Aging and counseling: developing a partnership.

Counselors are needed to help meet the mental health needs of older persons; yet, to be effective they must understand fully the special nee.ds of the older population. Counseling, an applied psychological science, is thus a field of study where gerontology curricula can be implemented optimally in a partnership manner. This article reviews the historical evolvement of gerocounselors and includes resources for special training of these professionals. Suggestions and resources for development of training programs and integration of gerontology and counseling curricula are provided. Article: The continued existence of academic programs in gerontology is essential if societal and individual needs related to increasing numbers of older persons are to be met. Mental Health is a major area of need, and one which requires full cooperation between academic gerontology and psychological sciences. Neither discipline, operating in isolation, can prepare effective practitioners, educators, or researchers to work with older persons. The counseling profession has, within the past decade, realized the necessity for development of a gerocounseling specialization. Moreover, counselors increasingly have turned to gerontologists for guidance in the development of special programs. A reciprocal relationship has evolved, and the potential exists for even more cooperative endeavors in curriculum planning and service. This article reviews the need for gerocounselors, and the historical development of this counseling specialization. This background information forms the basis for a discussion of suggestions for developing joint curricula and programs between gerontology and counselor education departments. Resources to assist and encourage institutions and individuals in working together are provided . Few gerontologists would dispute the claim that older persons need better and more extensive mental health services. Estimates of the numbers of elderly suffering from depression or some other form of treatable mental health care range from 25% (Kramer, Taube & Redick, 1975) to 65% (Special Committee on Aging, 1980). Over 50% of nursing home patients are diagnosed as having senility, or some other potentially treatable mental disorder (Select Committee on Aging, 1979). At least 50% of elderly mental hospital inpatients received no psychiatric care prior to admission. In terms of services, only 2-4% of persons seen in outpatient mental health clinics are elderly (Patterson, 1979). The counseling profession has been slow in responding to these needs, though, as explained later, rapid improvements have been made in recent years. As an applied science, counseling arose from psychological sciences that based theories of human development on Freudian concepts, Development was viewed primarily as child development. Adult crises and problems were resolved by reverting to childhood experiences and unresolved crises. Based on these premises, counselors were trained almost exclusively to work with children. Most counselors were school counselors, in elementary, middle and high schools. The need for assistance in career decision making required that counselors also be trained to work in junior college and universities. As population demographics have changed, theories of lifespan development have emerged, accompanied by increasing shifts in counselor preparation to include attention to the needs of adults. A virtual dearth of counseling literature dealing with adults and older people exists prior to 1975. In that year, two articles appeared in the professional literature that resulted in significant changes in the counseling profession. The first article, by Blake (1975), noted that older people were "the forgotten and the ignored" of the profession. He challenged counselors to find ways to meet the mental health needs of older persons. The second article, by Salisbury (1975), revealed that only 18 of 450, or 6% of all counselor education training programs offered even an elective course in the area of counseling older persons. A question that remained to be answered for many counselors was whether specialized training was, in fact, needed to work with older people. Gerontological specialists were consulted, and the answer provided: unequivocally, yes. Older persons do have special life circumstances and needs that differ in some ways from the needs of younger persons, Though the differences that exist are in degree, rather than in kind of need (Ohio, 1960), the cumulative impact of the biological, psychological and social processes of aging creates circumstances in the lives of many older persons that cannot fully be understood without a comprehensive knowledge of those processes. The application of generic counseling skills in working with older persons is not enough, To be warm and empathic and possess good counseling skills are necessary but not sufficient conditions tor effective counseling with older people, Counselors with this special population also must know as much as possible about their clients. Moreover, prior to interacting with older people they must examine their own biases that may act to inhibit or subvert intended helping interventions (Myers, 1981). Additional interactions with gerontologists led some counselors to understand the life review process as an important component of life satisfaction in older persons (Butler, 1974). Theories of aging opened avenues to new understanding of elderly clients. The potential role of counselors in helping older persons achieve life satisfaction became increasingly evident. Provided in isolation, this kind of information about older persons had little impact on the overall counseling profession, Obviously, some modifications in existing counselor