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Growing older can be a time of great joy and satisfaction for men as they look back on their accomplishments and gain more free time, but it can also be a challenging and distressing experience, especially for those men raised with the very traditional notions of what it means to be a \"real man.\" This book will help practitioners working with older and aging men understand the eras in which these men were raised, how they view the world, the gender role conflicts they experience, and the physical, mental, and emotional challenges and problems they face during the later stages of their lives. The authors discuss theories of masculinity and aging and therapeutic considerations for working with this special population. Making use of many detailed case studies, they explore the psychological issues that are commonly faced by older men, such as depression, anxiety, cognitive impairment, and substance use and abuse, as well as effective screening and assessment techniques, and treatment approaches. They then conclude with a look at the future directions of psychotherapy with older men. Part I: Setting the Stage. Life as an Older Man. Gender and Aging. Part II: Psychological Issues Affecting Older Men and Treatment Approaches. Therapeutic Considerations When Working with Older Men. Adjustment Difficulties. Depression. Anxiety. Health and Dealing with Chronic Physical Illness and Disability. Management of Substance Abuse and Use. Cognitive Impairment. Part III: Future Directions. Reducing Barriers. The Future. \"this book challenges preconceptions by creating an optimistic climate for any therapist working with older men to feel that psychotherapy can be a rewarding process that benefits the client.\" - David Blackbeard, New Therapist, March 2016 \"This is an invaluable and stunningly good book for readers who want to provide competent services to older men. It is right on target in presenting the most up-to-date psychological science and theories about men’s development in the latter part of their life span.\" - Melba J T Vasquez, PhD, ABPP, psychologist in independent practice, Austin, Texas; 2011 President, American Psychological Association \"This wonderful, much-needed resource for psychotherapists and counselors unpacks the layers of men’s' lives as they unfold in therapeutic relationships. It offers a true integration of multiple theoretical perspectives that is peppered liberally with case illustrations, making it a valuable resource for readers from any helping profession.\" - Sara Honn Qualls, PhD, Kraemer Family Professor of Aging Studies and Director, Gerontology Center, University of Colorado at Colorado Springs \"This excellent book addresses a critical void in the literature about providing mental health services to older men, an often overlooked but growing population.　 I highly recommend it!\" - Glenn E. Good, PhD, Professor and Associate Dean, University of Missouri; Coeditor of The New Handbook of Psychotherapy & Counseling with Men \"An intellectually thought-provoking but also very helpful book, full of practical advice for clinicians working in this field.\" - Dr. Hywel Pearce, The Journal of International Psychogeriatrics Tammi Vacha-Haase, Ph.D. , is an associate professor in the Counseling Psychology Doctoral Program in the Psychology Department at Colorado State University, USA, where she served as the Training Director of the program for 8 years. She is a licensed psychologist and currently serves as the consulting psychologists at several local long-term care and assisted living facilities. She has authored numerous articles, received several grants, and currently has an active research and training program in geropsychology. Dr. Vacha-Haase is a member of the Society for Counseling Psychology (Division 17), Psychologists in Long Term Care (PLTC), and the Geropsychology Training Committee. Stephen R. Wester, Ph.D., an Associate Professor of counseling psychology in the APA-approved Counseling Psychology Doctoral program housed within the Department of Educational Psychology at the University of Wisconsin-Milwaukee, USA. A prolific author and presenter, Stephen was recently named Researcher of the Year (2006) by the American Psychological Association’s Division 51 (Society for the Psychological Study of Men and Masculinity). His research interests include men and emotions, male gender role conflict, counseling men from diverse backgrounds, and multicultural expressions of masculinity. Heidi Fowell Christianson, MS, is currently a doctoral student in counseling psychology in the Department of Educational Psychology at the University of Wisconsin-Milwaukee, USA, while concurrently pursuing a certification in applied gerontology through UWM’s School of Social Work. A winner of the University of Wisconsin-Milwaukee’s Helen Bader Endowed Scholarship, for her work in geropsychology, three years running (2004, 2005, and 2006), Heidi’s research and professional interests include aging and health psychology, specifically psychotherapy with older adults, psychosocial interventions for people with chronic illness, and physical consequences of stress on the medically ill.

