Aging population around the world is growing fast. As the United Nations Statistics Division shows, the elderly of the world was about 865 million in 2010, and will reach 2.008 billion in 2050 [1
]. Moreover, according to National Bureau of Statistics of China, the Chinese elderly aged 60 and above were about 178 million in 2010, accounting for 13.26% of population [2
]. With the increasing number and proportion of the elderly, the geriatric mental health problem becomes more important. Depression is one of the most common mental disorders found in the elderly. In our recent survey of Chinese elderly, the prevalence of self-reported depressive symptoms (CES-D≥16) reached to 39.86% [3
]. Depression causes disability of functional impairment, reduces life satisfaction and quality, it is also associated with a high risk of suicidal behavior, and increases the burden and the costs of health and home care services [4
]. Therefore, the appropriate early intervention for the elderly individual suffering depression is significant and critical [7
At present, drug therapy and psychotherapy are two commonly used methods for the treatment of depression [9
]. Depression is mainly treated by medication for a long time [10
]. However, previous studies also indicated that pharmacologic approaches had numerous side effects [7
]. In addition, the elderly cannot learn any skills from the drug therapy in protection against the relapse of depression [8
]. Currently, increasing studies and reviews support the efficiency of psychotherapeutic treatment for depression. Cognitive or cognitive behavioral therapy [14
], problem-solving therapy [17
] and interpersonal therapy [18
] are widely accepted as methods in reducing the depression. Based on traditional interventions, reminiscence therapy is specially recommended for geriatric depressive adults. This psychotherapy has been designed and developed because of the recognition of the unique needs and concerns involved in adaptation to the late stage of life [8
The theoretical framework of reminiscence therapy derived from Erikson’s theory of ego development [20
]. Erikson divided life span into eight stages. In his theory, Erikson believed people would experience a main crisis or conflict in each stage, which served as a turning point in development and needed to be solved. For the elderly, the principle task is to achieve ego-integrity and avoid despair [21
]. Erikson suggested that assessment of the past was an essential component in successful completion of this task [8
]. Butler and Birren developed Erikson’s work and proposed that ego integrity could be achieved in an analytical and evaluative way to recall one’s past [22
]. In recent years, researchers developed the continuity theory and contributed other insights in understanding the importance of reminiscence. According to continuity theory, when individuals encounter life-events which need them to change or convert, they will use adaptive strategy by linking present to their past experiences. This strategy is adopted to “preserve and maintain existing internal and external structures” and “produce continuity in inner psychological characteristics as well as in social behavior and in social circumstances” [23
Reminiscence therapy is a method of using the memory to protect mental health and improve the quality of life. Reminiscence is not just to recall the past events or experiences. It is a structured process of systematically reflecting on one’s life with a focus on re-evaluation, resolving conflicts from the past, finding meaning in one’s life and assessing former adaptive coping responses [24
]. Watt and Wong (1991) defined six types of reminiscence: integrative, instrumental, transmissive, narrative, escapist and obsessive [27
]. They identified the integrative and instrumental reminiscence was related to adaptation and well-being among older adults, and developed the corresponding intervention manual [25
In the last several decades, increasing studies indicated that reminiscence therapy is effective for the elderly with depression [26
]. Besides alleviating the depression symptoms, reminiscence therapy was proved to improve self-esteem [34
], life satisfaction [35
], psychological well-being [36
], personal mastery [37
] and loneliness [39
]. However, the conclusion is not consistent [41
]. The reasons may be attributed as some studies did not follow randomized controlled trial (RCT) design, lack of strict protocol and had high dropout rates.
The purpose of the research is to examine the effect of reminiscence therapy on depressive symptom, self-esteem, life satisfaction, and loneliness in Chinese elderly.
Specifically, the aims are:
Firstly, we intend to explore whether reminiscence therapy will significant improve the experiment group’s depressive symptom in comparison with control group after six weeks therapy, and whether the efficacy can be maintained during three-month follow-up.
Secondly, we are interested in whether reminiscence therapy is a potential effective treatment to reduce the loneliness, increase the self-esteem and life satisfaction for the experiment group elderly.