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Effects of reminiscence interventions on psychosocial outcomes: A meta-analysis

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Abstract

This study integrated results from controlled trials of reminiscence interventions. Meta-analysis was used to aggregate results from 128 studies on 9 outcome VARIABLES. Compared to non-specific changes in control-group members, moderate improvements were observed at posttest with regard to ego-integrity (g=0.64) and depression (g=0.57 standard deviation units). Small effects were found on purpose in life (g=0.48), death preparation (g=0.40), mastery (g=0.40), mental health symptoms (g=0.33), positive well-being (g=0.33), social integration (g=0.31), and cognitive performance (g=0.24). Most effects were maintained at follow-up. We observed larger improvements of depressive symptoms in depressed individuals (g=1.09) and persons with chronic physical disease (g=0.94) than in other individuals, and in those receiving life-review therapy (g=1.28) rather than life-review or simple reminiscence. Moderating effects of the control condition were also detected. Reminiscence interventions affect a broad range of outcomes, and therapeutic as well as preventive effects are similar to those observed in other frequently used interventions.
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Effects of Reminiscence Interventions on Psychosocial Outcomes: A Meta-Analysis
MARTIN PINQUART1 & SIMON FORSTMEIER2
1Philipps University, Marburg, Germany; 2University of Zurich, Switzerland
Running head: Effects of reminiscence
Address correspondence to Martin Pinquart, Department of Psychology, Philipps University,
D-35032 Marburg, Germany. Phone: +41-3641-2823628, Fax: +41-6421-28-23685: Email:
pinquart@staff.uni-marburg.de.
Accepted by Aging & Mental Health
Vol. 16, No. 5, July 2012, 541558
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Effects of Reminiscence Interventions on Psychosocial Outcomes: A Meta-Analysis
Aging and Mental Health
Abstract
Objectives: This study integrated results from controlled trials of reminiscence interventions.
Methods: Meta-analysis was used to aggregate results from 128 studies on 9 outcome
variables. Results: Compared to non-specific changes in control-group members, moderate
improvements were observed at posttest with regard to ego-integrity (g=.64) and depression
(g=.57 standard deviation units). Small effects were found on purpose in life (g=.48), death
preparation (g=.40), mastery (g=.40), mental health symptoms (g=.33), positive well-being
(g=.33), social integration (g=.31), and cognitive performance (g=.24). Most effects were
maintained at follow-up. We observed larger improvements of depressive symptoms in
depressed individuals (g=1.09) and persons with chronic physical disease (g=.94) than in
other individuals, and in those receiving life-review therapy (g=1.28) rather than life-review
or simple reminiscence. Moderating effects of the control condition were also detected.
Conclusions: Reminiscence interventions affect a broad range of outcomes, and therapeutic as
well as preventive effects are similar to those observed in other frequently used interventions.
Key words: life-review, controlled trials, depression, ego-integrity
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Introduction
Reminiscence is defined as the process of thinking or telling someone about past experiences
that are personally significant. Based on the suggestion by Erikson (1959) and Butler (1963)
that reviewing one’s life is a central task of old age, reminiscence has increasingly been used
in older adults as a therapeutic mode for promoting self-acceptance and psychological health.
Different forms of reminiscence interventions may have different potential for solving
these tasks. Recently, Webster, Bohlmeijer and Westerhof (2010) and Westerhof, Bohlmeijer,
and Webster (2010) distinguished between simple reminiscence, life-review, and life-review
therapy. Simple reminiscence is mainly unstructured autobiographical storytelling with the
goal of communicating and teaching or informing others, remembering positive past events,
and enhancing positive feelings. Relative to simple reminiscence, life-review is much more
structured. Life-review usually covers the entire life span and is most often performed in a
one-to-one format. Rather than simply describing past events (as in simple reminiscence),
life-review focuses on the (re-)evaluation of life events and on the integration of positive and
negative life events in a coherent life story. Finally, life-review therapy refers to the use of
life-review with persons with serious mental health problems, such as depression. It is
characterized by linking life-review to a clear theory of causal factors of depression or mental
illness. Life-review therapy is focused on reducing bitterness revival and boredom and
promoting a positive view on one’s past. It often explicitly applies therapeutic techniques that
have been developed in other therapeutic frameworks, such as cognitive therapy, problem-
solving therapy, or narrative therapy.
Six meta-analyses have summarized effects of reminiscence. Large improvements of
depressive symptoms have been reported by Bohlmeijer, Smit, and Cuijpers (2003: d=.84
standard deviation units, based on 20 studies), Chin (2007; g=.90 standard deviation units, 6
studies), and Pinquart, Duberstein, and Lynness (2007; g=1.00, 8 studies with depressed older
adults). However, a recent meta-analysis on prevention of depression by Forsman,
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Schierenbeck, and Wahlbeck (2011) did not find a significant effect of reminiscence (d=.24,
based on 5 studies).
Effects on positive psychological well-being were smaller. Bohlmeijer et al. (2007)
found moderate improvements of positive well-being (d=.54), based on 15 studies. Chin
(2007) reported significant effects of reminiscence on positive affect (d=1.09, based on 6
studies) whereas no significant improvements were found with regard to life-satisfaction
(d=.22, based on 5 studies) or self-esteem (d=.51, based on 6 studies). Finally, Woods,
Spector, Jones, Orrell, and Davies (2005) did not find significant effects of reminiscence on
cognitive performance of dementia patients at posttest (d=.27, based on 5 studies). However,
participants in the intervention had higher cognitive performance at follow-up (d=.50).
Unfortunately, a large number of potential outcome variables were not addressed in
these meta-analyses, such as ego-integrity, mastery, meaning of life, and social integration. In
addition, most previous meta-analyses did not assess the effects of reminiscence at follow-up
as well as effects of moderator variables. Furthermore, available meta-analyses did not test
whether effects of reminiscence would also be found in young and middle-aged adults.
Thus, the goal of the present meta-analysis was to integrate the results of a larger
number of controlled studies on a broader range of outcome variables at posttest and follow-
up and to identify variables that moderate the size of the observed intervention effects.
Moderating effects of study characteristics
In order to have test power, the search for moderating effects of study characteristics
was limited to the two most often assessed outcomes, depression and positive well-being.
Forms of reminiscence. Because participants in life-review therapy have elevated
levels of depression or of other psychological symptoms (e.g., Webster et al., 2010) and
because life-review therapy often integrates applies psychotherapeutic techniques, life-review
therapy may show stronger improvement of depressive symptoms and positive well-being
than other forms of reminiscence.
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Health status at pretest. Lower pre-intervention levels of symptoms leave less room
for improvement. In fact, Bohlmeijer et al. (2003) found stronger improvements of depressive
symptoms if subjects showed elevated levels of depression at pretest. Similarly, individuals
who are psychologically distressed because of a chronic physical illness or cognitive decline
may show above-average improvements of psychological symptoms.
Format. Individual and group formats have unique advantages. Individual sessions
can be easily adapted to the needs of the participant and he/she might be more willing to talk
about critical experiences. However, a group format promotes social exchange with other
group members. Thus, interventions held on a one-to-one basis may show above-average
improvements of depression, and group reminiscence may show above-average effects on
social integration. Nonetheless, effect sizes on depression and positive well-being did not vary
between individual and group condition in meta-analyses of Bohlmeijer et al. (2003, 2007).
Number of sessions. Haight and Haight (2007) suggested that 6 to 8 sessions seem to
be sufficient to review one’s life. Bohlmeijer et al. (2007) did not find a moderating effect of
the number of sessions on change in positive well-being.
Control condition. Because participants of placebo control conditions may show
more positive change than those of no-treatment control conditions, the differences between
improvements in the reminiscence and control condition would be smaller. Nonetheless,
Bohlmeijer et al. (2007) found no significant differences between studies that used an active
placebo and those that did not.
Age. Reviewing one’s life and finding ego-integrity has been described as a
developmental task of old age (Butler, 1963; Erikson, 1959), and older adults are more likely
to use reminiscence for teaching others and death preparation (Webster & McCall, 1999).
