Reminiscence Therapy (RT) was first developed by Butler (1963) as a psychological intervention for older adults; however, research findings regarding its therapeutic utility as inconsistent and inconclusive (Karimia, et al. , 2010).
Not entirely sure what reminiscence meant, I looked it up. According to the Dictionary. com (2013), reminiscence is the act of recalling a past event or experience; reviving a retained memory or event. Reminiscence Therapy involves the discussion of past activities, events and experiences with another person or group of people.
It usually involves the aid of tangible prompts such as photographs, household and other familiar items from the past, music and archive sound recordings and is intended to aid in resolution of past issues or to connect to good memories, aiding in a sense of well-being. In this paper, I will be critiquing the article, evaluating the aspects of literature review in research that have been taught in NU310 over the past nine weeks to determine credibility of the study, reliability of the information and adherence to study guidelines. Title/Abstract
An abstract is a concise overview of the research information that includes the purpose, methodology, results and conclusions of the study. It should be able to stand alone and “allow a reader to decide whether or not to read the full text because your research and conclusions have relevance for his/her research” (Millbrook House, 2004).
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The abstract in this paper is concise and inclusive of the purpose, results and conclusion of the study. I was distracted by the lack of basic information about Reminiscence Therapy and found myself searching for definitions to better understand the erminology in the study in order to follow the writer. The results of that search are shared in my introduction. Despite the lack of definition, I did find the writers were clear in their purpose and indicated enough information regarding the outcomes that the analysis met the requirements. Based on this information and the literature reviews included in the study, I find the title to be appropriate, especially the portion “an empirical study” as it lets the reader know up front that this is an empirical study, which does not use a scientific method or theory.
Problem/Purpose Statement The introduction of this study begins with a broad statement regarding the research findings of reminiscence therapy and its therapeutic use being inconsistent and inconclusive. The writers launch right into a review of the literature, leading the reader down a twisting path of studies that result in greatly varying outcomes. The problem statement seems to be the lack of consistent and conclusive outcomes from past reminiscence therapy studies, but it’s not 100% clear.
In one paragraph the writers indicate in “reviewing 57 controlled studies to assess the effects of psychotherapy and other behavioral interventions on clinically depressed older adults …cognitive behavioral therapy and reminiscence therapy are particularly well-established and acceptable forms of depression treatment” (Karimia, et al. , 2010).
But quickly follow with a statement that “Lin, Dai, and Hwang (2003) carried out a systematic review [and] reported a lack of consistency in the findings of the research on therapeutic utility of reminiscence” (Karimia, et al. , 2010).
Not until the end of the introduction do the writers loosely define reminiscence and its usefulness in therapy. It is then that they hypothesize that integrative and instrumental intervention will produce statistically significant reduction in depression symptoms in the elderly. This statement defines to me that the purpose of this study is to show that integrative and instrumental reminiscence interventions will decrease the depressive symptoms in the older adult population. Literature Review/Theoretical Framework A strong review of the literature is present in the paper.
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The writers have acknowledged studies that resulted in inconsistent and inconclusive outcomes and the evolvement of the work done in relation to reminiscence therapy by other researchers. According to Karimia, et al. (2010); Watt, Wong and Cappeliez took the first steps toward removing the ambiguity of working with reminiscence by applying a widely accepted taxonomy and focusing on specific aspects within the classification. They noted identifying integrative and instrumental reminiscences as being particularly beneficial for positive adaptation and psychological well-being in older age.
While the title of the paper implies this study to be empirical in nature, it seems this information is the theoretical rationale that this study is based upon. The integrative reminiscence process is credited with aiding in the resolution of self worth, conflict resolution and integration of past and present while the instrumental reminiscence process “involves remembering past plans and goal-directed activities, recalling how one coped with past problems, and drawing from past experience to solve the present problems” (Karimia, et al. , 2010).
Design The study employed a three-group pre–post-test design with random allocation to instrumental or integrative reminiscence or an active social discussion control condition” (Karimia, et al. , 2010).
Pre-test/post-test designs are often used in behavioral research, primarily for the purpose of comparing groups and measuring change resulting from experimental treatments (interventions).
The intervention, short form group sessions, were conducted by a master’s level therapist who was supervised by a master’s level clinical psychologist. Pretesting in this study included the MMSE, GDS-15 and a demographic questionnaire.
