Supporting Older Adults Through Counseling

Posted on August 20, 2026 by LeadingAge Minnesota

Learning and professional development can take many forms, and LeadingAge Minnesota’s education partners offer additional opportunities for professionals to grow and explore new areas of expertise. One of those partners, Saint Mary’s University of Minnesota, offers graduate programs that help professionals build specialized knowledge and skills for the next step in their careers.

Saint Mary’s recently shared the story of Liam O’Sullivan, a student in its M.A. in Counseling & Psychological Services program. With a background spanning nursing, mental health and palliative care, Liam brings a unique perspective to his studies and a strong interest in supporting older adults.

In this Q&A, Liam shares what drew him to counseling, how his experiences working with older adults have shaped his approach to care, and what he’s learning as he prepares for the next chapter of his career.

Tell us about yourself - where you're from, your professional background, and what drew you to counseling as a career?

I grew up in London, England, and later in Germany. I was always the existential ponderer in the family; completing my BA in Philosophy at a politically aware university showed me that I needed to grapple with those issues in a way that would connect me to them more viscerally. Starting out as a nursing aide caring for people after strokes, I was made aware of how naïve I was about the practical issues of illness, but that I had a knack for talking to people in distress.

After moving into critical care, I saw that impressive and compassionate effort went into physical treatment, but that unaddressed mental health and psychosocial issues were more slippery, often sabotaging aspects like safe discharge and ongoing collaboration. That inspired me to do graduate training as a mental health nurse and get involved in qualitative research on patient experience and stigma. Working as a clinical lead in palliative care, I saw how layers of trauma, oppression and discrimination, desperate coping using substances, and the frustrations for patients of managing stigmatized illnesses required a holistic approach towards care.

Underneath all that, there were always those questions of meaning for patients and practitioners, which were hard to articulate and could undermine motivation for both unless they were explicated. Moving to the US was the perfect opportunity to focus down into existential and humanistic ways of counseling clients, and I start my MA practicum in January. I hope to work with older clients with disenfranchised grief, intergenerational trauma, and existential anxiety caused by our fast-moving and unequal world.

What made you interested in the M.A. in Counseling & Psychological Services program at Saint Mary's, and what have you learned so far that has informed your work with clients?

Saint Mary’s has a solid reputation in the Twin Cities for creating prepared and employment-ready practitioners, and job prospects are what every student wants to have! Completing an MA that covers topics including neuroscience, multicultural awareness, and psychopathology has helped me understand that psychotherapists can do so much in their careers.

The scope of practice is vast and covers group work, skills development, teaching and supervision, somatic interventions, systemic counseling for biological families and families of choice, organizational change… I am hardly doing the profession justice with this list. I hope to continue what is politely called a ‘portfolio career’ and is more honestly me going down rabbit holes that tend to collapse into one big transdisciplinary cavern.

As an immigrant to a state that has had so much upheaval in recent years, attending a course in the heart of such a diverse place has helped me understand the local context of care. The course is teaching me where my own experiences and identities may give fresh perspectives, or might need me to pay more humble attention to learn.

Tell us about the settings you've worked in with older adult clients - what key takeaways have you gotten from those experiences?

Much of my work with older adults has been in busy inner-city hospitals after an inpatient crisis admission. A state of crisis for seniors is sadly so often uncovered by an acute event such as a fractured hip, a recognition of dehydration by visiting carers, or family finding rotting food in a refrigerator. It would be so easy to blame the client for not seeking help, coping with alcohol, or even hiding their suffering. This points to the isolation that older adults often experience and feel.

I’ve found that it is important to take a systemic and clinical view that asks questions like: how can older men express their grief over the death of a spouse when they have been socialized to hide their feelings all their lives? What ageism is in me that automatically assumes a resourceful older person needs rescuing, but a less well-equipped younger person needs autonomy? How, and for what, can I engender hope in an older person who has lost much? And what practical support can I anticipate us needing, such as removing barriers to communication for people with hearing loss, cognitive deficits, or lack of technical know-how?

What advice would you give to someone just starting out in counseling & psychological services who's interested in working with older adult populations?

I am just starting out myself in a lot of ways, being a psychotherapy student, though I’ve worked with older adults for twenty years. I would say that when I was in my early twenties, as so many of my co-students are, there was a lot of countertransference onto me from clients as a ‘grandchild’ figure. It was sometimes difficult to feel taken seriously, especially when I was at the stage of life in which I felt I was still proving myself. Looking back, I did the best when humbly but confidently offering clients help and cracking a few jokes, rather than infantilizing them or holding them at arms’ reach. It was then that they would disclose thoughts of self-harm, their fear of managing their own urostomy, or feel safe enough to try transferring from bed to chair for the first time after a stroke.

Getting to know my co-students and professors has reaped rewards, helping me make connections with talented colleagues and feeling supported by like-minded people. I have been able to get involved in paid projects, such as creating a webinar for the Minnesota Association for Marriage and Family therapy and am putting together a submission for the Association for Death Education and Counseling’s conference next year. There is never enough time in a busy training course for experiential learning, and any practice you can get in interpersonal skills work is worth its weight in gold. Rolling your sleeves up as a support worker or nursing aide is demanding work while studying, but will get you informed about all areas of care, and you ahead of the curve.

Liam O’Sullivan is a student in the MA Counseling and Psychotherapy program at Saint Mary’s University of Minnesota. You can access his co-presented webinar on Family Therapy for Caregivers of Older Adults here.