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Counselling Older People: A Systematic Review By Andrew Hill & Alison Brettle. Rugby: British Association for Counselling and Psychotherapy. 2004. 92pp. $18.00 (pb). ISBN 190511401X

Published online by Cambridge University Press:  02 January 2018

Elizabeth Sampson*
Affiliation:
Department of Mental Health Sciences, Royal Free and University College Medical School, Rowland Hill Street, London NW3 2PF, UK. E-mail: e.sampson@medsch.ucl.ac.uk
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Abstract

Type
Columns
Copyright
Copyright © Royal College of Psychiatrists, 2006 

This report, from the British Association of Counselling and Psychotherapy, is a systematic review of the evidence base for counselling older people. ‘Counselling’ in this case has a broad definition and includes psychotherapy, cognitive–behavioural, interpersonal and validation therapy.

From a technical perspective this was a thorough project: a full range of databases were searched and the strategies used are described in detail. The checklists used for quality appraisal of studies are given and the description of the methodology is such that this report would serve as a useful template and resource for researchers wishing to carry out similar work. Inclusion and exclusion criteria are intentionally broad but clearly defined. Other aspects of the body of research in this field, such as the paucity of qualitative work, are discussed. This is not, however, a metaanalysis and fans of forest and funnel plots will be disappointed at the absence of a ‘bottom-line’ effect size for each of the interventions. The benefit of this approach is that this review is much easier to read and digest than the traditional Cochrane format.

The final section, on conclusions and implications for research and practice, is a concise overview of the report as a whole. The usual caveat that ‘more research is needed’ is entirely appropriate: of 47 included studies, the majority were carried out in the USA and only 7 in the UK.

Although I drift towards the ‘biological’ spectrum in terms of my research and practise of old age psychiatry, Hill & Brettle were successful in convincing me of the benefits of counselling for older people. It is almost 100 years since Freud allegedly stated that, after the age of 50, psychic structures become too rigid for individuals to benefit from psychotherapy. This report demonstrates good evidence that people benefit from psychological therapy throughout the lifespan. However, we still have to advocate for older people's access to psychological therapies. The authors outline the need for services in terms of the UK's National Service Framework for Older People, and the review would be a useful tool of persuasion for psychiatrists and service managers in old age psychiatry who wish to make a robust case for increasing the availability of psychological services to older people.

References

By Andrew Hill & Alison Brettle. Rugby: British Association for Counselling and Psychotherapy. 2004. 92pp. £18.00 (pb). ISBN 190511401X

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