Therapeutic Approach

Elderly Australian Population A Therapeutic Approach for the Mentally Ill
Introduction
Mood disturbances refer to a category of mental health issues that is utilized by mental health practitioners to describe all kinds of bipolar and depressive disorders broadly. A large number of individuals belonging to the senior population (65+ years of age) come in the high-risk group of the psychological illnesses development, substance abuse issues, neurological disorders, and other health issues like osteoarthritis, diabetes mellitus, and loss of hearing loss. Also, with age, individuals display a greater likelihood of experiencing several health issues simultaneously (WHO, 2017). More than 15 percent of individuals belonging to the senior age group are diagnosed with a neurological or psychological illness, with the latter group of illnesses accounting for 6.6 percent of all disabilities (DALYs- disability-adjusted life years) in this population group (WHO, 2017). Hence, this essay attempts to examine further the mood disturbance problem in the geriatric population (65+ years of age), focusing, in particular, on the senior population of Australia.
In the year 2016–17, the senior Australian population received a total of 950,000 mental healthcare services subsidized by the Medicare program. Such services made up nine percent of the overall eleven million mental healthcare- linked services that were Medicare-subsidized that year (AIHW, 2018). The year 2015–16 witnessed 46,500 healthcare facility separations for the senior Australian population, which had admitted mental healthcare overnight (accounting for 19 percent of overall mental healthcare connected separations). Roughly 10–15 percent of aged Australians living within the community are diagnosed with depression or anxiety (AIHW, 2015). Concerning community mental healthcare services in the same year, elderly individuals made up 779,000 mental healthcare service contacts (i.e., 8 percent of the overall patients) (AIHW, 2015). Females continue to display a greater tendency to develop mood disorders as compared to males.
Bio-psychosocial framework for the development of Mood disturbances
In addition to life stressors that are commonly experienced by all individuals, elderly persons might also be subject to biological stressors more commonly experienced in later adulthood (for instance, a continuous, significant functioning loss or decline). Such biological risks encompass cardiovascular, endocrine, neuroanatomical, and immune or inflammatory elements (Tseng et al., 2019). For instance, aged individuals may suffer decreased mobility, weakness, chronic pain, and other health challenges that call for some or other kinds of long-run care services (WHO, 2017). Besides, this population group displays a greater likelihood of being subject to events like loss of a loved one or a decline in socioeconomic standing following retirement from the workforce. All such stressors may lead to feelings of loneliness, seclusion, and mental/emotional distress among the aged population, calling for long-term healthcare services.
Mental and physical wellbeing have reciprocal effects on one another. For instance, the geriatric population suffering from physical illnesses like heart disease are more likely to be depressed as compared to healthy aged people (WHO, 2017). Further, depression, if left untreated among the elderly suffering from heart disease, may end up adversely impacting its outcome. Avoidance, as well as rumination, have been linked to depression over the lifespan. The term 'rumination' is used to describe ineffective coping, which entails passive, repeated mulling over one's distress. Among the geriatric population, a ruminative approach to coping has been linked to depression (Fiske et al., 2009).
With respect to major factors linked to mood disturbances, Abdul Manaf and colleagues (2016) utilized multiple logistical regression and identified a total of three societal determinants; being single, poor overall health, and living with one's family. The last of these determinants was revealed to be the lone significant element when it comes to mood disturbance. This research's findings were comparable to those by other scholars (Imran et al., 2009; Rashid et al., 2011; Taqui et al., 2007), revealing increased mood disturbance risks in single aged persons (i.e., unmarried, widowed, or divorced). The UN classifies living arrangements as (1) Single; (2) Living only with one's significant other; (3) Living with children, grandchildren, or children-in-law; (4) Living with some relative besides the above and; (5) Living only with some other unrelated persons (not counting one's significant other) (Tseng et al., 2019; United Nations, 2005). Moreover, aged persons are susceptible to abuse in the following forms – physical, mental, verbal, sexual, and financial abuse; acute loss of respect and regard; desertion; and inattention. Existing evidence indicates that one out of six elderly individuals is victims of abuse (WHO, 2017). Such abuse may potentially result in physical injuries as well as grave and, at times, enduring mental health consequences like anxiety and depression.
