Psychiatrists who work with older adults encounter diagnostic and therapeutic problems that are more complex than those encountered in young adult and middle-aged patients. Most older patients with psychiatric disorders do not fit easily into the diagnostic categories of DSM-IV-TR (American Psychiatric Association 2000) because they experience multiple symptoms that affect both physical and psychiatric functioning. This is especially true when treating the oldest members of this population (Blazer 2000). Once the problem is formulated by the clinician, usual treatment approaches must be modified both to manage the functional disability that results from the psychiatric problem and to reverse the underlying disorder.