Roles for the Counseling Psychologist in the Nursing Home.

Although the contributions made by counseling psychologists to nursing homes has been marginal, there are several services that can be provided to long-term care facilities by psychologists. Once familiar with the pattern of nursing home life, the psychologist will be able to provide services indirectly as a consultant or trainer, and directly in the delivery of mental health services. As consultants and trainers, psychologists can influence continuing education programs often required of nursing home personnel to include training on mental health needs of nursing home residents. Four workshops developed to provide such education include: (1) Crisis Management in Older Persons; (2) The Family of the Nursing Home Resident: Adversary or Advocate; (3) Using Volunteers in the Nursing Home and Making It Work; and (4) Brief Interventions for Problem Behaviors of Residents. The most frequently requested direct service is for assessment of residents' mental status and treatment recommendations. If diagnostic reports and recommendations are used for care planning, the counseling psychologist can have input into the management of such predictable resident behavior problems as oppositional and noncompliant behavior, depression, agitation and anxiety, social withdrawal, and cognitive disorientation. Although the magnitude of mental health problems in nursing homes and the inadequacy of current services concern counseling psychologists, the problems of adequate and legitimate financial reimbursement must be addressed at a national level if professionals are to be attracted to the field of geriatric mental health in long-term care settings. (NB)