All assessments were conducted by the clinical psychologist, who was not the therapist leading the intervention, and was blind to the subjects’ assigned intervention group. Post testing included the administration of the GDS-15 only. Participants were randomized into three groups, one group serving as the control group. Designs that involve collecting data from different groups and examining the differences between groups are also called mixed-design groups. Sample Methodology/Patient Rights The sample group for this study was obtained from volunteers who lived at the Kahrizak Nursing Home located in Iran. Participants were selected ased on five inclusion and three exclusion criteria, some of which was discussed in the previous paragraph. There were 109 volunteers, 94 of whom passed the initial interview and moved on to be assessed for eligibility in the study. Forty-eight participants met the inclusion criteria. From those 48 participants, 39 were randomly selected and placed into study groups. “In order to form matched groups in terms of depression severity, and gender, participants were systematically divided into three groups, and were then randomly assigned to the three conditions of intervention (integrative, instrumental, or social discussion) (Karimia, et al. 2010).
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From the beginning of time it has been evident that as humans we function better in groups than individually (Joining pg. 4). The Cro-Magnon's discovered early in time that they were more efficient and productive working in groups than when working independently. Once they pooled their resources, people, and knowledge the possibilities were endless. Until I read the text Joining Together, I had ...
Ten participants were excluded from the study during the eligibility trials due to illness. Proper attention was paid to the participants’ ethical rights to ensure understanding of the study’s purpose and that language and educational barriers were addressed. Interviews were conducted to assess the ability of prospective participants to understand and speak Persian at the onset of the study and verbiage in the GDS-15 and MMSE were modified to make the content culturally suitable with respect to the community and participants.
The final sample included 29 participants (12 men and 17 women); 10 in the integrative reminiscence group, nine in the instrumental reminiscence group, and 10 in the social discussion group. The age of the participants ranged from 64 to 87; the distribution of genders within each group being 59% women and 41% men. Level of depression on the GDS-15 prior to the interventions revealed that across the three groups, the participants demonstrated equal amounts of mild, moderate, and severe symptoms of depression. Data Collection/Reliability
Study participants were administered the MMSE, the GDS-15, and a demographic questionnaire to obtain quantifiable data used in the study. The MMSE, a short, structured interview, measured the cognitive state of each candidate. A score of greater than 21, on a scale of 0-30, was used as exclusion criteria to determine those who were not cognitively able to participate. Depression symptoms were measured with the GDS-15. Scores of 0–4 are considered normal; 5–8 indicate mild; 9–11 moderate; and 12–15 indicate severe depression symptoms.
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Does the average person experience depression throughout their life Troy R. Mettler Research Report Introductory Psychology 110 Instructor: Jack Mino 12/15/99 Introduction In psychology, depression is a mental illness in which a person experiences deep, unshakable sadness and diminished interest in nearly all activities, it involves disturbances in emotion (Encarta). Depression is among the most ...
There was not an exclusion factor for this test. According to Polit & Beck (2010), the quality of interview information and reliability of data relies heavily on interviewer proficiency and consistency. The clinical psychologist, masters prepared, was blinded to the subjects’ intervention group. The role of the psychologist was to conduct all of the interviews and testing. “All the questions of the MMSE, GDS-15, and the demographic questionnaire were asked orally and the oral answers were written down by the psychologist” (Karimia, et al. , 2010).
Three distinct groups were established by randomization of study participants who met inclusion criteria; the integrative reminiscence group, the instrumental reminiscence group, and the social discussion group. Randomization to treatment conditions is noted by Polit & Beck (2010) to provide the best control method for managing validity threats to a study. Each study group had six weekly sessions of 90 min each focusing on a weekly theme, conducted by a masters prepared therapist and supervised by a psychologist, yet not the psychologist who conducted the pre-testing to avoid testing confounding.
At the conclusion of the intervention, weekly sessions, participants were again assessed on the GDS-15 by the clinical psychologists. Data Analysis In this study, “analysis of covariance (ANCOVA) was used to determine differences in the depression scores between pre-test and post-test in the three groups, taking into account the effect of pre-test scores (depression severity) as a covariate variable” (Karimia, et al. , 2010).
ANCOVA is a statistical control used to remove the effect of a confounding variable when other control methods may not have achieved comparability.
