The Greying Elephant in the Room: Substance Abuse and Older Adults
by Carol Tosone
Explore the growing problem of substance abuse among older adults through this case study of a 68-year-old client struggling with alcoholism and depression.
As the older adult population increases, so does the number of substance abusers in this age group. In fact, government data reports that the aging baby boomers make up the fastest growing group of substance abusers. In order to address this growing problem, social workers must learn more about working with older clients as well as how to assess and treat substance abuse within this population.

The Greying Elephant in the Room aims to shed light on this seldom discussed issue, while also providing social work students with a comprehensive view of its treatment. In this video, you'll see the portrayal of Denise, a social work student who recently began working with older adults. Denise's new client, Carol, is a 68-year-old woman who lives alone and was recently hospitalized after a fall. Denise soon finds out there is more to Carol's story than she realized.

Woven in between scenes of Denise and Carol's sessions are enlightening clips of Denise's meetings with her supervisor, Dr. Straussner, who is not an actor but a real professor of Social Work at NYU. These valuable clips portray the way a new social work student may typically approach a similar case, and her supervisor's guidance in response. Dr. Straussner helps Denise see the possibility of Carol's substance abuse and offers suggestions to help her address this concern. In addition to providing useful information specific to substance abuse, Dr. Straussner provides insightful suggestions helpful in working with any older adults. She shows Denise and the viewers how to handle various situations with older clients in session, including treatment resistance, countertransference and self-disclosure.

The video portrays Denise's growth as she returns for more sessions with Carol following her supervision meetings. Denise applies things she has learned from her supervisor, such as gathering information about Carol's prescriptions and screening for imminent danger. Through Carol, the video depicts many common experiences of older clients with substance abuse issues: loss, loneliness, depression, anger, and denial. It also shows Denise's attempts to encourage Carol's treatment.

The Greying Elephant in the Room offers an accurate portrayal of social work with older clients, and the ways social workers can engage, assess, diagnose, and treat substance abuse within this population.
In Depth
If you're interested in more information about substance abuse in older clients, this video is for you. While it thoroughly covers substance abuse among older people, it also provides general information useful in working with all older clients. The accurate portrayal of the intern's supervision meetings offers viewers great tips and tools to carry with you in any work with older clients. You'll learn from the intern's progress as well as from her mistakes, and you'll enhance your knowledge of the growing substance abuse problem among older adults.

From watching this video, you will:
  • Learn important facts and statistics about older adults and substance abuse.
  • Become familiar with the necessary steps to engage, assess, diagnose, and treat older adults with substance abuse issues.
  • Watch as an experienced supervisor shares tips on how to handle various situations with older adults in session, including treatment resistance, countertransference and self-disclosure.

Length of video: 00:42:04

English subtitles available

Group ISBN-10 #: 1-60124-492-4

Group ISBN-13 #: 978-1-60124-492-5

Dr. Carol Tosone is an associate professor of social work and recipient of the NYU Distinguished Teaching Award. Dr. Tosone, who joined the NYU Silver School of Social Work faculty in 1993, is a Distinguished Scholar in Social Work in the National Academies of Practice in Washington, DC. Dr. Tosone was selected for a Fulbright Senior Specialist Award for teaching and research at the Hanoi University of Education in Vietnam. She also taught as Distinguished Visiting Lydia Rappaport Professor at Smith College for Social Work. Dr. Tosone received her certification in psychoanalysis and psychotherapy from the Postgraduate Center for Mental Health, where she was the recipient of the Postgraduate Memorial Award.

Prior to her appointment at NYU, Dr. Tosone was an assistant professor of social work in psychiatry at Temple University School of Medicine in Philadelphia, PA. She is editor-in-chief of the Clinical Social Work Journal and serves on the editorial boards of Social Work in Mental Health, Social Work in Health Care, Psychoanalytic Social Work, Psychoanalytic Perspectives, Smith College Studies in Social Work, and the online journal Beyond the Couch. She also serves as a consulting reviewer to numerous other psychotherapy journals and publishers.

Dr. Tosone is series editor for Essential Clinical Social Work Series published by Springer; co-editor of three books, Love and Attachment: Contemporary Issues and Treatment Considerations, Short-term Treatment, Doing More with Less: Using Long-term Skills in Short-Term Treatment, and Contemporary Clinical Practice: The Holding Environment Under Assault; and author of numerous professional articles and book chapters. She has also served as the executive producer, writer, and narrator of educational and community service media, including Why Am I Here?: Engaging the Reluctant Client; Feel Free to Feel Better: FEMA Trauma Training; Rewarding Challenges: Social Work with Older Adults; The Greying Elephant in the Room: Substance Abuse and Older Adults; Look Back to Move Ahead; Look Back to Move Ahead: Social Work with Survivors of Trauma; and No Periods, Only Commas: A Portrait of Tiffany.

Dr. Tosone has been quoted or cited in the New York Times, as well as other newspapers and magazines as an expert on trauma and women’s issues. Dr. Tosone has served as a visiting professor or guest lecturer at several international universities, including Hyllum University in South Korea, Sanata Dhara University in Java, Tonjgi University in Shanghai, and Peking University and China University of Political Science and Law in Beijing. Dr. Tosone’s primary research interest is clinician exposure to collective trauma. She has served as a consultant to Psychology Beyond Borders in Indonesia; a member of the Doctors without Borders Hurricane Sandy Mental Health Response Team; and as a consultant to UNICEF and the Afghanistan Ministry of Labour, Social Affairs, Martyrs, and Disabled in the development of National Occupational Skills Standards for Social Work. Since joining the NYU faculty, Dr. Tosone has delivered over 100 professional papers and presentations in academic, medical, and mental health settings in the United States, as well as international venues in Asia, Australia, Europe, the Middle East, and South America. 
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