The authors explored the influence of role induction on men's perceptions of career counseling and attitudes toward seeking professional help. Two separate role inductions were presented to 268 male college students; the first discussed holistic career counseling, and the second integrated a discussion of male gender role socialization. Results demonstrated that participants who viewed the holistic role induction reported greater valuing of career counseling when compared with a control group. However, results indicated no difference in perceptions of career counseling between a holistic career counseling role induction and one that included socialized male perceptions of counseling.

Facilitating quality of life as people adjust to end-of-life has been considered one of the hallmarks of palliative care (NHPCO, n.d.). Although the dominant model used by clinicians to facilitate quality of life at end-of-life (e.g., Kübler-Ross' 1969 stage model) suggests that acceptance is the ideal state of adjustment, other researchers have found (e.g., Reed et al., 1994) realistic acceptance to predict poorer quality of life in terminally ill patients. Research in this area has been scant. Additionally, Kübler-Ross' stage model lacked empirical scrutiny and did not adequately predict adjustment to end-of-life. An adjustment to illness model, the Cognitive Adaptation Theory (CAT; Taylor, 1983), suggests that people adjust to illness using slightly illusionary, positive attributions of self, control, and meaning. However, Cognitive Adaptation has not been tested with a terminally ill population and has been poorly operationalized in extant literature, measuring optimism instead of meaning. This study explored the Cognitive Adaptation Theory, including meaning (LRI; Battista & Almond, 1973), control (CBI; Sirois, 2007), and self-esteem (Rosenberg Self-Esteem Scale; Rosenberg, 1965), as well as the role of optimism (LOT-R; Scheier et al., 1994), in a population of 80 culturally diverse late-stage cancer patients using a correlational cross-sectional design. Multiple regression analyses tested whether Cognitive Adaptation indices predicted psychological and physical quality of life (SF-36; Ware et al., 1993) at end-of-life and whether this effect was moderated or mediated (Baron & Kenny, 1986) by optimism. Results suggested that Cognitive Adaptation Theory (Taylor, 1983) applied to late-stage cancer patients. Greater levels of self-esteem, control, and meaning predicted physical and psychological quality of life. Physical quality of life was most influenced by control beliefs, while psychological quality of life was most influenced by self-esteem. Optimism independently predicted physical quality of life and neither mediated nor moderated the relationship between Cognitive Adaptation and quality of life. This study demonstrated that slightly positive, illusionary beliefs of self, control, and meaning predicted quality of life even in the presence of clear, disconfirmatory environmental evidence. Results call into question broad application of Kübler-Ross' (1969) stage model in facilitating quality of life in dying cancer patients.

Harold Arnold looked around the waiting room as he sat calmly waiting for his appointment with the therapist. He wasn’t sure why he was actually here, but his wife had said he “needed help.” She believed that he was different since the car accident a year ago, when his longtime friend didn’t see the red light and ran into oncoming traffic. After having driven a bus route for over 40 years before retiring at the age of 70, Mr. Arnold saw the collision coming but could do nothing to stop it. Mr. Arnold had been in the passenger side at the time and received only a few cuts and bruises, but his friend who had been driving sustained massive injuries and died a few hours later at the hospital. Yes, it was hard to have a friend die, but at the age of 84, Mr. Arnold had lost a number of family members and friends, and he expected to lose many more in the upcoming years. Maybe he had lost some weight over the past few months and was having difficulty sleeping at night, with a few more headaches during the day. What did his wife expect at his age? After his stroke several years ago, he never returned to the outdoor activities of hunting and fishing that he once enjoyed. He was feeling a bit tense; these types of hassles would be hard on any guy. But he was used to change-growing up as a “military brat” and having been the son of an army colonel who had served in the First World War, he learned as a young boy how to “keep a stiff upper lip” and “never show weakness” as well as adapt to change. And at times he missed his son who had moved to Florida several months ago after his own retirement to be closer to the grandchildren-Mr. Arnold’s greatgrandchildren. It was hard for Mr. Arnold and his wife to no longer have their only child living nearby, and they rarely heard from him. Had he been a terrible father and an even worse grandfather? Maybe it was hopeless.

