In an intake session with Teresa, an 80-year-old woman, you notice that she is very thin and her appearance is disheveled. Teresa reports that she recently moved in with her son and daughter-in-law due to declining health and the death of her husband. Teresa reports that her son and daughter-in-law are often “too busy” to help her with food or buy her clothes or personal items. Teresa describes herself as happy until recently and now feels depressed and hopeless.
Due to Teresa’s age, the recent loss of her husband, her reports of depression and hopelessness, and her disheveled and thin appearance, a report to the Department of Family Services is necessary due to Wyoming’s laws that state any person who suspects elder abuse is a mandatory reporter (Wyoming State Statute, 2020) as well as the code of ethics (American Psychological Association, 2017). A suicide assessment may also be warranted due to the reported depression, hopelessness, and loss of meaning (Fisher, 2017). The report may be made with Teresa in order to maintain her trust and dignity and help support the therapeutic alliance (American Psychological Association, 2013).
Interventions with the entire family as well as individual interventions with Teresa are indicated. Couples therapy for the son and daughter-in-law may be helpful depending on the assessment of the family. Teresa is my individual client, therefore I would refer the family to a competent family therapist who would also refer to a different couples therapist, if necessary, in order to avoid dual relationships (Fisher, 2017).
For Teresa, individual psychotherapy is indicated. Multiple modalities could be effective to help Teresa deal with her depression. I am competent in Mindfulness Based psychotherapy and yoga-based therapy, which has been shown to be effective with depression symptoms (Bridges & Sharma, 2017), so these are the interventions that I would begin using with Dave (Fisher, 2017). Teresa may also benefit from a support group or group therapy for seniors with strained familial relationships.
For the prevention of further neglect, family interventions may be necessary. As stated above, referral to family therapy and a support group for Teresa may help create boundaries and an understanding of needs. Reporting to Department of Family Services is also a preventative measure as the social workers in the department can help the family connect with services that may not be known to me or that are only available to their clients. This could include home help, health programs, and social programs for Teresa, which would not only help prevent further neglect, but could help with the treatment of her depression.
Teresa is struggling with neglect from her son and daughter-in-law. It appears, due to ill health, that Teresa has a hard time caring for herself and needs more help than the family is aware of. Teresa requires individual therapy to help her with the feelings of depression and hopelessness that have appeared during her time with her son. The three family members will be referred to family therapy in order to help prevent further neglect and harm. A report will be made to the Department of Family Services in order to make sure Teresa has all of her medical and social/emotional needs met in the home and to help provide further services if necessary.
American Psychological Association. (2013). Reporting Child Abuse and Neglect. Good Practice, 2-5.
American Psychological Association. (2017). Ethical Principles of Psychologists and Code of Conduct.
Bridges, L., & Sharma, M. (2017). The Efficacy of Yoga as a Form of Treatment for Depression. Journal of Evidenced Based Complementary and Alternative Medicine, 22(4), 1017–1028.
Fisher, C. (2017). Decoding the ethics code: A practical guide for psychologists. SAGE.
Wyoming State Statute. (2020). Practice Act.