preparation programs were necessary in order to teach counselors what was known about older persons. Equally as important, a means had to be devised for helping counselors apply knowledge about older persons within the context of the counseling relationship. Generic counselor preparation was, and is still, necessary but somehow it had to be tailored to the special needs of older people. DEVELOPMENT OF GERONTOLOGICAL COUNSELOR PREPARATION PROGRAMS In recognition of the need for preparing gerocounselors, the American Personnel and Guidance Association (APGA), the national professional association for counselors, entered into a two-year cooperative agreement with the U.S. Administration on Aging (AoA) to develop curricular materials for use in graduate counselor education programs. Between 1977 and 1978, the Special Training Project on Counseling the Aged operated to bridge the gap between aging and counseling. A panel of expert gerontologists and counselors was brought together to explore ways to integrate the two disciplines. Three products resulted. Counseling the Aged: A Syllabus for Educators (Ganikos, 1979) is a graduate text that presents gerontological information along with implications of this information for counselors. A Handbook for Conducting Workshops on the Counseling Needs of Older Persons (Ganikos, et al., 1979) is a companion manual that is designed to assist counselors in preparing workshops, content sessions and units within courses dealing with the special needs of older people. The third product, Hey, Don't Pass Me By, is a slide-tape Presentation that depicts the potential role of counseling in the lives of older people. The two books produced by this project were disseminated to all counselor education departments in the country, in the hope that each would implement the materials through the development of appropriate coursework. A post-project review of progress in gerocounselor training brought several important facts into bold relief. First, the development of new courses and programs was a time-consuming process, and not by any means automatic. Second, the preparation of counselors with a gerontology specialization would require, at best, 11/2 to 2 years. In the unlikely event that most counselor education programs would offer this specialty, it would still be years before significant inroads could be made in the mental health needs of the older population. Moreover, it appeared increasingly unlikely that the preparation of professional counselors could ever hope fully to meet the mental health needs of older people. A readily apparent solution to this dilemma seemed to be the training of service providers who already work with older persons in basic communication and referral skills. These individuals could be trained as paraprofessional or older peer counselors in as little time as 15 to 20 hours. Again, the lack of curriculum resources for such training presented a problem. So, APGA entered into a second cooperative agreement with AoA, this time to produce materials to train paraprofessional or peer counselors to work with older people. The second project was implemented in the same manner as the first, in terms of cooperation and work between gerontologists and counselors. A panel of experts in both areas was brought together several times over the twoyear duration of the project to help plan and advise on the conduct of the project and development of materials. The following three-volume set of books was produced. Counseling Older Persons, Volume I, Guidelines for a Team Approach to Training (Myers, Finnerty-Fried & Graves, 1981) presents a blueprint for action to encourage interaction between gerontologists and counselors. A model for effective cooperation in the development of paraprofessional gerocounselor training programs is presented, along with a directory of counselor educators and gerontological practitioners who have used this model in their communities throughout the country. Counseling Older Persons, Volume II, Basic Helping Skills for Service Providers (Myers & Ganikos, 1981) is a text, written at art eighth-grade reading level, designed for use in teaching service providers to older people basic communication and referral skills. Counseling Older Persons, Volume III, A Trainer's Manual for Basic Helping Skills, is designed to accompany the basic text and provides useful information, exercises and evaluation suggestions for trainers. The net result of the two APGA/AoA projects has been to stimulate the development of gerontological counseling as a specialty within counselor preparation programs. A study by Myers (in press), reveals that currently at least 114 or a 23% of all counselor education programs offer course-work to prepare gerontological counselors, a substantial increase over the 18 programs identified by Salisbury (1975). The increasing visibility of gerocounselor preparation is aided by a recent study showing that graduates of these 114 programs are, in fact, able to locate employment where their skills may be applied to work with older people (Myers & Blake, in press). The professional literature in counseling reflects the growing concern with the needs of older persons, as evidenced by increasing numbers of articles, research reports, and special issues of journals devoted to this topic. The trend towards increasing emphasis on gerocounselor preparation likely will continue. As the knowledge base in gerontology continues to grow, counselor educators must continue to work closely with gerontologists to assure the integration of this knowledge into counselor education programs. What is needed, in effect, is, a partnership between aging and counseling. THE AGING/COUNSELING PARTNERSHIP The partnership between aging and counseling is one of mutual aid and