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Working psychologically with older people

Dr Georgina Charlesworth

Wednesday, 5 March 2025


The world has never seen as many people aged 65 and above. There are many ‘age pioneers’ navigating unchartered territory as the first generation within their families to live to very old age. Younger therapists often have concerns about working with older service users, even though many people in older cohorts are better educated and more psychologically-minded than their predecessors, and even though comparative studies of younger and older clients consistently show that the small proportion of older clients seen in all-age adult services have better outcomes than their younger counterparts. There is considerable heterogeneity in older populations meaning that there is no ‘one size fits all’ approach to psychological therapy with people in later-life. The evidence-base for CBT with older people is largely based on different protocols to those implemented in Talking Therapies services, raising questions about how to be flexible whilst maintaining fidelity.  The workshop aim is to equip practitioners with skills to work psychologically across generational divides, and provide strategies for overcoming fears associated with old-age.

The event will be equivalent to 5.1/2hrs of CPD.


Building on guidance for foundational competences in geropsychology, this workshop will cover skills for engagement, assessment, formulation and intervention. In part 1 we will consider the therapist-client relationship as a unique form of intergenerational working and explore the barriers and facilitators for engagement by clients and therapists. In part 2 we will consider assessment for psychological therapy, including contextual factors such as personal, family and cultural history, current physical and (neuro)cognitive comorbidities and ‘person-environment fit’. In part 3, we will focus on skills development for psychological intervention with common fears and realities in later life including loneliness and isolation, illness and caregiving, bereavement and loss. Finally, in part 4, we will identify alternatives to individual psychological therapy, including group work and peer support, involvement of others from family and community networks, interventions focussed on the social and physical environment, and other psychologically informed care-plans.

Learning Objectives

You will learn:
1) methods for conceptualising cultural differences between younger therapists and older service users
2) strategies to address barriers to cross-generational engagement and collaboration
3) when and how to adapt standard protocols, and applying a ‘flexibility within fidelity’ approach
4) ‘session-management’ strategies e.g. dealing with too much talk or too little talk;
5) skills for working with common fears and realities such as loneliness, illness, rejection
6) where to find further materials and resources

Training Modalities

Didactic content, Q&A, video and polls.

Key References

Charlesworth, G. (2022). Embedding the silver thread in all-age psychological services: training and supervising younger therapists to deliver CBT for anxiety or depression to older people with multi-morbidity. The Cognitive Behaviour Therapist, 15, e49.

Charlesworth, G., & Greenfield, S. (2004). Overcoming barriers to collaborative conceptualization in cognitive therapy with older adults. Behavioural and Cognitive Psychotherapy, 32(4), 411-422.

Fredman, G., Anderson, E., Stott, J (2010) Being with Older People: A Systemic Approach. Routledge.

Laidlaw, K., & McAlpine, S. (2008). Cognitive behaviour therapy: How is it different with older people?. Journal of Rational-Emotive & Cognitive-Behavior Therapy, 26, 250-262.

Pachana. N.A. & Laidlaw. K (2014) (Eds.), The Oxford Handbook of Clinical Geropsychology. Oxford University Press.

Qualls, S. H. (2022). Knowledge of aging reduces risk of harm: Why you need to read this special issue. Clinical Psychology: Science and Practice, 29(1), 76.

About the presenter

Georgina Charlesworth is a Consultant Clinical Psychologist on North East London NHS Foundation Trust and Associate Professor in the Department of Clinical, Educational and Health Psychology, University College London. She has specialised in work with older people and also people with dementia of all ages since qualifying as a clinical psychologist in 1995. She completed the Oxford Cognitive Therapy course in 1997 with a clinical distinction for her work with older clients. She has delivered psychological interventions in a range of NHS settings including all-age psychology services, older adult community mental health teams, inpatient mental health units, psychiatric liaison within acute hospitals, and Memory Clinics, plus work in care homes. She has led funded research on psychological and social interventions for people with dementia and their family carers including CBT, self-management, befriending and peer-support.

Who should attend

This event is suitable for anyone providing psychological therapy to people who are a generation or more older than themselves. Material covered will be relevant to those working in all-age services, and those new to old-age specialist services. For those specialising in late-life work, it will provide an opportunity to reflect on strategies for supporting, training and supervising those new to work with older people.

Details coming soon

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