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However as you grow, especially in the secondary and tertiary levels of education, the learning process would become more advanced and complicated. At these stages, it would not be just memorizing facts, but would also involve the understanding of more complicated concepts, theories and formulas while analyzing and solving problems. Such situations often demand a student to seek assistance of ...
The depressive symptoms of the integrative reminiscence group were significantly lower than those of the control group, yet there was little difference in the instrumental reminiscence group and the control group. The mean score of the integrative group at pre-test (9. 40) and the instrumental group at pre-test (9. 22) were both within the range for moderate depression. The mean score of each group at post-test improved, integrative (4. 70) and instrumental (7. 0), but only the integrative group returned to normal on the GDS-15 scale.
The findings suggest that integrative reminiscence intervention was better than instrumental reminiscence intervention for reducing symptoms of depression. Discussion The writers note that in the Watt & Cappeliez (2000) study, both the integrative and instrumental studies resulted in significant reduction in depression symptoms. At first look, it appears the integrative reminiscence interventions were very effective in returning an older adult participant to within normal range on the depression scale (GDS-15) yet the instrumental reminiscence interventions were not.
However, once the researchers compared the data using the Scheffe test, the results for neither were statistically significant. Despite that, there was an apparent change in the perception of depressive symptoms in the participants as indicated by both mean scores moving from the moderately depressed range to the mild or normal range. Limitations to the study were noted by the writers as no follow-up study to discover the level of stability of the interventions effects, small sample size and the reliance on a single measure of depressive symptoms as an outcome measure.
I also see the convenience sample taken from the nursing home to be another limitation of the study. As the writers note, in the Iranian culture, it is not customary for older adults to live in nursing homes. Residents of this nursing home could potentially be feeling a sense of depression, perhaps the attachment of a stigma, based on the lack of connection to family. I have concern with the adaptation of the GDS-15 and MMSE to allow for cultural sensitivity and wonder if the censoring of the content and language might have changed the test results. Conclusion
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The lack of a strong start in the introduction of this study left me wondering if the problem or purpose statement were missing, leaving the direction of the study to wander aimlessly. The six paragraphs of literature review that essentially indicated a history of inconsistent and inconclusive results would have caused me to not continue had this not been an assigned reading. More information in the early stage of the paper about reminiscence therapy and what exactly the integrative and instrumental interventions were might have held my attention and inspired me to read further for results.
Instead I struggled to stay focused and absorb the information being provided. The researchers’ hypothesis stated that integrative and instrumental reminiscence interventions would produce statistically significant reduction in depression symptoms in the older adult population. The analysis of pre-test to post-test changes did reveal that integrative reminiscence therapy led to statistically significant reduction in symptoms of depression in comparison to the control group. While instrumental reminiscence therapy also reduced depressive symptoms, this improvement was not statistically significant compared to the control group.
Even though the results may not have been statistically significant, I would have to offer that any reduction in depressive symptoms is significant in the mental health arena. This study does provide additional support for the effectiveness of integrative reminiscence therapy as an intervention for depressed older adults living. The general statement “this study also provides support for the hypothesis that certain types of reminiscence produce their own specific effects” caused me to read the article through once more to look for what specific effects were produced.
I found no indication of what could be important qualitative data from the interventions that might also support the writers’ statement. Unfortunately, while this study was able to indicate an improvement in depression utilizing integrative reminiscence therapy, I am not convinced the results are reproducible. I would hesitate to base my practice on this study. References Dictionary. com. (2013).
reminiscence. Retrieved from Dictionary. com: http://dictionary. reference. com/browse/reminiscence? s=ts Karimia, H. , Dolatshaheeb, B. , Momenia, K. , Khodabakhshic, A. , Rezaeid, M. & A. A. Kamrani, A. (2010).
Effectiveness of integrative and instrumental reminiscence therapies on depression symptoms reduction in institutionalized older adults: An empirical study. Aging & Mental Health, 14(7), 881–887. Millbrook House. (2004).
Writing the Abstract. Retrieved from Writing a literature review as your dissertation: http://www2. plymouth. ac. uk/millbrook/rsources/litrev/lrabstract. htm Polit, D. , & Beck, C. (2012).
Nursing research; Generating and assessing evidence for nursing practice (9th ed. ).
Philadelphia, PA: Lippencott Williams & Wilkins.
