Responding to Unwanted Behaviors & Motivating Clients in Therapy

1. Depression in Older Adulthood

It is a myth that all older adults are at increased risk of depression. Risk factors for geriatric depression and common treatment options are explored in this chapter, along with the effects of depression on cognitive abilities.

2. Bandura’s Motivational Theory

Motivation is highly correlated with ultimate therapeutic outcomes. We will explore one of the most useful theories of motivation and introduce how therapists and other professionals can use it to develop short-term motivation strategies that help to improve clients’ beliefs that they can do the necessary work. The idea that clients need to be aware of the benefits of doing specific therapeutic exercises is introduced. One of the best predictors of a client’s success is their self-efficacy, or their belief that they can do something and attain a desired outcome. We will discuss the concept of self-efficacy and ways to improve a client’s self-efficacy for therapy.

3. Outcome Expectations (What’s in it for Me)

Whether or not someone is willing to do some behavior is, in part, determined by their knowledge of the benefits of doing that behavior. We will discuss how to connect the therapy exercises to functional goals and outcomes that the client wants. Strategies for how therapists and other professionals can better explain why exercises are being prescribed are provided. There are other tools that professionals can use to maximize motivation. They can point out the consequences for not engaging in therapy. Practitioners can also benefit from asking clients to report the frequency and duration of home exercises. Caregivers can also be used to maximize motivation and therapeutic outcomes.

4. Behavioral Management Strategies: Executive Functioning Enhancement

Unfortunately, people with dementia and traumatic brain injuries often engage in behaviors that can negatively affect their quality of life. Caregivers and staff members are often unsure how to handle unwanted and challenging behaviors. In this chapter, we will look at how executive functioning mediates behavior and use that to develop intervention strategies so people can better inhibit unwanted behavior.

5. Behavioral Management Strategies: Retrogenesis and Redirecting

Often times people with more advanced cognitive impairment will be living in the past and have even lost more recent memories. We will discuss these phenomena and how this process usually abides by the principles of retrogenesis. We will then discuss interventions designed to redirect attention by taking advantage of what the person remembers and comprehends. The goal will be to reduce unwanted behavior and the need for pharmaceutical interventions.