but older adults already know the consequences, side effects and usually are more prone to try natural options. My grandma, for example, always refused to take the important medications such as her pressure medicine or antidepressants, and there was no way to convince her, she preferred to take homeopathy or some natural remedy instead. I am almost sure that, for an anxiety treatment, she definitely would have chosen therapy.

  • Dot

    Dot

    October 19th, 2011 at 12:55 PM

    Perhaps these older adults see this as a chance to talk to someone who will actually listen to their wants and needs. Because you know that for many of them they have adult children who have stopped listening to what they want and have started making all of the decisions for them. That has to be hard to let go of that responsibility. So maybe therapy is a way for them to work some of this out and to feel a little more in control again.

  • Celine

    Celine

    October 20th, 2011 at 8:16 PM

    Psychology is better than pharmaceutical drugs any day.And to see that the older folk prefer the former to the latter is an encouraging thing.Maybe because they have used the latter before and have come to realize that it’s not really a quick fix but has many drawbacks?

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