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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 Test | Table of Contents | Gestalt
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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 Test.

 
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Health disparities between genderqueer, transgender, and cisgender individuals: An extension of minority stress theory. - March 21, 2019
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A caballo regalao no se le mira el colmillo: Colonial mentality and Puerto Rican depression. - April 18, 2019
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The development and validation of the Emotional Cultivation Scale: An East Asian cultural perspective. - April 15, 2019
Research on emotion regulation in East Asian children and adolescents is limited. One obstacle hindering the development of emotion regulation for East Asian children and adolescents is the lack of a culturally sensitive measure. To fill this gap, we have developed and validated the Emotional Cultivation Scale using samples of Taiwanese children and adolescents. In Study 1, an exploratory factor analysis (n = 341) identified two factors: Cultivating Emotion Strategies and Understanding Emotion Connotations. A confirmatory factor analysis (n = 358) confirmed this two-factor structure. Coefficient αs were .69 to .88 for Emotional Cultivation. Convergent validity was evidenced by positive associations with cognitive reappraisal and cognitive flexibility. Discriminant validity was supported by a nonsignificant association with suppression. Concurrent validity was revealed by positive associations with positive affect, basic psychological need satisfaction, gratitude, responsiveness from teachers, responsiveness from parents, and academic self-efficacy. Incremental validity was evidenced by the finding that emotional cultivation significantly accounted for an additional 2 to 20% of the variance in predicting cognitive flexibility, positive affect, basic psychological need satisfaction, gratitude, responsiveness from teachers, responsiveness from parents, and academic self-efficacy above and beyond cognitive reappraisal and suppression. Results from the multigroup analysis further indicated factor loading invariance and validity invariance between boys and girls and between elementary and middle schools. The factor structure was cross-validated by a clinical sample of Taiwanese children and adolescents (N = 161) and their parents in Study 2 (N = 159). The counseling implications were discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Cognitive and affective expectation of stigma, coping efficacy, and psychological distress among sexual minority people of color. - May 30, 2019
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Surviving and thriving: Voices of Latina/o engineering students at a Hispanic serving institution. - April 15, 2019
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