Caring for Traumatized Elders: Lessons Learned From Trauma-Informed Care.

The Psychiatric Consultation Service at Massachusetts General Hospital sees medical and surgical inpatients with comorbid psychiatric symptoms and conditions. During their twice-weekly rounds, Dr Stern and other members of the Consultation Service discuss diagnosis and management of hospitalized patients with complex medical or surgical problems who also demonstrate psychiatric symptoms or conditions. These discussions have given rise to rounds reports that will prove useful for clinicians practicing at the interface of medicine and psychiatry.Prim Care Companion CNS Disord 2024;26(2):23f03643. Author affiliations are listed at the end of this article.

Child Maltreatment Among Older Adults: A Narrative Review of Psychotherapeutic Interventions and Clinical Considerations.

OBJECTIVES: The goals of this narrative review are to review the literature on psychotherapeutic interventions for older adults with histories of child maltreatment (CM) and to examine the unique considerations for assessing, diagnosing, and treating older adults with CM histories. METHODS: Online database searches were conducted to identify the extant research into the efficacy of psychotherapeutic interventions for older adults with CM-related trauma. RESULTS: Eight studies met inclusion criteria. The primary target diagnoses were post-traumatic stress disorder and depression. Psychotherapeutic interventions included Narrative Exposure Therapy, exposure-based treatments, Life Review Therapy, integrated treatments, and a spiritually-focused group therapy. CONCLUSIONS: While limited in number and generalizability due to study design and sample size and characteristics, the studies provide preliminary evidence of potentially effective psychotherapeutic treatments for older adults with CM histories. Further research is needed to determine the most effective psychotherapeutic interventions for this population. CLINICAL IMPLICATIONS: Many older adults suffer for decades with the repercussions of CM. Due to knowledge gaps regarding best practices for treating older adults with CM histories, many clinicians are poorly equipped to treat this population. Therefore, awareness of CM-related pathology and familiarity with effective psychotherapeutic interventions are essential for clinicians to meet the needs of this population.

Cognitive-Behavioral Treatments for Anxiety and Stress-Related Disorders.

Cognitive-behavioral therapy (CBT) is a first-line, empirically supported intervention for anxiety disorders. CBT refers to a family of techniques that are designed to target maladaptive thoughts and behaviors that maintain anxiety over time. Several individual CBT protocols have been developed for individual presentations of anxiety. The article describes common and unique components of CBT interventions for the treatment of patients with anxiety and related disorders (i.e., panic disorder, social anxiety disorder, generalized anxiety disorder, obsessive-compulsive disorder, posttraumatic stress disorder, prolonged grief). Recent strategies for enhancing the efficacy of CBT protocols are highlighted as well.

Tailoring Trauma-Sensitive Yoga for High-Risk Populations in Public-Sector Settings.

Low-income, racial-minority, high-risk populations have limited access to evidence-based treatments for posttraumatic stress disorder (PTSD), and their acceptance of complementary interventions is unknown. Trauma Center Trauma-Sensitive Yoga (TC-TSY), which has demonstrated efficacy in community samples, has not yet been widely used with ethnic minority low-income individuals. This article presents a culturally tailored version of a TC-TSY intervention delivered as a drop-in service in a public hospital-based clinic to patients with histories of interpersonal violence and suicide attempts. TC-TSY was iteratively tailored to meet the unique clinical needs of individuals within this setting. Group facilitator observations are summarized; they describe a successful initial implementation and culturally informed adaptation of the group intervention. The facilitators' observations illustrated that group members accepted the integration of this structured, gentle yoga practice into outpatient behavioral health programming and identified site-specific modifications to inform formal study. The process by which TC-TSY was adapted and implemented for Black individuals with a history of interpersonal trauma at risk for suicidal behavior can serve as a guide for tailoring other complementary, integrative interventions to meet the needs of unique clinical settings. This process is offered as a foundation for future systematic testing of this complementary, integrated, culturally adapted trauma therapy in high-risk clinical populations.