There is no question; older adults can, and do, benefit from psychotherapy (Scogin & McElreath, 1994). Although no single modality of psychological intervention has proved to be most effective (Scogin & McElreath, 1994), a number of individual psychotherapeutic interventions have been offered for treating older adults, including interpersonal psychotherapy (Hinrichsen, 2008), cognitive-behavioral treatments (e.g., Satre, Knight, & Steven, 2006; Stanley, Beck, & Glassco, 1996), and reminiscence therapy (Fielden, 1992). Significant progress is being made regarding empirically supported treatments or evidence-based practice, still in their infancy, for older clients. A noteworthy contribution on evidence-based psychological treatment for older adults was provided as Scogin (2007) and his colleagues provided reviews of psychological treatment for anxiety (Ayers, Sorrell, Thorp, & Wetherell, 2007), insomnia (McCurry, Logsdon, Teri, & Vitiello, 2007), and behavior disturbances among older adults suffering from dementia (Logsdon, McCurry, & Teri, 2007). An additional article (Gallagher-Thompson & Coon, 2007) reviewed treatment strategies for family caregivers of older adults.

Richard Donovan, age 70, was the older of two children. His sister, age 55, now lived in a different state, and his parents had recently died. Mr. Donovan never married, instead devoting 45 years of service to the local high school, first as an English teacher and later as the principal. Described by his colleagues as gentlemanly and civil, Principal Donovan valued rules and procedures that served him well in his academic roles. He could be a perfectionist at times, based on his belief that high standards were needed to mold children into proper adults. Colleagues, as well as parents of students, often noted he could be rigid and controlling. To fill his days after retirement, Mr. Donovan decided to volunteer at the high school where he had served so long. However, this experience did not go well; he often tried to take over projects and was described by other volunteers as bossy and domineering. Mr. Donovan became easily offended by what he called the inefficiency of the other volunteers. This would be followed by a ranting discourse on how the younger generation had deteriorated, exhibiting behaviors that would not have been tolerated while he was principal. Mr. Donovan had long been accustomed to having people serve him in his personal life; being unmarried, he hired people to clean and cook for him. Interested in academic pursuits, he retained a handyman and a mechanic to complete lawn care and car repair. However, as his health deteriorated, Mr. Donovan began to demand the same servile treatment from professionals in the health care system. He was often frustrated, as he believed the health care providers did not “put forth their best efforts” and were “unresponsive” to his needs. When confronted, Mr. Donovan became more demanding of those around him, which led to many health care workers avoiding him in response to his sharp criticism.

James LaCrane started his first therapy session with a summary: “I’ve had a really good life. But now I’m faced with losing my wife. I was at the doctor’s office last week, and he told me the cancer in my brain is back. I’ve got to sell everything I own: my home, my car. … In addition, my oldest son just told me he’s getting a divorce. I haven’t had to deal with any of these things before and now all at once at the age of 75. I don’t know how I am going to get through this. I had a panic attack several days ago; the last time I had one was in my 30s when I lost my job. And I know what a panic attack is because I had them as a kid. In junior high I was teased a lot at school because my father was White and my mother was Asian. It comes on all of a sudden. Just like that I can’t breathe, my heart starts beating hard and fast, I have chest pains-it feels like a heart attack, but I’ve been checked out by the cardiologist, and I’m fine. Overall, I just think I am losing control. If I’m honest, I’d say I’ve always been a worrier. Even my friends have noticed that I’ve been on edge; I’m just always tensed up. I’m even restless all night; seems like I can’t ever shut my mind off.

In response to the expanding older population and the increasing numbers of older adults with chronic illnesses and advances in medical technology that extend life spans, NASW (2004) issued standards for practice in end-of-life care. Eleven basic standards such as knowledge, self-awareness, treatment planning, and ethics were identified regarding clinical work in assessment, treatment, resource linkage, advocacy, and leadership in work with the dying. These guidelines are meant to be applied within the context of an aging population and culturally diverse families and communities that may hold different beliefs about illness, wellness, and medical care. NASW highlighted the culturally related factors involved in working with older adults, including perceptions of illness and death, communication styles, decision making, family support, and use of service delivery system. The recent Multicultural Competency in Geropsychology (APA, Committee on Aging, 2009)provides further explorations of key issues regarding the infusion of multicultural competence when working with older adults.