Thus, older adults may be more interested in reminiscence than younger adults. This might
lead to larger intervention effects in older samples. However, Bohlmeijer et al. (2007) did not
find larger effects of reminiscence in samples with a mean age of 80 years or above compared
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to samples with a mean age of 68-79 years.
Gender. Webster and McCall (1999) observed that women are more likely than men
to use reminiscence for remembering negative events and clarifying ones identity. Thus,
women may benefit more from interventions aimed at finding meaning in life and accepting
ones past. Nonetheless, Bohlmeijer et al. (2003) did not find a significant moderating effect
of gender.
Residence. Bohlmeijer et al. (2007) found smaller effects of reminiscence on
psychological well-being in residential care than in community-dwelling older adults. We
tested whether Bohlmeijer’s result could be replicated.
Publication status. Because studies with insignificant effects may be less likely to be
published (Lipsey & Wilson, 2001), published studies may show larger effects than
unpublished studies.
Study quality. Randomization, blinding of raters, use of a treatment manual of
interventions, training of interventionists, treatment integrity, use of intent-to-treat analysis,
and sufficient test power are criteria for the quality of the study (Cuijpers, Smit, Bohlmeijer,
Hollon, & Andersson, 2010). Low study quality may cause random error rather than
systematic error (Lipsey & Wilson, 2001). In fact, no moderating effect of the quality of the
studies was found in the meta-analysis by Bohlmeijer et al. (2003).
Methods
Selection of studies
Studies were identified by search of electronic data bases (CINAHL, Google scholar,
Medline, PsycInfo, Psyndex; search terms: (reminiscence or life-review or autobiographical
storytelling or autobiographical writing) and (intervention or therapy or trial) and cross-
referencing. In order to be included in the meta-analysis, a study had to
a) examine the effects of (simple) reminiscence, life-review, or life-review therapy
b) use a control condition that did not receive an active psychological treatment
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c) use one or a combination of the following outcomes: depression, other psychological
symptoms (e.g., anxiety), positive psychological well-being (e.g., life-satisfaction),
ego-integrity, purpose in life, mastery, cognitive performance, social integration, and
preparation for death
d) provide sufficient information for computing effect sizes, and
e) be published/ presented before November 2011.
From the identified 253 studies, 125 had to be excluded because they had no control
condition (65), they were case studies (22), they did not provide quantitative data (10), the
control condition was an active psychological treatment rather than a placebo condition (7),
they duplicated results from other papers (7), the intervention condition combined
reminiscence and other forms of psychological treatment (6), the study was not available by
interlibrary loan (5), or insufficient information was provided for computing effect sizes (3).
Finally, 128 studies were included in the present meta-analysis (see, Appendix I and II).
Measures
Depressive symptoms. Depression was assessed with the Geriatric Depression Scale
(Sheikh & Yesavage, 1986; 37 studies), the Beck Depression Inventory (Beck, Steer, &
Brown, 1996; 13 studies), the Center for Epidemiological Studies Depression Scale (Radloff,
1977; 11 studies), and other measures (21 studies).
Other psychological symptoms. These symptoms were measured with the State-
Trait-Anxiety Inventory (Spielberger, Gorsuch, & Lushene, 1970; five studies), the Symptom
Checklist SCL-90 (Derogatis, 1994; three studies), and other measures (15 studies).
Psychological well-being. Studies used the Life Satisfaction Index (Neugarten,
Havighurst, & Tobin, 1961; 28 studies), the Self-Esteem Scale (Rosenberg, 1965; 22 studies),
the Affect Balance Scale (Bradburn, 1969; 13 studies), and other scales (47 studies).
Ego-integrity. This variable was assessed with six different measures, such as the
Ego-integrity Scale (Boylin, Gordon, & Nehrke, 1976; one study).
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Meaning of/purpose in life. This variable was assessed with the Purpose in Life Test
(Crumbaugh, 1968; four studies) and related instruments (seven studies).
Mastery. This variable was measured with the mastery scale by Pearlin and Schooler
(1978; three studies) and related instruments (12 studies).
Cognitive performance. This variable was assessed with the Mini Mental State
Examination (Folstein, Folstein, & McHugh, 1975; 15 studies) and related scales (11 studies).
Social integration. Social integration was assessed with measures of frequency and/or
quality of social contacts (10 studies) and loneliness scales (13 studies).
Preparation for death. This variable was assessed with measures of (low levels of)
death anxiety (e.g., Death Anxiety Scale; Templer, 1970; three studies), preparation for the
end of life (Steinhauser et al., 2004; one study), and lack of denial of death (one study).
Study quality. A modified version of the checklist by Cuijpers et al. (2010) was used
that assesses 8 criteria of study quality (e.g., randomization, training of therapists or group
leaders). One criterion of the original checklist (meeting criteria for a clinical diagnosis) did
not apply to our study. This criterion was replaced by the sum-category of lack of additional
problems with study quality, such as problems with sociodemographic equivalence of
intervention and control group. A sum-score was computed with higher scores indicating better
quality.
Coded variables. We coded type of reminiscence (based on the criteria defined by
Webster et al., 2010; 1=simple reminiscence, 2=life-review, 3=life-review therapy), illness at
pretest (1=none, 2=depression, 3=dementia, 4=chronic physical disease), number of sessions
(continuous variable), format (0=individual, 1=group), control condition (0=only testing/wait list
control, 1=active placebo), mean age (continuous variable), percentage of women (continuous
variable), publication status (1=published, 0=unpublished), residence (1=private home,
2=nursing home/residential care), study quality (continuous variable), and the size of the
statistical effects. Based on 20% of the included studies, an inter-rater agreement of r=.89 was
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established for continuous variables and of 90% for categorical variables. Differences were
resolved by discussion.
Statistical Integration of Findings
Calculations for the meta-analysis were performed in five steps, using random-effects
models and the method of moments (Lipsey & Wilson, 2001). A random-effects meta-
analysis is appropriate if the effect sizes vary between studies beyond sample error, and not
all sources of variation may be identified.
1. We computed effect sizes d for each study as the difference in the post-treatment measure
between the reminiscence condition and control condition divided by the pooled standard
deviation (SD). Positive scores indicate improvements. Outliers that were more than two
SD from the mean of the effect sizes were recoded to the value at two SD.
2. Effect sizes were adjusted for differences in the outcome measures between the
intervention group and control group at pretest and for bias due to overestimation of the
population effect size in small samples (using Hedges’ unbiased estimator g which is
defined as g=d*[1- ]; Hedges, 1981).
3. Effect sizes were weighted by the inverse of their variance. Weighted mean effect sizes
(=) and 95%-confidence intervals (CI; ±1.96*SE( )); with SE being the standard
error of ) were computed.
4. Homogeneity of effect sizes was computed by use of the Q statistic, with Q =
(.
5. In order to test the influence of moderator variables, we used an analogue of analysis of
variance and meta-regression. Differences between two conditions are interpreted as
significant when the 95%-CIs do not overlap.
To interpret the practical significance of the results, we used Cohen’s criteria.
According to Cohen (1992), improvements of d ≥ .8 are interpreted as large, of d=.50 as
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medium, and of d=.20 as small.
Results
Eighty-two interventions provided simple reminiscence, 37 offered life-review and
another 18 studies life-review therapy. Most studies offered reminiscence in a group format
(90 studies). Seventy-five percent of the included studies randomly allocated the participants
to the intervention and control condition (95 studies). Ninety-five studies were published. The
interventions offered, on average, 10.1 sessions (SD=10.6, range 1 72) and lasted about 8.3
weeks (SD=7.7; range 1 78). Follow-up data were provided in 27 studies with a mean time
interval of 22.9 weeks (SD=28.8, range 2 156 weeks) since the end of the intervention.
The 128 intervention studies provided results for 4,067 adults who received a
reminiscence intervention and 4,337 control group members. The participants had a mean age
of 73.1 years (SD=12.7; range 18.8-85.7 years); 66% were women, and 28% were married.
