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Enhancing Your Therapy with Gestalt Approaches
Gestalt Therapy continuing education psychology CEUs

Section 17
Implementing Gestalt Reminiscence Therapy with Older Adults

CEU Question 17 | CEU Answer Booklet | Table of Contents | Gestalt
Counselor CEUs, Social Worker CEUs, Psychologist CEs, MFT CEUs

The Cork Older Adult Intervention Project is based on a developmental model of the person in which the emotional, social and spiritual growth of older adults is viewed as continuing until death. The particular therapeutic method used is gestalt reminiscence therapy (O'Leary and Barry, 1998; 2000). This approach uses storytelling as a means of identifying unfinished business (O'Leary and Nieuwstraten, 1999). It develops intrapersonal and interpersonal contact and considers environmental contexts. Because this integrative approach views development as a lifelong process, merely facilitating older adults to recall the past would not be considered sufficient. Participants are also challenged to continue to develop themselves in the present. Gestalt reminiscence therapy is primarily used as a group approach, thereby creating a greater opportunity for interpersonal contact and feedback and the formation of new friendships.

Recall of the past can enhance identity as participants relive former achievements. Reminiscence can develop self-esteem by increasing the level of self-referent knowledge (Kovach, 1990). Buffer (1963) viewed storytelling as a method which allowed older adults to come to terms both with their past lives as they were and with their own mortality. However, unexpressed feelings and unvoiced thoughts often arise as individuals remember unpleasant incidents in the past. Within gestalt reminiscence therapy, a supportive environment is created which allows participants to experience feelings associated with such events and come to terms with them.

Participants in gestalt reminiscence therapy increase their awareness, become more responsible for themselves and free themselves from shelved issues. Awareness is focused on the `here and now' and may involve either a current, recent or more distant event. Increased responsibility for themselves allows older adults to have a greater sense of empowerment, even within a nursing home setting. Group members are enabled to live more fully in the present by coming to terms with unfinished business. Emotions accompanying a particular story can be identified, expressed and completed.

Memories can be triggered in social interaction: being asked about memories will spark off memories (Sacks, 1995). However, memories can also be `objectified'. Particular articles can trigger memories because of their associations--when and where they were acquired or from whom they were received. Fairhurst (1997) stated that these type of objects are not just material things, they `are memories' (Fairhurst, 1997, p. 69). Memories can be embodied in places as well as possessions especially if the people associated with them are deceased.

Butler (1963) saw memories as a potential fount of mastery, wisdom and gratification. Reminiscing, therefore, has a therapeutic potential that goes beyond its social function. Recounting memories can be a way to approach talking about and appraising one's own life. Watt and Wong (1991) outlined a taxonomy of reminiscence as a first step in developing the therapeutic use of memories. They identified six different types: integrative, instrumental, transmissive, narrative, escapist and obsessive. The function of integrative reminiscence is to attain meaning and reconciliation with regard to one's past. It may involve working through feelings of guilt, failure and depression. Instrumental reminiscence acts as a buffer against emotional distress, as the person recalls past efforts in coping with difficult situations, sometimes in order to help solve a present difficulty. Watt (1986) found that this type of reminiscing is associated with `successful ageing' (cited in Watt and Wong, 1991). An instructive aspect identifies transmissive reminiscing: the speaker can `hand on' some enduring values acquired when growing up in a different era. These reminiscences, therefore, always concern `a moral'. They differ from purely narrative reminiscences, which are restricted to `descriptive or factual accounts of the past for the purpose of providing biographical information' (Watt and Wong, 1991, p. 49).

The two forms of memory-sharing which are not as adaptive in a coping sense are escapist and obsessive. The former has a fantasy/daydreaming quality, which can be viewed as beneficial by the speaker. Since the accent is on the `good old days', it allows an escape from a possibly much more gloomy present. The relief experienced is usually only temporary however. Obsessive reminiscing shows the preoccupation with disturbing past events and the speaker may be haunted by feelings of `guilt, resentment and despair' (Watt and Wong, 1991, p. 51). This type of reminiscence would be viewed as a marker of `unfinished business' in gestalt reminiscence therapy. Watt and Wong (1991) coded their subjects' recollections according to 11 themes: childhood memories; dating and marriage; domestic life; children and grandchildren; significant others (including relatives and friends); education and career (including personal accomplishments); societal events; health; relocation; death; and existential beliefs (including religious or philosophical beliefs regarding life and death).

Memories are the raw material of gestalt reminiscence therapy. Memories emerge through a number of different avenues, such as linking to objects and people, locations, past achievements, historical events, private events and public occasions, sensitive issues, a particular word, past and recent events. Recounting them can have a number of different functions from a social and therapeutic point of view. Memories can link people's experiences, giving group members a common ground and providing important interpersonal contact. The feeling of `shared experience' this type of reminiscing provides may then develop into subsequent interpersonal bonding. The group process is also facilitated through the linking of themes between group members. Memories can also serve to boost either the self-esteem of the speaker or another group participant by concentrating on past achievements. They can furthermore help to identify unfinished business, which may need to be worked on within the group setting or in one-to-one therapy. From a social-historical point of view, the act of relating memories can give the teller a sense of `empowerment' as a personal expert on the times they lived in.
- O'Leary, Eleanor; Nieuwstraten, Inge M.; The exploration of memories in Gestalt reminiscence therapy; Counselling Psychology Quarterly, Jun2001, Vol. 14 Issue 2
The article above contains foundational information. Articles below contain optional updates.


