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The elderly were prompt to participate in behavioral motivation and were given a choice of treatments with medication or problem-solving therapy (PST). The PST is less than ten sessions designed for elderly patients that are a successful medication for treating depression. This process showed short-term and ongoing therapy and preventing relapse over the year-long treatment, with a two week follow up then to a monthly follow up (Katon et al., 2005).The social worker would measure the outcome of IMPACT, with the Patient Health Questionnaire–9 (PHQ-9). A range scale from zero to three, from not at all to nearly every day over the past two weeks for the nine questions. The last part of the questionnaire is range from not difficult, to extremely difficult when indicating how hard it is to work, at home taking care ofthings or being around people (Unutzer et al., 2008).Cultural Considerations.Culture is what is passed down through generations such as behaviors, language, attitudes, and beliefs; race is not part of the culture. In treatment, the social worker needs to understand the background of the elderly culture. Ethnic minority elderly tend to be more different since many are born overseas, and may not speak English. They can have different values and histories that some may not understand. The American-born could have poor education and some, such as African American’s who have faced segregation until the civil rightsmovement. With everyone having a cultural heritage, culture is more relevant in treatment 6
ELDERLY AND DEPRESSION especially when there is a difference in the background of culture between the elderly and thesocial worker. Due to these differences, the elderly population is more likely to avoid help or to participate in treatments (Sakauye, 2015).Code of EthicsThe Code of Ethics tells us, our main objective is to aid individuals in need and to deal with community problems. Social workers need to give respect to dignity and worth of the individual, with mindfulness of differences of culture and ethnic diversity, along with the importance of human relationship to understand how important it is for change (National Association of Social Workers, 2017). Since the elderly population is suffering from significant depression, the social worker is a mandated reporter should make sure to voice this. “The general expectation that social workers will keep the information confidential does not apply when disclosure is necessary to prevent serious, foreseeable, and imminent harm to a client or others” (NASW, 2017, Privacy and Confidentiality section, para. 3). Trauma-Informed LensTrauma-informed care is based on trauma theory, which impacts the growing process of the experiences of that individual. Social workers approach individuals with the long-term influences of traumatic experiences of life and environmental outlook. Trauma includes encounters that intimidate death, violence, or bodily harm. Long- term results appear to be the reaction the person has to the incident, involving emotions of anxiety, vulnerability, and terror.