Average effect sizes for the outcome variables are provided in Table 1. At posttest,
improvements of all outcome variables were statistically significant. Largest improvements
were found for ego-integrity (g=.64), followed by depression (g=.57), purpose in life (g=.48),
death preparation (g=.40), mastery (g=.40), mental health (g=.33), positive well-being
(g=.33), social integration (g=.31), and cognitive performance (g=.24). As indicated by the
non-overlap of the 95%-CIs, improvements of depression were larger than improvements of
positive mental health, and cognitive performance. At follow-up, intervention effects persisted
for 6 out of 9 main outcome variables (depression, other indicators of mental health, sum of
indicators of positive well-being, ego integrity, cognitive performance, death preparation).
[Insert Table 1]
Recently Cuijpers et al. (2010) found some evidence for a publication bias in research
on therapy for depressed adults which may lead to an overestimation of the effect sizes. In
order to test for such a bias, we applied the trim-and-fill algorithm (Duvall & Tweedie, 2001).
Applying this procedure led to lower estimations of improvements of ego-integrity (g=.50,
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Z=1.98, p<.05) and life-satisfaction at posttest (g=-.01, Z=-.14, n.s.). However, effects of
reminiscence on purpose in life (g=.73, Z=4.54, p<.001) and death preparation (g=.52,
Z=2.95, p<.01) were even somewhat larger after applying the trim-and-fill algorithm. The
lower improvement of life-satisfaction after application of the trim-and-fill algorithm may be
based on the fact that studies on change in life-satisfaction with small samples often used a
passive control condition (r=.21) which led to larger relative improvements after reminiscence
(Table 2). Because the small number of included studies with small effect sizes seemed to be
a result of the use of different study designs of published studies rather than of a failure to
identify unpublished studies with low or even negative effects, we used the original data for
the following analyses.
About 70% of the effect sizes were heterogeneous (Table 1). Therefore, we searched
for moderating effects of study characteristics. As shown by the significant Q-statistic,
intervention effects on depressive symptoms and positive well-being varied by the form of
reminiscence (Table 2). Stronger effects were found in life-review therapy than in other life-
review interventions and in simple reminiscence.
Change of depression also varied by the kind of diseases at pretest. Improvements of
depressive symptoms were stronger in depressed individuals than in healthy and demented
persons, and in individuals with chronic physical illness as compared to healthy individuals.
However, diseases at pretest did not moderate the size of improvement of positive well-being.
Similarly, no moderating effects of format of the intervention (group versus individual
format) or number of sessions were found. Change of positive well-being varied between
studies with active versus passive control condition. Weaker relative effects of reminiscence
were found in studies with an active control condition.
Levels of change of depressive symptoms and positive well-being did not vary by age,
gender, forms of residence of the participants, and study quality.
[Insert Table 2]
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The assessed moderator variables are not completely independent of each other. For
example, most studies with dementia patients use simple reminiscence. Thus, we also tested
whether the effects of significant univariate moderators would persist in multivariate analysis.
A weighted multiple linear regression analysis was computed with life-review therapy (1=yes,
0=no), depression status at pretest (1=depressed, 0=not depressed), physical illness at pretest
(1=yes, 0=no) as independent variables and change in depressive symptoms as dependent
variable. In that analysis, only initial depression status (B=.75, β=.47, Z=4.06, p<.001) and
physical illness at pretest (B=.62, β=.28, Z=2.98, p<.01) were significant moderators. As only
one significant moderator of improvement of positive well-being has been identified, there
was no need for a multivariate analysis with regard to this variable.
Due to the smaller number of available studies, we did not compute the full set of
moderator analyses for the other outcomes. However, because benefits of reminiscence on
social integration may be larger in interventions with group format than with one-to-one
format we tested whether this would be the case. Because the only available meta-analysis on
effects of reminiscence on cognitive performance focused on dementia patients (Woods et al.,
2005), we also tested whether cognitive intact individuals would benefit from reminiscence
with regard to cognitive outcomes as well. We did not find a moderator effect of group format
on change in social integration (Q(1,22)=.61, n.s.). The moderating effect of dementia status
on change in cognitive performance was also not significant (Q(1,27)=3.22, n.s.).
Nonetheless, significant improvements of cognitive performance were only found in
individuals with cognitive impairment (g=.33, Z=4.00, p<.001), but not in cognitively intact
persons (g=.12, Z=1.37, n.s.).
Discussion
The present meta-analysis found positive immediate effects of reminiscence
interventions on all assessed outcomes. Effects on depression, other indicators of mental
health, positive well-being, ego-integrity, cognitive performance, and death preparation were
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maintained at follow-up. In addition, effect sizes on depression and positive well-being
varied, in part, by form of reminiscence, symptoms at pretest, and kind of control condition.
We start the discussion with a comparison of our results with those of previous meta-analyses.
The largest effect size of reminiscence on depression of previous meta-analyses
(Pinquart et al., 2007) was exclusively based on studies with depressed older adults, and the
present meta-analysis found a similar effect size for that group in a larger data set. Our
observed effect on depression in individuals with no medical condition was similar to the
effect size reported by Forsman et al. (2011) on preventive trials. Our mean effects on positive
well-being were somewhat smaller than those reported by Bohlmeijer et al. (2007) and Chin
(2007) with regard to positive affect in particular. Bohlmeijer et al. (2007) used Cohen’s d
rather than Hedges’ g, which led to somewhat larger estimates (Lipsey & Wilson, 2001). In
addition, as our analyses on positive well-being included more than 5 times more effect sizes
than the two previous meta-analyses, we attained more reliable results.
The effect size on cognitive performance was very similar to that of a previous meta-
analysis by Woods et al. (2005), although we found a significant effect already at pretest,
probably because of higher test power. Thus, available results indicate that reminiscence can
slightly improve cognitive performance of individuals with cognitive impairment, although
they do not yet provide sufficient evidence for such an effect in cognitively intact individuals.
The present meta-analysis showed that reminiscence affects a broad range of outcome
variables. The moderate effect of reminiscence interventions on ego-integrity supports
Butler’s (1963) suggestion that reminiscence interventions are a useful tool for the
development of an accepting attitude towards one’s own life. Unfortunately, there were too
few studies to compare the effects of different forms of reminiscence on that outcome
variable.
Although only six out of nine follow-up effects were significant, the effect sizes at
follow-up were not smaller than those at posttest. Thus, the loss of effects at follow-up seems
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to be based on the smaller number of available studies that provided follow-up data.
Few moderator variables had significant effects. The present meta-analysis is the first
to show that life-review therapy has stronger effects on depression than life-review or simple
reminiscence, and that this effect is explained by the higher levels of depressive symptoms of
participants receiving life-review therapy at pretest. Interestingly, “non-therapeutic” life-
review interventions did not differ in their effects on depression and positive well-being from
simple reminiscence.
The present meta-analysis is also the first to find support for the assumption that
patients with chronic physical illness benefit more from reminiscence interventions than
healthy individuals, at least with regard to depressive symptoms. This effect may be based on
their elevated levels of depression at pretest and/or on an emergent need to find ego-integrity
because of limited remaining life-expectancy due to AIDS, cancer, or other severe diseases.
In line with Bohlmeijer et al. (2003, 2007) we found that the observed effect sizes did
not vary between individual and group format and by the number of sessions. This indicates
that one-to-one and group-based interventions work and that prolonging the intervention
beyond seven sessions does not have an additional effect.
In contrast to Bohlmeijer et al. (2007), we observed larger relative improvements of
positive well-being if the control condition did not receive any intervention as compared to a
placebo intervention. This result indicates that non-specific interventions, such as socializing
and discussion of current events, can also be a source of positive feelings.
