By DIANE TOROIAN KEAGGY
As a volunteer senior peer counselor for Providence Health & Services in Southern California, Joan Barrie helps older adults grapple with common problems that arrive with age — the loneliness that follows a spouse's death, the anger that accompanies the loss of independence, the depression that follows a life-changing diagnosis.
And then there are other challenges like Internet dating and intimacy after 70.
"It is not always what you expect," says Barrie, who is 79 years old. "But we approach every client the same way. We are not judgmental. We build that feeling of trust so they feel comfortable opening up to us about anything."
The Providence Peer Counseling Program currently provides free weekly counseling to 100 seniors, many of whom are poor and homebound. Last year, the program delivered 5,100 hours of therapy. Volunteer peer counselors receive 12 weeks of training and meet biweekly with mental health professionals and fellow counselors to discuss their cases.
Lightening the mood
Ron Sorensen, director of community partnerships, says the program has proven to be an innovative and cost-effective way to serve the region's growing senior population.
"We saw the real need in our senior community for this," said Sorensen. "And we've seen real success. We do a mood assessment at the beginning and the end of counseling and based on the data we've seen a big improvement — an average of 43 percent — in their mood. And they tell us, 'This has really affected my life.'"
Clients also report fewer illnesses and trips to the hospital, said Sorensen. Some also have reduced their use of antidepressants.
Setting boundaries
Clients are referred to the programs from other Providence facilities, physicians, community senior centers or friends. Before placement, family therapist Barbara Silverberg assesses whether the patient would benefit from peer counseling or needs more intensive therapy and monitoring from a professional. Peer counseling is not appropriate for everyone. Those who need more intensive therapy and monitoring are connected to a professional therapist. But, for many seniors, talking to a peer who understands their experiences firsthand is helpful. Peer counselors are at least 50 years old.
"Peer counseling is not a substitute for professional mental health care," said Sorensen. "What peer counseling is, is just that — a peer who is there to listen. In many cases the client is more at ease with a peer."
And yet, according to senior outreach coordinator Norma Villalobos, peer counselors are not pals.
"With peer counseling, we may share a bit of our background where it might be helpful," said Silverberg. "But we do set boundaries. This is not just a friendly visit or visiting your neighbor. This is about setting goals with them and having a therapeutic alliance."
Getting to the point
Barrie takes a very systematic approach to counseling. For instance, when clients say nothing in their lives is good — a common complaint — she works with them to make a list of those things that do make them in happy.
"Everyone I've challenged to do that has found something good," said Barrie. "We move on from there to find ways to get rid of the bad things. It is very solution focused."
The process can take months, sometimes years. But unlike most health insurance plans that limit mental health services, this program serves seniors for as long as they need the help.
"Sometimes the initial problem we hear about at intake is not the problem," said Barrie. "You have to build that trust before they can come out with the real problem."
For instance Barrie was working with a client who had a troubled relationship with her daughter.
"We talked about that for 13 weeks," said Barrie. "And then she told me a secret thing about her husband which was quite serious. She said, 'I had to know I could trust you. You and I and he are the only ones who know this.' We needed all of that time to get to that point."
Hierarchy of needs
Many of the seniors served by the program have problems beyond depression. Some can't get to the store or can't afford their rent. Providence Health & Services addresses those issues as well. A group of senior volunteers shuttle clients to the doctor's office or the grocery store; Villalobos also helps connect clients to housing or health agencies that help seniors.
Peer counselors, Villalobos and Silverberg share resources and advice during biweekly meetings. They all help each other cope with the feelings that arise when serving clients with such great needs.
Silverberg admits it can be a lot to bear. "I recently had two clients who died, and it threw me," she said. "I decided to bring it up in supervision, and we discussed it as a group; it was to take care of myself. It was really important for the group to talk about this and self-care."
Ultimately, though, Barrie said she gets more out of the program than she gives.
"To get out and meet different people has been really good for me," said Barrie. "One of the things I hear a lot from seniors is that they feel like their lives don't have a purpose anymore. This work gives me purpose."
Adapt and serve
Providence has expanded the program and now offers volunteer peer counselors to Latino seniors. It also now dispatches volunteer counselors to elementary and middle schools that have none. Sorensen says the peer counseling model can be adapted to serve any number of different populations.
"We know that there is a strong tie between mental health and physical health," said Sorensen. "So helping and supporting people with this need ties back directly to our mission — serving the most vulnerable."
Barrie, a former preschool teacher, also works with the children. She may not be their peer, but her peer counselor skill set translates — she listens actively.
"Some of these students come from large families or families with a lot of stress and turmoil," said Barrie. "When a counselor shows up and listens to them it may be the only time during the week when someone is really listening to what they have to say."