Changes attributed to mood disturbances
A person diagnosed with any mood disorder might experience various behavioral, mood, communication, cognitive, and physical functioning variations based on the kind of disorder they suffer from and their personality.
Mood disorders may bring about changes in individual conduct as well as impact their capability of managing everyday tasks related to school or work (da Costa Lane Valiengo et al., 2016). In the initial stages after the development of the disorder, changes in conduct may involve irritability, sleep issues, and emotional liability.
Cognitive variations associated with mood disturbances encompass impairment in social judgment, attention issues, and feelings of hopelessness or worthlessness. Co-occurring indications like fluctuating attention, confusion, or autonomic dysfunction might be indicative of delirium.
Further, mood disturbances may bring about mood variations in the aged because of sluggishness or loss of energy, disinterest in passions and pastimes, and a prolonged or intense feeling of excitement, euphoria, or joy.
Physical changes associated with mood disturbances encompass the incapability of standing, lying down, or sitting for longer durations, confused or fast speech, constipation, diarrhea, and other digestive issues, and muscular/body aches.
Concept of recovery in mental health practice
Clinical recovery implies having no or a smaller amount of symptoms. On the other hand, personal recovery implies leading a meaningful life according to the individual, within the milieu of their personal experience with acute mental health issues. Personal recovery fosters individual wellness, including the definition of personal recovery targets, development of self-respect, confidence, hardiness, a sense of purpose, and the capability of maintaining relationships (Healthtalk Australia, n.d.). Clinical and individual recovery aren't mutually exclusive; rather, they may work together. For the patient suffering from the mental health problem, recovery implies acquiring and maintaining hope, leading an active life, understanding one's capabilities as well as weaknesses, personal independence, positive sense of self, social identity, and purpose and meaning in life (Department of Health, 2010). The term recovery denotes internal conditions an individual self-reporting being in the recovery stage experiences such as hope, recuperation, connection, and empowerment, as well as external conditions facilitating recovery like recovery-focused services, a positive recuperative culture, and human rights exercise (Jacobson and Greenley, 2001 p. 482).
The therapeutic approach to managing mood disturbances
Mood disorders are usually successfully treatable. Treatments encompass therapeutic processes like Psychotherapy — the most commonly used treatment being interpersonal and cognitive-behavioral therapies, which revolve around altering the inaccurate opinion the individual holds about him/herself and his/her surrounding environment (Picardi & Gaetano, 2014). Additionally, it facilitates honing of relational/interpersonal abilities, and determination of environmental stressors (which includes how to steer clear of them).
Interpersonal psychotherapy (IPT) and cognitive-behavioral therapy (CBT) are greatly supported by empirical research. Extant research works indicate that CBT, particularly cognitive treatment or CT, proves specific and effective when it comes to treating mood disturbance issues (Picardi & Gaetano, 2014). Reliable indications exist of its enduring specific as well as effective impact when it comes to preventing relapse and recurrence. IPT's effectiveness as a therapeutic approach is also evidently corroborated by research if adopted by qualified therapists. The treatment strategy is specific and effective in the reduction of acute distress, potentially preventing relapse as well as recurrence so long as treatment is maintained. 
Sounder evidence exists for contextual strategies like contingency management and behavioral activation that were tested against other effective approaches in wholly clinical samples. Less strong support exists for the problem solving therapeutic approach since supporting researches was conducted on general practice patient samples or recruited volunteers (Picardi & Gaetano, 2014). On the whole, when administered by qualified, experienced therapists, behavioral therapies, CBT (particularly CT), and IPT prove just as successful as drugs when it comes to treating mood disturbance patients.