Despite the suggestion that reminiscence may be a particularly useful intervention for
older adults, the present meta-analysis did not find lower effect sizes on young or middle-aged
adults than on older adults. Nonetheless, only about 6% of the available intervention studies
focused on young and middle-aged adults, and some of them assessed individuals with severe
physical illness (e.g., Ando, Morita, Akechi, & Okamoto, 2010), who may have a stronger
need for reminiscence than their healthy peers. Thus, there is a need for more research on the
15
effects of reminiscence interventions on young or middle-aged adults.
The quality of the study did not moderate the size of effects. This indicates that our
results are quite robust with regard to study quality.
Limitations and Conclusions
Some limitations of the present meta-analysis have to be mentioned. First, very limited
numbers of studies were available for some outcomes (e.g., ego-integrity), subgroups (e.g.,
persons younger than 60 years), and for follow-up assessments. Second, we used broad
categories of three forms of reminiscence. There were variations within these categories, for
example with regard to theoretical background, level of structure, the biographical events
addressed, and the therapeutic strategies. In addition, differences between interventions in the
levels of structure and inclusion of evaluations of life are often gradual rather than categorical.
Thus, other raters might have come to somewhat different conclusions regarding how some
studies might be coded. Nonetheless, levels of interrater-agreement were satisfactory and the
effect sizes for simple reminiscence, life-review, and life-review therapy were homogeneous,
thus indicating that similarities of the effects within these conditions prevail. Third, we
focused on main effects of moderator variables. Combining moderator variables would lead to
small subsets of studies that lack test power for the identification of statistical significance.
Fourth, no data were available for some moderators, such as whether individuals with
unresolved biographical conflicts would benefit more from life-review than other persons.
Fifth, we did not limit the included studies to those with highest quality. However, we were
able to show that study quality did not moderate the size of the effects, which is a relevant
result.
Nonetheless, several conclusions can be drawn from the present meta-analysis. First,
we conclude that reminiscence interventions produce small to moderate improvements of
depressive symptoms, other indicators of mental health, ego-integrity, positive well-being,
purpose in life, mastery, cognitive performance, social integration, and death preparation.
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Second, the largest effects on depressive symptoms can be expected when applying life-
review therapy to depressed adults. Therapeutic effects for these interventions are similar to
those observed for psychotherapeutic interventions with depressed older adults in general
(Pinquart et al., 2007). Third, interventionists could either use simple reminiscence or life-
review to promote positive well-being when not working with depressed adults. Fourth, more
work is recommended on effects of reminiscence interventions on ego-integrity and death
preparation, on reminiscence with younger adults, and on long-term effects on all assessed
outcomes. In addition, more research is needed on who benefits most from reminiscence
interventions, such as those with unresolved biographical conflicts and persistent regrets.
Finally, with regard to practical consequences, our meta-analysis indicates that reminiscence
is a worthwhile intervention that should be offered to older adults and other persons who are
interested in remembering the past, reviewing their lives, and finding ego-integrity. However,
we should have realistic expectations about the (low) effects as long as reminiscence is used
with the goal of enhancing psychological well-being and quality of life or preventing
problems rather than as therapeutic intervention with psychologically distressed individuals.
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20
Table 1. Average effects of reminiscence interventions at posttest and follow-up
Variable
k
g
Z
Q
Posttest
Depression
92
.57
.44
.70
8.64***
367.32***
Mental health
29
.33
.16
.51
3.77***
64.29***
Positive well-being
101
.33
.23
.42
6.88***
258.23***
Life-satisfaction
55
.22
.09
.35
3.43***
116.19***
Self-esteem
39
.20
.07
.33
2.98**
67.18**
Positive affect
33
.41
.27
.54
5.86***
68.31***
Ego-integrity
10
.64
.22
1.06
2.99**
41.12***
Purpose in life
14
.48
.14
.82
2.73**
54.71***
Mastery
21
.40
.15
.65
3.16**
105.14***
Cognitive
performance
28
.23
.11
.34
3.83***
32.90
Social integration
23
.31
.12
.50
3.23**
63.57***
Death preparation
5
.40
.09
.71
2.50*
3.44
Follow-up
Depression
20
.50
.24
.76
3.76***
86.85***
Mental health
9
.39
.02
.77
2.06*
43.93***
Positive well-being
22
.32
.12
.52
3.14**
54.59**
Life-satisfaction
14
.36
.12
.60
2.91**
23.31*
Self-esteem
10
.26
-.00
.52
1.93
14.89
Positive affect
4
.22
-.04
.48
1.68
1.38
Ego-integrity
3
.98
.00
1.96
1.96*
13.08**
Purpose in life
3
.24
-.04
.53
1.67
.39
Mastery
6
.28
-.30
.86
.95
31.16***
Cognitive
performance
11
.18
.01
.35
2.05*
8.34
Social integration
6
.15
-.25
.56
.74
14.75**
Death preparation
2
1.00
.04
1.96
2.05*
3.31
Note. * p<.05; ** p<.01; *** p<.001. k=number of treated subsamples; g=effect size (positive
scores indicate improvements); 95%-C.I.=95% confidence interval of the effect size; t=test of
significance of the effect size; Q=test of homogeneity of the effect size (significant values
indicate heterogeneity).
21
Table 2. Influences of moderator variables on change in depressive symptoms and positive well-being at posttest
Variable
Depressive symptoms
Positive well-being
k
g
95%-CI
Z
Q
k
g
95%-CI
Z
Q
Form of reminiscence
23.56***
13.57*
Simple reminiscence
50
.52
.35
.68
6.13***
60.01
63
.24
.13
.36
4.21***
63.10
Life-review
27
.31
.09
.54
2.72**
19.36
32
.38
.21
.54
4.52***
30.88
Life-review therapy
15
1.28
.95
1.61
7.65***
13.81
5
1.02
.61
1.42
4.94***
8.13
Health conditions at pretest
32.64***
2.53
No
47
.31
.15
.48
3.75**
44.06
65
.28
.17
.40
4.76***
64.18
Depression
23
1.09
.85
1.33
8.73***
28.70
12
.48
.19
.77
3.21***
7.52
Dementia
12
.31
-.02
.65
1.86
4.67
14
.23
-.06
.51
1.55
12.13
Physical illness
10
.94
.56
1.31
4.85***
12.63
9
.61
.32
.91
4.05***
16.37*
Format
1.33
.65
Individual format
27
.69
.44
.94
5.42***
34.01
37
.36
.21
.52
4.55***
41.06
Group format
65
.52
.35
.68
6.17***
60.51
65
.31
.19
.44
4.93***
68.90
Number of sessions (median split)
.42
.39
≤ 7 sessions
39
.63
.42
.84
5.83***
39.97
47
.32
.18
.45
4.50***
46.11
> 7 sessions
51
.54
.35
.72
5.62***
52.56
51
.38
.24
.52
5.36***
53.56
Control condition1
1.57
5.12*
Active condition
37
.45
.23
.67
3.95***
41.73
46
.18
.04
.32
2.49*
33.43
Only tests/WLC
62
.61
.42
.80
6.84***
66.85
65
.39
.27
.52
6.06***
87.20
Age
2.84
.15
< 60 years
6
.68
.15
1.22
2.50*
5.08
11
.36
.08
.65
2.51*
6.62
60 80 years
59
.59
.42
.75
7.10***
66.11
54
.35
.22
.48
5.42***
65.90
> 80 years
22
.33
.06
.60
2.43*
18.18
28
.39
.22
.56
4.56***
22.59
Gender
1.44
.64
22
< 33% women
10
.71
.30
1.12
3.40***
8.53
12
.45
.15
.74
2.97**
13.55
33-66% women
19
.67
.37
.97
4.40***
14.59
18
.33
.08
.57
2.64**
8.27
> 66% women
52
.50
.32
.68
5.46***
60.45
59
.32
.19
.44
4.83***
67.40
Residence
1.83
1.46
Private home
42
.65
.45
.85
6.30***
43.64
41
.39
.24
.54
5.02***
33.92
Nursing
home/residential care
43
.53
.33
.73
5.242***
47.75
47
.31
.17
.46
4.32***
59.70
Mixed forms
7
.32
-.15
.79
1.34
4.02
11
.19
-.11
.49
1.25
7.22
Publication status
.13
.20
Published
70
.58
.43
.74
7.28***
62.97
68
.35
.23
.46
5.79***
72.56
Unpublished
22
.52
.24
.81
3.56***
32.05
33
.30
.12
.47
3.32***
29.51
Study quality
2.62
3.72
Below median
33
.42
.19
.65
3.59***
26.40
38
.47
.30
.64
5.39***
39.94
Above median
59
.65
.82
1.21
7.68***
69.02
63
.27
.15
.38
4.47***
67.31
Notes. WLC = wait list control condition. 1 Separate effect sizes were computed in that analysis if the study included an active and a passive control
condition. k=number of treated subsamples; g=effect size (positive scores indicate improvements); 95%-C.I.=95% confidence interval of the effect
size; t=test of significance of the effect size; Q=test of homogeneity of the effect size. * p<.05; ** p<.01; *** p<.001.
