Psychodynamic interventions in dementia
Perspectives in psychodynamic theory in Australia and New Zealand are primarily dominated by the Conversational Model, developed by Robert Hobson and Russell Meares. Beyond this modality, psychodynamic interventions are in their infancy in many regions. However, there is considerable heterogeneity in old age mental health services across the nations, owing to the organic way in which services were formalised from existing practices, rather than centrally planned according to any heuristic. This inconsistency in service delivery naturally leads to significantly inadequate services in certain areas, however it also leads to surprisingly creative interventions in some others, with pockets of innovative interventions for older persons with cognitive impairment that have psychodynamic underpinnings for their rationale. This chapter will outline in detail three examples of these interventions for the reader to consider. It is suggested that, when systematic evidence is lacking, the question of how to design an old age service that effectively uses psychodynamic theory in a largely critical broader administrative culture is perhaps best informed by serendipity.