Not taking into account procedural and principle-based differences, every CBT approach offers patients issue-oriented, collaborative therapy, which considers how occurrences and circumstances are viewed and interpreted, their attitudes about themselves, their worldview, and activities and capabilities using which they carry out interactions with the surrounding world. CBT strategies are naturally implicitly or explicitly educative. In comparison to the remaining approaches that exist, they are more focused on the present as compared to the past (Picardi & Gaetano, 2014). Research-founded treatment protocols often have an associated time limit, lasting from 12-16 weekly sessions. However, in actual practice, the therapist may personalize treatment to individual patients' unique needs through decreasing/increasing sessions' quantity and frequency.
Effectiveness of Psychotherapy in treating mood disturbances
Psychotherapy is increasingly being acknowledged as a key therapeutic alternative when it comes to treating mood disorders during the past few decades. Some empirical research-backed therapies for acute depression are CBT, behavioral therapy, IPT, and psychodynamic psychotherapy (the last for the short run and to a smaller degree). Meta-analysis indicates psychotherapy's clinical relevance and importance, though it fails to reveal the larger impacts on chronic depression (Picardi & Gaetano, 2014). Psychotherapy in the chronic geriatric population ought to consider several key differences between individuals suffering from acute and chronic depression (more acute social skill deficiencies, identification with the ailment, enduring feelings of hopelessness, and more time needed for adapting to improved circumstances).
Psychotherapy is effective in treating mood disorders. Against commonly-held beliefs, it is at least just as effective (if not more effective) in case of patients displaying acute symptoms as in the case of patients displaying mild symptoms. Psychotherapy is equally effective in mood disorder treatment and better at avoiding relapse when compared to medicines (Hunsley et al., 2013). Superior-quality treatment studies prove, time and again, that psychological approaches can bring about appreciable improvements in the functioning of mood disorder-diagnosed patients, in addition to those diagnosed with anxiety and connected ailments. For the majority of such ailments, backing proofs are more extensive in the case of adults as compared to the adolescent or geriatric populations; nevertheless, innumerable treatment researches (effectiveness as well as efficacy researches) support psychotherapy's worth when it comes to successfully treating these populations. Also, psychological approaches may aid in dealing with the psychosocial facets of commonly occurring physical ailments, as evidenced by psychotherapy research on CHD.
One problem with this standalone treatment is: in certain cases, medicines and psychotherapy combined will prove more advantageous as compared to either approach by itself. In comparison to standalone medicine usage in treating bipolar disorder, its combination with psychotherapy results in improved patient functioning and fewer relapse events (Hunsley et al., 2013). Emergent evidence indicates that integrating psychotherapy with medication leads to improved compliance with treatment, decreased suicide rates, and decreased subjective disease burden.
One weakness linked to psychotherapy is: it is usually more time-consuming for psychotherapy to yield noticeable benefits as compared to medication to the patient receiving treatment – i.e., 6-8 weeks or more for psychotherapy, in comparison to 4-6 weeks in case of drugs (Hoch, 1955). Based on mood disorder severity and other geriatric population-specific factors, therapists choose two or more approaches combined from an array of psychotherapeutic interventions at their disposal. Irrespective of approach adopted, the basis of all is: forging trust between patient and therapist, a process that mostly takes longer in case of patients diagnosed with a mood disorder. Without the forging of a relationship founded on trust, the patient won't share his issues, confidences, or life experiences.
Conclusion
Mood disturbances refer to a category of mental health issues that is utilized by mental health practitioners to broadly describe all kinds of bipolar and depressive disorders. The most widely occurring forms of these disorders include acute depression, bipolar disorder, substance-produced mood disorder, dysthymic disorder, and mood disorder because of a particular general illness. Mood disorders don't have any explicit cause. Healthcare experts believe they stem from chemical imbalances within the patient's brain. Some kinds of mood disorders are believed to be genetic, though researchers are yet to link any genes them. Generally, almost all mood disorder patients experience constant irritability, helplessness, hopelessness, and misery. If left untreated, the symptoms can persist for several weeks or months, or even years, affecting the patient's quality of life. Depressive disorders are commonly treated using medications, psychotherapy, family therapy, CBT, or therapy, and medications combined. In certain instances, other treatment approaches like transcranial stimulation and electroconvulsive therapy may be adopted.
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