23
Appendix I: Selected Characteristics of the Included Studies
Authors
Nreminisc.
Ncontrol
Dropout
rate
Randomiz.
Age
%
women
Health
condition
Form
Set-
ting
#
sess.
f-u
Outcomes
Afonso & Bueno (2010),
Afonso et al. (2011)
30
60
yes
76.0
83
depression
LRT
I
5
EI, D, PIL, PWB,
SI
Akanuma et al. (2011)
12
12
0
yes
78.4
75
dementia
SR
G
12
COG, D, SI
Ando et al. (2006)
15
21
0
no
53.0
80
phys. illness
LR
I
4
D, PWB
Ando et al. (2010)
34
35
10.4
yes
56.0
56
phys. illness
LR
I
2
DP, EI, MH, PIL
Arean et al. (1993)
27
20
25
yes
66.7
70
depression
LRT
G
12
D, EI
Arkoff et al. (2004)
18
18
no
65.5
100
no
LR
G
14
MA, PIL, PWB,
SI
Arkoff et al. (2006)
30
36
no
18.8
83
no
LR
G
14
MA, PIL, PWB,
SI
Baines et al. (1987)
20
10
yes
82.1
93
dementia
SR
G
20
4
COG, MH, PWB
Bass & Greger (1996)
4
8
0
no
68.5
dementia
SR
G
8
D
Bevis (2008)
24
24
17.1
yes
84.8
76.5
dementia
SR
G
6
D, MH, PWB
Blohm (1998)
14
26
11.1
yes
85.7
93
no
SR
G
8
D, DP, EI, MH,
PWB
Bohlmeijer et al. (2008)
57
36
12.2
no
63.9
61
depression
LRT
G
8
PIL
Bohlmeijer et al. (2009)
64
43
13
no
64.0
75
no
LR
G
8
D, SWE
Bramlett & Gueldner
(1993)
34
41
7.4
no
71.5
81
no
SR
G
3
9
SWE
Brooker & Duce (2000)
25
25
7.4
no
81.9
dementia
SR
G
2
PWB
Bryant et al. (2005)
43
22
yes
20.0
63
no
SR
I
14
PWB
Burnside (1990)
24
19
no
75.6
100
no
SR
G
8
PWB
Chao et al. (2006)
10
8
16.7
no
79.6
25
physical
SR
G
9
D, PWB
24
dependence
Chen (2011)
20
20
yes
phys. illness
LR
I
3
EI, PWB
Chiang et al. (2008)
36
39
yes
78.3
0
no
LR
G
8
4
PWB
Chiang et al. (2010)
45
47
30.8
yes
77.4
0
no
SR
G
8
13
D, MH, SI
Cho (2008)
19
21
26.3
no
44.4
0
no
LR
G
6
D, MH, PIL
Christopher (1986)
33
32
38.5
yes
76.6
58.5
dementia
SR
G
32
12
COG, D
Cook (1991)
14
18
22.2
yes
81.3
41.5
no
SR
G
16
D, PWB
Cook (1998)
12
24
yes
82.3
100
depression
SR
G
16
PWB
Cooper (1982)
12
15
15.6
yes
72.5
96
no
SR
G
12
PWB
Dai et al. (2010)
62
67
3.2
yes
70
58
depression
LRT
G
6
PWB
Daleo (1999)
13
13
7.1
no
75
69
depression
SR
G
9
D
Davis (2004)
7
7
22.2
no
68.5
stroke
LR
I
3
D, PWB
Dehkordi et al. (2009)
32
32
8.9
yes
no
SR
G
8
D
de Medeiros et al. (2011)
36
15
2.5
yes
80.6
64
no
SR, LR
G
8
34
COG, D, PWB, SI
Emery (2002)
18
8
38.6
yes
84.0
84
no
SR
G
8
8
D, MH, PIL,
PWB, SI
Erlen et al. (2001)
10
10
9
yes
43.7
20
phys. illness
LR
I
4
52
D, PIL, PWB
Erlich (1979)
12
24
yes
no
LR
G
4
PIL, PWB
Feng et al. (2010)
62
67
3.2
yes
70
58
depression
LRT
G
6
D
Ferguson (1980)
15
15
no
81.5
100
no
SR
G
24
PWB
Fielden (1990)
15
16
no
74.7
74
no
SR
G
9
MH, PWB, SI
Fischer (1989)
21
11
8.6
yes
71.5
no
SR
G
12
D
Fry (1983)
108
54
yes
79.6
59
depression
LRT,
SR
I
5
D, PWB, SI, SWE
Fry & Barker (2002)
20
18
5
no
30.5
100
no
SR
G
6
D, PWB, SWE,
25
Georgmiller & Maloney
(1984)
34
29
0
no
74.6
no
LR
G
7
DP
Goldwasser & Auerbach
(1996)
20
16
8.3
yes
83.1
72
no
SR
I
1
PWB
Goldwasser et al. (1987)
9
18
11
yes
81.6
82
dementia
SR
G
10
?
COG, D
Gonçalves et al. (2009)
11
11
yes
80.7
100
depression
LRT
I
4
D, PWB
Gudex et al. (2010)
127
137
26.8
yes
82.3
68
mixed
SR
G, I
26
COG, MH, SWB
Gurm (1990)
18
17
5.4
no
82.6
78
no
SR
G
8
D
Haight (1988)
16
35
15
yes
76
78
mobility
impairment
LR
I
6
PWB
Haight (1989)
6
6
0
yes
74
67
no
LR
I
6
PWB
Haight (1992)
10
12
19
yes
76
78
depression
LRT
I
6
52
PWB
Haight & Dias (1992)
150
38
21.7
no
78
77
no
LR, SR
G, I
7
D, PWB
Haight et al. (1995)
6
10
11.1
no
77
100
no
LR
I
6
PWB
Haight et al. (1998)
104
97
20-47.6
yes
79.9
69
no
LR
I
6
44
D, PWB
Haight et al. (2000)
26
26
79.7
yes
79.6
69
no
LR
I
6
156
D, PWB
Haight et al. (2003)
7
7
no
60
dementia
LR
I
8
C, PWB
Haight et al. (2006)
15
16
0
yes
79.5
81
dementia
LR
I
6
C, D, PWB, SI
Hanaoka & Okamura
(2004)
40
37
4.8
yes
81.6
86
no
LR
G
8
12
D, PWB
Haslam et al. (2010)
53
20
29.3
yes
81
dementia
SR
G, I
6
C, PWB
Hedgpeth & Hale (1983)
20
20
yes
76.3
80
no
SR
I
1
C, D, MH, SWE
Hoffman (2003)
5
5
0
no
46
100
cancer
LR
I
D, DP, PIL, PWB
Hosenfeld (1989)
8
8
23.8
yes
77.9
100
no
SR
I
6
PWB
Hsieh et al. (2010)
29
32
12.1
yes
77.9
62.5
dementia
SR
G
12
D
26
Hsu & Wang (2009)
24
21
6.2
yes
77.9
74
no
SR
G
7
D
Hughston & Merriam
(1982)
28
28
21.4
yes
68.2
76
no
SR
I
4
C
Ito et al. (2007)
17
28
15
yes
82.9
56
dementia
SR
G
13
C
Karimi et al. (2010)
19
10
25.6
yes
70.5
56
depression
LRT
G
6
D
King (1978)
4
14
40
yes
66
25
no
SR
G
16
PWB
Koffman (2000)
23
6
12
yes
72.4
50
no
LR
G
8
D, EI, MH, PWB
Korte et al. (in press)
99
102
7
yes
63.5
80
depression
LRT
G
8
13
D, MH
Lai et al. (2004)
36
65
14.9
yes
82.6
78
dementia
SR
I
6
6
PWB, SI
Lappe (1987)
42
41
yes
83.3
88
no
SR
G
15
PWB
LaTour (1987)
8
9
yes
79.5
no
SR
G
8
PWB
Ligon (2007)
29
30
1.7
yes
81.1
77
no
SR
I
3
10
PWB
Lin (2010)
17
17
10.5
yes
77.6
57
dementia
LR
G
20
C, D, MH
Liu et al. (2007)
12
14
29.4
yes
74.7
17
no
SR
G
10
D, PWB, SI
Mandel (1988)
22
25
yes
78.1
13.6
no
SR
G
16
D, MH, PWB
Mannelli (1999)
38
36
14.9
no
71.2
76
no
SR
G
10
D, PWB,
Mastel-Smith et al. (2007)
15
16
6.1
yes
70.1
81
no
SR
G
10
D
Masten-McGilvray (1990)
33
17
17.5
yes
77.2
64
no
LR, SR
G
8
8
PWB, SI, SWE
McMurdo & Rennie
(1993)
29
20
10
no
79.3
81
no
SR
G
63
C, D, PWB
Miller (1985)
15
33
25
yes
77.8
no
LR
G
8
26
D, PIL, PWB
Mitchell (1989)
38
34
10
yes
75.6
71
no
SR
G
4
PWB
Mohammedzadeh et al.
