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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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Critical consciousness moderates the relationship between transphobia and “bathroom bill” voting. - July 12, 2018
In recent years, antitransgender legislation that focuses on gender and the use of public restrooms—so-called bathroom bills—has been considered in many states in the United States. The present study was designed to extend research on transphobic attitudes and elucidate links between religious fundamentalism, social dominance orientation, transphobia, and voting for bathroom bills. Further, we examined the moderating influence of critical consciousness on the relationship between transphobic attitudes and voting on a hypothetical bathroom bill. Results of a moderated mediation multinomial logistic regression path analysis using data from a sample of 282 college students (154 women and 128 men) indicated that religious fundamentalism and social dominance orientation were associated with transphobic attitudes. Transphobia was associated with lower likelihood to vote against or abstain from voting on the bill, compared to voting for it. Critical consciousness was also associated with greater likelihood of voting against the bill rather than for it. The interaction between transphobia and critical consciousness was associated with voting against rather than for the bill, such that at higher levels of transphobia, those higher in critical consciousness were more likely to vote against the bill rather than for it. Implications for incorporating critical consciousness into advocacy efforts to promote transgender rights are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
Socialization and well-being in multiracial individuals: A moderated mediation model of racial ambiguity and identity. - July 12, 2018
Scholarly interest in racial socialization is growing, but researchers’ understanding of how and when racial socialization relates to well-being is underdeveloped, particularly for multiracial populations. The present study investigated moderated mediation models to understand whether the indirect relations of egalitarian socialization to subjective well-being and self-esteem through integrated multiracial identification were conditional on phenotypic racial ambiguity among 383 multiracial adults. Tests of moderated mediation in primary analyses were significant for subjective well-being and self-esteem. Consistent with the hypotheses, egalitarian socialization was linked to a stronger multiracial integrated identity, which was positively associated with subjective well-being and self-esteem for those with moderate and high phenotypic racial ambiguity. This indirect effect was not significant for those reporting low phenotypic racial ambiguity. Results suggested a positive role of egalitarian socialization in relation to integrated identity and well-being for multiracial adults. This study highlights a culturally relevant pathway through which egalitarian socialization impacts well-being through racial identification for multiracial adults and the conditions of phenotypic racial ambiguity that contextualize this indirect effect. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
Work as a calling: A theoretical model. - July 12, 2018
Perceiving work as a calling has been positioned as a key pathway to enhancing work-related well-being. However, no formal theory exists attempting to explain predictors and outcomes of living a calling at work. To address this important gap, this article introduces a theoretical, empirically testable model of work as a calling - the Work as Calling Theory (WCT) - that is suitable for the contemporary world of work. Drawing from research and theory in counseling, vocational, multicultural, and industrial-organizational psychology, as well as dozens of quantitative and qualitative studies on calling, the WCT is presented in three parts: (a) predictors of living a calling, (b) variables that moderate and mediate the relation of perceiving a calling to living a calling, and (c) positive (job satisfaction, job performance) and potentially negative (burnout, workaholism, exploitation) outcomes that result from living a calling. Finally, practical implications are suggested for counselors and managers, who respectively may seek to help clients and employees live a calling. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
When in doubt, sit quietly: A qualitative investigation of experienced therapists’ perceptions of self-disclosure. - July 12, 2018
Using consensual qualitative research (CQR), we analyzed 13 interviews of experienced psychotherapists about general intentions for therapist self-disclosure (TSD), experiences with successful TSDs, experiences with unsuccessful TSDs, and instances of unmanifested urges to disclose. For TSD generally (i.e., not about a specific instance), typical intentions were to facilitate exploration and build and maintain the therapeutic relationship. Therapists typically reported becoming more comfortable using TSD over time. In successful TSDs, the typical content was accurate, relevant similarities between therapist and client; typical consequences were positive. In unsuccessful TSDs, the typical antecedent was countertransference reactions; the typical intention was to provide support; typical content involved therapists mistakenly perceiving similarities with clients; and the general consequences were negative. In instances when therapists repressed the urge to disclose, the typical antecedent was countertransference and the content typically seemed relevant to the client’s issues. We conclude that effective use of TSD requires general attunement to the client’s dynamics, attunement to the client’s readiness in the moment, ability to manage countertransference, and ability to use a specific TSD appropriately. Implications for practice, training, and research are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
Self-compassion buffers the link between self-criticism and depression in trauma-exposed firefighters. - June 21, 2018
Firefighters are frequently exposed to highly stressful, potentially traumatic events (PTEs). More than 50%, however, show no significant elevation in trauma-related symptomatology (e.g., depression). In the past, self-compassion has been discussed to promote psychological and behavioral flexibility that is vital to a successful adaptation to PTEs. The goal of this study was to understand whether and how self-compassion may alleviate personal suffering in the face of PTEs. We hypothesized that individuals who encounter their profession-related affective experiences with greater self-compassion, show lower levels of depressive symptoms because self-compassion buffers processes that perpetuate negative affectivity in response to PTEs (i.e., self-critical tendencies). Male firefighters (N = 123) completed self-report questionnaires about the severity of current depressive symptoms; prior traumatic, duty-related events; and the self-compassion scale that assesses two distinct factors: self-criticism and self-compassion. A stepwise regression model was employed to examine differential and interactive contributions of self-criticism and self-compassion to symptoms of depression across the cumulative range of exposure to PTEs. Our results indicate that the positive association between self-criticism and depression is buffered by enhanced levels of self-compassion. This moderation, however, only emerged for firefighters with substantial amounts of PTEs experience in the past. The present work provides insight into protective effects of self-compassion in the face of cumulative PTEs. It suggests that, particularly for severely trauma-exposed firefighters, self-compassion may confer resilience, that is, act as a protective factor from the development of depressive symptoms. Findings are discussed in light of counseling implications. (PsycINFO Database Record (c) 2018 APA, all rights reserved)

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