interdependence, formed with the ultimate goal of improved mental health service delivery to older people. A variety of ways to implement this partnership are possible, and many are currently underway across the country. In the following paragraphs, ways in which gerontologists can contribute to counselor education are discussed, followed by some suggested ways the counselor educators can contribute to the preparation of gerontologists. Resources for assistance to both members of the partnership are included. Academic gerontologists, especially in those institutions having gerontology centers serve as valuable resources to counselor education departments involved in preparation of gerocounselors. Often, a graduate certificate program is available on a campus-wide basis. Students preparing to be gerocounselors may be encouraged to enroll in the certificate pro-gram and thus can gain an extensive knowledge base in gerontology. Gerontologists can assist counselor educators in developing curricula by making suggestions on appropriate content and resources to avoid duplication with existing courses and maximize opportunities for a broad base of student learning experiences. Gerontology faculty also can serve as guest lecturers for counselor education courses dealing with older people. Counselor educators, on the other hand, also can serve as resource per-sons for academic gerontologists. Again, both disciplines can work together to plan curricula to minimize overlap in course content and maximize institutional resources for preparation of gerontological practitioners. Service courses can be offered to assist non-counseling gerontology majors to develop basic communication skills that will be useful in working with older person, in a variety of settings. Curriculum resources described earlier are available and suitable for these purposes. Counselor educators also can serve as guest lecturers in other gerontology classes on campus, and can provide information for students relevant to the mental health needs of and service delivery systems available to older people. Where few or no institutional resources exist in the area of gerocounseling, gerontologists wanting assistance in addressing mental health concerns have an existing avenue to turn to for help. The Committee on Adult Development and Aging of the American Personnel and Guidance Association is comprised of counselor educators having specializations in this area. The Committee has built on the work of APGA's two aging projects and has continued to expand the development of a national network of gerocounselors and counselor education programs offering coursework in aging. These persons are available to serve as resources for gerontologists seeking to establish or enhance the mental health component of training programs at their respective institutions. The Committee can serve as a resource for information and referral, and a link between counseling educators and academic gerontologists. CONCLUSIONA variety of avenues may, and in fact must be pursued if the mental health needs of older persons are to be meteffectively. The development of a partnership between aging and counseling, already begun in manyinstitutions, offers promise for helping to maximize limited resources. prevent duplication of effort andstrengthen academic programs in both gerontology and counseling. The AGPA Committee on AdultDevelopment and Aging is a readily available resource to aid the building of this viable partnership. REFERENCESBlake, R. Counseling in gerontology. Personnel and Guidance Journal, 1975, 53(10), 733-737. Butler, R. N.Successful aging and on the rule of the life review. Geriatrics, 1974.Ganikos, M., et al. A handbook for conducting workshops on the counseling needs. of older people Falls Church, VA: American Personnel & Guidance Association, 1979.Ganikos, M. Counseling the aged: A training syllabus for educators. Falls Church, VA: American Personnel &Guidance Association, 1979.Kramer, M., Taube, C. A., & Redick, R. W. Patterns of use of psychiatric facilities by the aged: Past, presentand future. In C. Eisdorfer & M. P. Lawton (eds.), The psychology of adult development and aging.Washington, D. C.: American Psychological Association, 1975.Myers, J. E. Counseling older persons, Volume III, a trainer's manual for basic helping skills. Falls Church,VA: American Personnel & Guidance Association, 1981.Myers, J. E. Gerontological counseling training: The state of the art. Personnel & Guidance Journal, in press.Myers, J. E., & Blake, R. Employment of gerontological counseling graduates: A follow up study. Submitted toAssociation for Counselor Education and Supervision.Myers, J. E., Finnerty-Fried, P. F., & Graves, C. Counseling older persons, Volume 1, guidelines for a teamapproach to training. Falls Church, VA: American Personnel & Guidance Association, 1981. Myers, J. E., & Ganikos, M. L. Counseling older persons, Volume II, basic helping skills for service providers.Falls Church, VA: American Personnel & Guidance Association, 1981.Ohio, Governor's Commission on Aging. Ohio's senior citizens. Columbus: State of Ohio, 1960. Patterson, R.Community mental health centers: A survey of services for the elderly. Issues in Mental Health & Aging,Volume III: Services (DHEW Publication No, (ADM) 79-665), 26-30.Salisbury, H. Counseling the elderly: A neglected area of counselor education and supervision. CounselorEducation and Supervision, 1975, 14(3), 237-238,Select Committee on Aging, United States House of Representatives. National conference on mentalhealth and the elderly. Washington, D.C.: United States Government Printing Office, 1979.Special Committee on Aging, United States Senate. Aging and mental health: Overcoming barriers to service.Washington, D.C.: U.S, Government Printing Office, 1980.