(2011)
18
18
yes
no
LRT
I
D
Morgan (2000), Morgan &
8
9
0
yes
dementia
LR
I
12
6
C, D, PWB
27
Woods (2010)
Namazi & Haynes (1994)
5
10
no
81
100
dementia
SR
G
12
C
Nomura (2009)
40
40
yes
82.6
71
no
LR
I
5-6
D, PWB
Nomura & Hashimoto
(2006)
22
26
yes
81.9
96
no
SR
G
8
12
D, EI, MH, PWB
Norris (2001)
25
48
6.4
yes
78.2
92
no
SR
I
4
PWB
Okumura et al. (2008)
8
8
no
84
100
dementia
SR
G
5
C, PWB
Parsons (1983)
41
47
22.9
yes
76.6
20.7
no
SR
G
5
PWB, SI
Pearson (2006)
13
12
yes
82
100
no
LR
G
6
D, EI, SWB
Pot et al. (2010),
Westerhof et al. (2010)
79
74
4.8
yes
72.5
64.4
no
LRT
G
12
39
D, MH, PIL,
PWB, SWE
Rattenbury (1993) study 1
76
101
25.5-
43.7
yes
83
70
no
SR
G
55
PWB
Rattenbury (1993) study 2
7
8
11.8
yes
67
50
cognitive
impairment
SR
G
8
C, PWB, SI
Rattenbury & Stones
(1989)
8
16
8
yes
85
no
SR
G
8
D, PWB
Reddin (2006)
26
11
19.6
yes
81
97
no
LR, SR
G
7
D, PWB
ReVille (1996)
40
80
20
yes
72.4
70
no
LR
I
6
D, PWB
Richeson & Thorson
(2002)
150
224
no
70.4
no
SR
G
8
PWB
Rybarczyk & Auerbach
(1990)
56
50
0
yes
65.7
0
phys. illness
LR, SR
I
1
MH, SWE
Rybarczyk et al. (1993)
72
34
yes
65
33
phys. illness
LR, SR
I
1
PWB, MH, SWE
Scates et al. (1985)
17
17
16
yes
75.1
64
no
SR
G
6
MH, PWB
Schafer et al. (1986)
128
57
no
73.5
no
SR
G, I
12
PWB, SI, SWE
28
Serrano et al. (2004)
20
23
14
yes
75.8
83
depression
LRT
I
4
D, PWB
Shellman et al. (2009)
19
37
0
yes
72.6
77
no
LR
I
8
D
Shi et al. (2007)
36
38
yes
depression
SR
G
6
D
Siviş et al. (2005)
5
5
no
68
60
no
SR
G
6
PWB
Steinhauser et al. (2008)
12
18
54
yes
62
46
phys. illness
SR
I
3
2
D, DP, MH
Stevens-Ratchford (1993)
12
12
0
yes
79.9
67
no
SR
G
6
D, PWB
Stinson & Kirk (2006)
10
8
16.6
yes
81.8
100
no
SR
G
12
D
Stinson et al. (2010)
22
25
12
yes
82.5
100
no
SR
G
12
D
Su et al. (in press)
49
44
3.9
yes
77.4
29
phys. illness
LR
G
73
C, D
Tabourne (1995)
16
17
no
63
dementia
SR
G
24
PWB
Tadaka et al. (2000)
11
10
8.3
yes
83.3
50
dementia
SR
G
COG
Tadaka & Kanagawa
(2007)
28
27
6.6
yes
84.2
70
dementia
SR
G
8
26
C, D
Tatchell et al. (2003)
49
42
9.9
no
78
81
no
SR
I
5
MH, SI
Taylor-Price (1995)
17
17
yes
78.2
100
no
SR
G
12
D, PWB
Thorgrimsen et al. (2002)
7
4
9.1
yes
79.6
57
dementia
SR
G
18
C, PWB
Tourangeau (1988)
13
12
0
yes
78.4
76
no
SR
G
8
D
Vaughan & Kinnier (1996)
10
19
50.9
yes
39.5
4
phys. illness
LR
G
6
D, DP, PIL, PWB
Wang (2005)
25
23
yes
79.5
40
no
SR
I
17
D, PWB
Wang (2007)
51
51
5.9
yes
79.8
53
dementia
SR
G
8
C, D
Wang et al. (2005)
46
48
13
yes
75.6
45
no
SR
I
17
D, PWB
Wang et al. (2009)
38
39
10.5
yes
79.3
47
dementia
SR
G
8
MH
Watt & Cappeliez (1996)
21
5
35
yes
66.4
54
depression
LRT
G
6
D
Watt & Cappeliez (2000)
27
13
35
yes
66.8
54
depression
LRT
G
6
13
D
29
Weiss (1994)
20
8
30
yes
depression
LRT
G
6
PWB
Wilson (2006)
30
15
no
77.3
76
depression
SR,
LRT
I
24
D
Wu et al. (2011)
35
39
4
no
81.3
0
phys. illness
SR
G
12
D, PWB
Youssef (1990)
21
21
39
yes
65.7
100
no
SR
G
6
D
Notes. Nreminisc/Ncontrol=number of completers in experimental and control condition. C=cognitive performance, D=depression, DP=death preparation, EI=ego
integrity, G=group format, I=individual (one-to-one) format, LR=life-review, LRT=life review therapy, MA=mastery, MH=mental health (other than depression),
PIL=purpose in life, PWB=positive psychological well-being, SI=social integration, SR=simple reminiscence. # sess.=number of sessions, f-u=follow-up interval
(in weeks). Age and percentage of women refers to the reminiscence condition.
30
Appendix II: Studies Included in the Meta-Analysis
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31
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... Interestingly, television being used as a reminiscence intervention tool was spoken about when Liam said 'I use zoom and whatsapp to keep in touch with family, and I like to watch the re-runs of old TV shows like Only Fools and Horses and Minder, they remind me of when life was better and less complicated, I like to think about those days from time to time'. A meta-analysis of reminiscence based therapeutic interventions by Pinquart and Forstmeier (2012) concluded there were many positive immediate effects of such activities and they can help improve cognitive performance of individuals with cognitive impairment and alleviate depressive symptoms also. ...
