One of programs I was involved in at the CU Aging Center this year was the At Home Mental Health Service program. We partner with a local social service agency for seniors to provide therapy for clients in their homes. These individuals typically have a number of physical or emotional problems that make it difficult for them to leave their homes to obtain services.
Some things I learned through my work in this program:
1) It's OK to set boundaries: For example, asking clients to put pets in another room or not to smoke during the session is not selfish or too demanding, rather it's a way for me to take care of myself in order to give my full attention to the needs of my clients.
2) Therapy goals can never be too clear: This is particularly relevant with older clients who are dealing with loneliness. Sometimes I was seen as a "visitor" coming for social reasons. While increased social contact may be helpful in and of itself this may not be the best use of a therapist's skills.
3) Good supervision is essential: Of course supervision is always necessary, but it's especially important when dealing with complex clients. It was extremely helpful to have a team of peers and more experienced clinicians to discuss cases with and a place where I could admit I had no idea of what I was doing!
4) A lot of older adults who could benefit from therapy are out of the "reach" of traditional services: Several of the clients who I worked with through this program probably would have never engaged in therapy if it meant weekly trips to a clinic to meet with a therapist.
Though challenging, my participation in the At Home program was a valuable experience in helping me to develop as a therapist.