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Personal Reflection Exercise #3
The preceding section contained information about implementing Gestalt reminiscence therapy with older adults.  Write three case study examples regarding how you might use the content of this section in your practice.

Online Continuing Education QUESTION 17
What are four benefits to using Gestalt reminiscence therapy with older adults? Record the letter of the correct answer the CEU Answer Booklet.

 
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The scientific future of counseling psychology: Five specific areas of predictions. - June 29, 2017
To honor the 125th anniversary of the American Psychological Association, the scientific future of counseling psychology is highlighted in this special section. Five areas of research growth are covered: three in psychotherapy (research relative to sexual and gender minorities, the importance of the client perspective, and applications of machine learning), one in the application of the cultural lens approach, and one on aspects of privilege. Each of these areas has specific, testable hypotheses that can serve as stimuli for future research. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
White male power and privilege: The relationship between White supremacy and social class. - June 29, 2017
Counseling psychologists have studied privilege as an individual behavior, belief, and attitude related to an individual’s privileged identity such as masculinity, Whiteness, or Christianity. Conceptualizing individual privileged identities in this way means that privileged identities may exist alongside marginalized intersectional identities. However, in this article, the author defines privilege as a multi-identity act that is facilitated and supported by institutions and organizations (e.g., banks, law enforcement, and schools). These institutions are defined as power-governors that regulate access to scaffolds of privilege afforded to the affluent and wealthy. The author posits that power-governors were created to support an ideology of White supremacy and to organize actors within the system to perpetuate and legitimize the status quo. The author describes the ways in which White wealthy men use privilege as a means to access and gain power while White men in lower- and working-classes use privilege to build relationships and legitimize inequality. The author also discusses the proxy privilege of White women and people of color and how this privilege is in fact restricted to specific physical spaces and is limited due to their overt marginalized identities. Recommendations for privilege research are provided. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
The future of counseling psychology research viewed through the cultural lens approach. - June 29, 2017
In this article, we address the need for the future of counseling psychology research to adequately address issues of relevance and application of our theories across cultural groups. We bring the cultural lens approach (CLA; Hardin, Robitschek, Flores, Navarro, & Ashton, 2014) home to its roots in counseling psychology and address the approach’s application specifically within counseling psychology theory. First we provide a brief description of the CLA. Then we offer an in-depth example of how to apply the CLA to a specific theory, using Super’s (1953, 1957) Life-Span, Life-Space Theory of Career Development, and more specifically, the self-concept as an example. Importantly, we articulate how the CLA yields specific, testable hypotheses, providing multiple examples. We conclude with implications of the CLA for implementation of counseling psychology values, evaluating psychological theory, and research training. Adopting the CLA in future counseling psychology research will increase the cultural sensitivity of our work and widen the relevance and applicability of our findings. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Client-focused psychotherapy research. - June 29, 2017
Although the field of professional psychology has definitive evidence that therapy is effective, we do not yet have a good understanding of how therapy works or what makes it so effective. Although hundreds of research studies have been conducted on various aspects of psychotherapy, including client factors and outcome, in the current paper we argue that a key component of the psychotherapy enterprise that warrants additional empirical attention is the client. We readily acknowledge the need for researchers to continue to examine other aspects of psychotherapy, such as therapist factors, the therapy relationship, and the effectiveness of certain therapies or interventions for specific psychological conditions and problems. However, we believe that by pursuing research questions from the perspective of the client that we might be able to better understand clients’ experience in therapy and ways to tailor therapies and interventions to clients, uncover evidence about what actually engages and motivates the client, and gain a broader perspective about the nature of the therapy relationship. In the current paper we highlight fruitful areas for client-focused research, and within each area, we propose research questions that might stimulate further thinking and future empirical inquiries. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Improving the lives of sexual and gender minorities: The promise of psychotherapy research. - June 29, 2017
Current psychotherapy research with sexual and gender minorities (SGMs) is inadequate to address the health disparities in this population. Psychotherapy can benefit from research demonstrating the unique experiences of SGMs with respect to behavioral health, internalized stigma, coping, and resilience. This article describes research approaches, questions, and measurement that can be employed to study psychotherapy. Given the impact of minority stress and microaggressions on SGM individuals, many of the recommendations provided in this article focus on how these components should be infused throughout a diverse range of psychotherapy interventions. Namely, we provide recommendations for researchers focusing on SGM populations in randomized controlled trials and psychotherapy process research. We also provide 7 specific recommendations that focus on psychotherapy research measurement with SGM populations and how researchers can focus their efforts to reduce disparities for SGM individuals. Finally, we identify additional constructs to consider for future intervention research with SGM individuals. (PsycINFO Database Record (c) 2017 APA, all rights reserved)

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