... A meta-analysis by Pinquart and Forstmeier (2012) involved integrating the results from the controlled trials of 129 reminiscence based interventions studies. ...
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Aims Research into psychosocial and therapeutic interventions that people with a diagnosis of alcohol related brain damage (ARBD) access to further their recovery is scarce. The aim of this research project was to explore the potential benefits or limitations that such interventions can have in relation to their quality of life (QOL) as well as advancing this field of knowledge. Methods A search of the literature was completed to ascertain what is known of this topic. Semi-structured qualitative interviews were carried out with six participants with a diagnosis of ARBD residing in a supported residential setting. A grounded theory methodology was utilised to identify emerging themes. Results The themes of family input, television and technology, choice, decision making and goal-setting were identified as being key themes of the participant responses with the multifaceted roles of television being of particular interest. Conclusion The role of family can be helpful in many ways as well as providing a source of hope and motivation and this should be promoted whenever possible. Offering people with ARBD therapeutic opportunities should be encouraged as low motivation and indecision may be a presenting symptom. However, the multi-functioning role that television can play in the recovery process was most surprising and should be explored further by researchers.
... Interestingly, television being used as a reminiscence intervention tool was spoken about when Liam said 'I use zoom and whatsapp to keep in touch with family, and I like to watch the re-runs of old TV shows like Only Fools and Horses and Minder, they remind me of when life was better and less complicated, I like to think about those days from time to time'. A meta-analysis of reminiscence based therapeutic interventions by Pinquart and Forstmeier (2012) concluded there were many positive immediate effects of such activities and they can help improve cognitive performance of individuals with cognitive impairment and alleviate depressive symptoms also. ...
... A meta-analysis by Pinquart and Forstmeier (2012) involved integrating the results from the controlled trials of 129 reminiscence based interventions studies. ...
Preprint
Full-text available
Aims Research into psychosocial and therapeutic interventions that people with a diagnosis of alcohol related brain damage (ARBD) access to further their recovery is scarce. The aim of this research project was to explore the potential benefits or limitations that such interventions can have for in relation to their quality of life (QOL) as well as advancing this field of knowledge. Methods A search of the literature was completed to ascertain what is known of this topic. Semi-structured qualitative interviews were carried out with six participants with a diagnosis of ARBD residing in a supported residential setting. A grounded theory methodology was utilised to identify emerging themes. Results The themes of family input, television and technology; choice, decision making and goal-setting were identified as being key themes of participant responses with the various roles of television being of particular interest. Conclusion The role of family can be helpful in many ways as well as providing a source of hope and motivation and should be promoted whenever possible. Offering people with ARBD therapeutic opportunities should be encouraged as low motivation and indecision may be present. However, the multi-functioning role that television can play in the recovery process was most surprising and should be explored further by researchers.
... meditation). Reminiscence-based therapies focus mainly on the retrieval of episodic memories and on working on their content (Pinquart & Forstmeier, 2012). Although these interventions are effective on self-esteem, the effects are small (d = 0.24, Niveau et al., 2021a) and transient (Pinquart & Forstmeier, 2012), which could be related to an isolated mobilization of episodic self-perceptions without the effort to modify generic self-representations stored in semantic memory (Niveau et al., 2022). ...
... Reminiscence-based therapies focus mainly on the retrieval of episodic memories and on working on their content (Pinquart & Forstmeier, 2012). Although these interventions are effective on self-esteem, the effects are small (d = 0.24, Niveau et al., 2021a) and transient (Pinquart & Forstmeier, 2012), which could be related to an isolated mobilization of episodic self-perceptions without the effort to modify generic self-representations stored in semantic memory (Niveau et al., 2022). ...
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... [19][20][21] There are 3 main types of RT: simple reminiscence, life review, and life review therapy. 22 Simple reminiscence usually focuses on the individual's own pleasant and happy memories, 23 and can be carried out in groups, pairs, or oneon-one by nurses and social workers in the community, nursing homes, and other places. Life review is used for the exploration of both positive and negative life experiences. ...
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... PA is defined as a strategy to carry out a specific exercise program or to improve a person's overall daily activity level (Cramp et al., 2013). Psychosocial interventions were defined as a range of therapies based upon a specific change in behavior theory to resolve maladaptive behaviors and distorted thoughts that contribute to depression (e.g., ST, CT and CC) (Pinquart and Forstmeier, 2012;Sukhato et al., 2017). The control group included the no treatment group, usual care group, active control group and waitlist group. ...
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Résumé Introduction Faire face à sa propre mortalité permet d’avoir une plus grande conscience de son histoire de vie, faire du lien entre ses différentes expériences personnelles et ouvre à l’introspection que ce soit dans l’échange ou le silence. Objectif Recueillir le travail cognitivo-émotionnel s’opérant chez des patients en soins palliatifs et apprécier l’utilisation et l’apport de la réminiscence ainsi que la place du silence dans le discours. Méthode Notre étude est transversale, exploratoire, qualitative. Les entretiens sont réalisés par la psychologue via une grille d’entretien préalablement définie pour cette étude. Les éléments non verbaux ont été pris en compte suite à l’entretien. Neuf patients, exclusivement des femmes, âgées de 71 ans en moyenne, atteintes de cancer, hospitalisées et qui se sont vues annoncer la fin des traitements curatifs ont été incluses. Résultats Après une analyse thématique, il apparaît que les préoccupations des patients sont principalement axées sur leur rapport à leur fin de vie et la mort. Nous observons une majorité de réminiscences négatives et que les apports de ces dernières sont variées. La fonction principale du silence est émotionnelle lors de l’évocation de thème de la fin de vie et de la maladie. Conclusion Il apparaît nécessaire de laisser la place aux questionnements autour de la fin de vie ainsi que d’interroger les réminiscences qui peuvent être activées suite à la proximité de la mort. La reconnaissance des différents types de silence doit également faire partie des capacités d’écoute des professionnels.
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Objectives This study aimed to examine the feasibility of unpaid, family/friend caregivers conducting life reviews with people with dementia in long-term care and community settings and reported on how we adapted the intervention modality under the COVID-19 pandemic. Methods Twenty-one caregiver-care recipient dyads completed 6 weekly life review sessions. The intervention format was modified to accommodate COVID-19 restrictions. Primary and secondary outcome measures were analyzed based on repeated measures at baseline and post-intervention. Results Due to the changing nature of the pandemic, we iterated the caregiver training intervention four times to accommodate caregivers’ needs while having faced multiple recruitment challenges with care facility residents. Care recipients’ depression appeared to have improved (p = .001). Conclusions Although the COVID-19 pandemic created unique recruitment challenges, all the care recipients seemed to enjoy the life review activities supported by the positive outcomes in gaining socialization opportunities. It may be beneficial to offer a more self-paced intervention modality to ease the burden on caregivers. Clinical implications It appears that unpaid family/friend caregivers can provide life reviews to their loved ones with dementia. Training the caregivers on how to provide life reviews can be an easy, low-risk activity that might ameliorate depressive symptoms in the care recipients.
