Diversity and cultural competence. Experience working with older adults of different ages and with varying challenges. Gero-specific ethics. These are among the elements identified as integral to preparing psychologists to work with older adults and incorporated into an aspirational geropsychology training model at a June meeting of about 50 delegates from across APA. The Pikes Peak Model, named for the conference's Colorado Springs location, also outlines paths for gaining these skills at the doctoral, internship, postdoctoral and postlicensure levels.

Among those sponsoring the historic conference, which builds on APA's Guidelines for Psychological Practice with Older Adults, were the Retirement Research Foundation, APA's Council of Representatives and its Divs. 20 (Adult Development and Aging), 12 (Society of Clinical Psychology) and its Section II (Clinical Geropsychology), 40 (Clinical Neuropsychology) and 42 (Independent Practice). Other contributors included Psychologists in Long Term Care, the Association of Psychology Postdoctoral and Internship Centers, the Council of University Directors of Clinical Psychology, and APA's Board of Educational Affairs and Committee on Division/APA Relations. Many APA divisions also sponsored individual delegates. For a complete list of sponsors, go to the APA Monitor main page.

Trained geropsychologists needed

A backdrop to the conference is the U.S. Census Bureau projection that adults 65 years of age or older will make up approximately 20 percent of the U.S. population by the year 2020. This rapidly growing group will require psychologists to know more about treating older adults. However, the nation lacks a sufficient number of training programs in geropsychology and established paths for practicing psychologists to become proficient in aging issues, noted conference delegates. The conference attendees' mission was to identify such paths to competency and to promulgate skills needed for practice with older clients.

Conference Planning Committee Co-chair Bob G. Knight, PhD, emphasized that the field had already established geropsychology competencies in two earlier conferences--Older Boulder, held in 1981, and Older Boulder II, in 1992. In 1998, in the wake of Older Boulder II the APA's Commission for the Recognition of Specialties and Proficiencies in Professional Psychology (CRSPPP) recognized geropsychology as a proficiency, and in 2004, the Guidelines for Psychological Practice with Older Adults were established by APA's Council of Representatives (see Guidelines for Psychological Practice With Older Adults for the guidelines). However, CRSPPP denied geropsychology specialty status in 2005 because of the lack of a clear training model, said Knight, a gerontology and psychology professor at the Andrus Gerontology Center at the University of Southern California. But, he underscored, the main Colorado Springs conference aim was to develop an aspirational training model for competent geropsychologists, not to achieve specialty status.

To do that, conference delegates spent two and a half days discussing in groups such competency areas such as clinical aging knowledge, professional geropsychology functioning, assessment, intervention and consultation, advancing the field, models for different levels of training and how to deliver training.

The Pikes Peak Model

At the end of the conference, Knight and co-chair Michele Karel, PhD, staff psychologist at Veterans Affairs Boston Healthcare System and an assistant psychology professor at Harvard Medical School, unveiled the emerging "Pike's Peak Model" for training in professional geropsychology. The specifics of the model will appear later in publication, but conference attendees agreed that they had identified key areas that every geropsychology training program needs to address, such as:

  • Ageism and attitudes toward older adults--overcoming stereotypical ideas about aging.

  • Diversity and cultural competence--understanding how different ethnicities, cultures and even health status can impact an older adult's treatment.

  • Gerospecific ethics--learning about aging-specific issues such as informed consent, competency, elder abuse and end-of-life decision-making.

  • Professional practice issues--understanding the Medicare system and regulations and billing and coding procedures.

Training should also provide experience with a wide range of older adult populations of different ages and health status and in different environments such as clinics, nursing homes and primary-care settings.

They also agreed that achieving competence in geropsychology should be linked to attaining specific skills laid out in the guidelines--not defined by types or hours of training. Psychologists who want to become gerocompetent after licensure will need resources such as continuing education, distance-learning opportunities and self-study materials.

"The conference process went very well, better than our most positive expectations," says Knight. "The Pikes Peak Model will provide guidelines for training in professional geropsychology that should be useful to both programs and individuals."

Members of the conference's planning committee presented the model at a symposium in August at the APA's Annual Convention in New Orleans.