Evidence-Based Mental Health Practices for Older Iowans

1. Evidence-Based Mental Health Practices for Older Iowans Brian Kaskie, PhD Center on Aging University of Iowa June 22, 2010

2. National EBP Project:6 Selected Practices • Assertive Community Treatment • Co-occurring Disorders: Integrated Treatment • Family Psycho-education • Illness Management and Recovery • Medication Management Approaches in Psychiatry (MedMAP) • Supported Employment

3. Results of Initial Iowa Assessment: Models with strong Evidence-Base

5. Treating Older Iowans • American Psychological Association (2004) Guidelines for Providing Care to Older Adults American Psychologist, 59, 4, 236-260,

6. Treating Older Iowans • Gatz et al. (1998) Empirically validated treatments for older adults. Journal of Mental Health & Aging, 4,1, 9-46, 1998. • Bartels et al. (2002) Evidence Based Practice in Geriatric Mental Health

8. Evidence-Based TreatmentsDEPRESSION PRESCRIPTION MEDICATION - Serotonin-Norepinephrine Reuptake Inhibitors - Selective Serontonin Reuptake Inhibitors TARGETS - Major, uni-polar depression - Depressive symptoms - co-occurring disorders - co-morbid conditions

9. Evidence-Based TreatmentsANXIETY PRESCRIPTION MEDICATION - Anti-depressants - Buspirone - Benzodiazipines TARGETS - ADs = OCD, panic, phobia - BuSpar = GAD

10. Evidence-Based TreatmentsALCOHOL & SUSBTANCE ABUSE PRESCRIPTION MEDICATION - Naltrexone - Acamprosate and antabuse TARGETS - Pain Medication - Altered states

11. Evidence-Based TreatmentsDEMENTIA PRESCRIPTION MEDICATION - Aspirin - Cholinesterase inhibitors: donepezil, rivastigmine, galantamine - Memantine TARGETS - Early stage - Psychosis

12. Evidence-Based TreatmentsPSYCHOTHERAPY VALIDATED APPROACHES - Cognitive Therapy - Behavioral Therapy - Interpersonal Therapy - Life Review - Environmental

13. Evidence-Based TreatmentsPSYCHOTHERAPY PROBLEM SOLVING THERAPY - Problem Definition - Goal setting - Solutions - Path selection - Strategy - Execute - Evaluate

14. THANK YOU