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WHAT IS KNOWN ON THE SUBJECT? Reminiscence therapy is a common psychosocial intervention in mental health nursing. Numerous secondary studies have explored the effects of reminiscence therapy interventions in older adults, and while the effects are significant, conflicting results remain. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE? To date, research on reminiscence therapy has examined different disorders in isolation from one another. By illustrating the evidence gaps between studies, this paper highlights the need for a new evidence-based summary overview of reminiscence therapy research. The results suggest that reminiscence therapy can be beneficial to the improvement of mental health and quality of life for older people. However, we found that the secondary studies were not of high quality and that further high-quality literature supporting the evidence is still needed. Introduction: Reminiscence therapy is an alternative to pharmaceutical intervention provided during long-term care, especially for older people with mental and psychological problems. However, the effects of reminiscence therapy remain inconclusive. Aim: The present study aimed to systematically identify, synthesise, and describe the research evidence and quality of systematic reviews (SRs) related to reminiscence interventions for older people through an evidence-mapping approach. Methods: Commonly used English and Chinese databases, including PubMed, EMBASE, The Cochrane Library, Web of Science, CNKI, WANFANG, VIP, and SinoMed, were searched from inception till 31 Mar 2022. The study type was restricted to SRs with or without meta-analysis. The methodological quality of the included SRs was assessed by A Measurement Tool to Assess Systematic Reviews (AMSTAR-2). The Microsoft Excel 2019 tool was used for data extraction and coding, and bubble charts were used to synthesise information on the study population, intervention category, original study sample size, and classification of findings. Results: A total of 28 SRs were enrolled, including 514 original studies, 91.4% of which were randomised controlled trials. The main participants of the study were depressed older people (7 publications), older people with dementia (10 publications), and ordinary older people (8 publications). The findings of 26 (92.8%) publications were categorised as either 'beneficial' or 'potentially beneficial'. The primary outcome indicators of the effectiveness of the reminiscence intervention for older people are mental and psychological problems (especially depressive symptoms and cognitive functioning), quality of life, and categories of positive psychology (e.g., life satisfaction, happiness, and self-esteem). The main factors influencing the intervention effect were the intervention period, residential setting, intervention format (group/individual), and intervention intensity. The intervention settings/contexts were mainly community and long-term care facilities. However, the methodological quality of 27 (96.4%) of the SRs was scored as either 'Low' or 'Critically Low'. Discussion: Reminiscence therapy has been used to study the mental health and quality of life of older people in various conditions, with significant results. However, due to the limited evidence included in the studies and the low methodological quality, there is still a need to focus on the issue of effectiveness and evidence gaps for different interventions in the field of recall in the future, in addition to efforts to improve the methodological quality and standardise the reporting process for the evaluation of reminiscence intervention systems. Implications for practice: Reminiscence therapy may be considered a useful non-pharmacological intervention for older people with mental and psychological problems. A standard protocol for reminiscence therapy may be necessary for future studies.
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Depression is the most frequent mental health problem in older people, and it’s tough to manage because of late-life health issues and cognitive impairment. The study aim to investigate the efficacy of psycho-social intervention for managing depression in older adults and to explore whether types of interventions, specific aspects of the study, and research participants moderate the magnitude of the effectiveness of interventions. we searched different database and followed PRISMA guidelines. Include studies from 2001 to 2021 conducted among the elderly population aged 60 and above. The quality assessment technique developed by the Cochrane Collaboration was used to look for potential sources of bias. Comprehensive meta-analysis is used to analysing effect size. It is found that Psychosocial interventions are effective in reducing depression among older adults. The overall intervention effect size (hedges’ g) was found to be 1.118 (95% CI: 0.835- 1.402), significant at the 0.0001 level. Based on subgroup analysis it is clear that experimental design and severity of depression do not play changes in the effect size of intervention but cognitive impairments can influence the intervention effectiveness.
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Background: Patients with Alzheimer's disease (AD) present with cognitive function deterioration, neuropsychiatric symptoms (NPS)-especially depression-and low quality of life (QoL). Management of AD remains difficult, especially in the elderly. Reminiscence therapy (RT) is a well-known cognitive rehabilitation intervention that can be adopted in nursing and residential care homes to restore autobiographical memory, ameliorate NPS, and improve the QoL of people with dementia. However, the evidence-based efficacy of RT for elderly patients with AD remains to be determined. Methods: Here, we synthesized findings of randomized controlled trials (RCTs) exploring the effects of RT on cognition, depression, and QoL in elderly people with AD, according to the most recent PRISMA statement. We searched for RCTs in PubMed, Web of Science, and Cochrane Central Register of Controlled Trials, and in trial registries (i.e., clinicaltrials.gov and International Clinical Trials Registry Platform of the World Health Organization). Two review authors extracted data of interest, with cognition, depression, and QoL measures as outcomes. Results: A total of five articles were included in the final analysis. Findings globally showed that RT, both administered in individual or group sessions at least once a week for 30-35 min over a period of 12 weeks, is effective in supporting global cognition, ameliorating depression, and improving specific aspects of the QoL in elderly people with AD. Conclusions: RT has the potential to be a routine non-pharmacological therapy for elderly people with AD, thanks to its wider effects on the individual in terms of cognitive vitality and emotional status promotion, with positive implications for patient's daily life. Despite such evidences, caution should be used in findings' generalizability in relation to the paucity of existing RCTs with long-term follow-up.
Article
There is little empirical evidence on the impact of reminiscence work in general, and life review therapy in particular, with people with dementia. People with mild to moderate cognitive impairment living in care homes were randomly allocated to a life review intervention (n=8) or a treatment as usual comparison condition (n=9). The intervention was carried out with people individually and culminated in the creation of a life story book detailing information from the reviewer's life. Measures of depression and autobiographical memory were taken for all participants at the pre, post and 6 week follow up assessment stages. The life review participants improved significantly more on the Geriatric Depression Scale short-form (group x time interaction F (2,15)=13.97; p=0.009), with a mean 3.25 point reduction in depression scores at the 6 week follow-up assessment; in contrast, depression scores of control participants showed no change. In comparison to the control group, the life review participants were also significantly more able to recall personal facts from their lives at follow up (group x time interaction F (2, 15) = 5.92; p=0.007). Case vignettes of the life review process and its impact are presented, and clinical issues discussed. Life review was often not an easy process for the participant, and is demanding of therapeutic skills in relation to the powerful emotions and feelings of loss it may elicit. The life story book was typically viewed positively, with the life review process and the therapeutic relationship valued at its completion. This study is the first to associate an improvement in autobiographical memory in dementia with a reminiscence intervention, and is indicative of a possible psychological therapy for depressed mood in dementia, which is believed to be highly prevalent in care homes.
Article
The purpose to this study was to determine the effects of autobiographical writing on the subjective well-being of older adults. Autobiographical writing classes are popular courses offered by many Institutes for Learning in Retirement throughout the United States and Canada. Many individuals feel these types of courses have great potential for meeting the developmental needs of older adults. However, only limited research has been done specifically on the efficacy of autobiographical writing. Therefore, a need was seen to conduct research that investigated the outcomes of autobiographical writing classes. ^ A quasi-experimental nonequivalent control group was used in the research design. The intent of the study was to see if there were differences between the participants who enrolled in an autobiographical writing class and those who took part in a liberal arts class offered through the Institutes for Learning in Retirement. The courses were held during the Fall Semester of 2000. It was hypothesized that there would be a statistically significant difference between those who participated in the autobiographical writing classes and those who participated in the liberal arts classes on three dependent measures of subjective well-being. A total of 328 research participants, whose ages ranged from 50 to 97, completed the pretest and posttest measures. ^ The major hypothesis was analyzed using a split-plot analysis of variance, and the results indicated a statistically significant difference between the negative affect of older adults who participated in the autobiographical writing classes and those who participated in the liberal arts classes. The negative affect of the students enrolled in the autobiographical writing classes decreased from pretest to posttest when compared to the liberal arts classes in this study. No statistical significance was found from pretest to posttest on the other two dependent measures (positive affect and satisfaction with life) when comparing the two groups.
Article
To date, there is little information on the therapeutic effects of the life review beyond one year. This analysis followed fifty-two of 256 subjects who lived for at least three years in a nursing home. These participants received either a life review or friendly visit and took part in four repeated testings to determine the lasting effects of the life review at two and three years. Measures of integrity (life satisfaction, psychosocial well being, self-esteem) and despair (depression, hopelessness, and sucide intent) were used as pretest, posttest, and retest. Results showed a trend toward continued and by year three significant improvement over time in those who received the life review on measures of depression (t = −2.20, p < .03), life satisfaction (t = 2.51, p < .02), and self-esteem (t = −2.31, p < .03).