Integrative and instrumental reminiscence therapies for depression in older adults: intervention strategies and treatment effectiveness

Reminiscence has been identified as an important contributor to adaptation in later life by gerontologists, developmental theorists and clinical practitioners. Despite its wide acceptance as an intervention, there remains some doubt about its therapeutic efficiency. In order to assess the value of reminiscence for the treatment of depression in older adults, cognitive theories of depression were integrated with reminiscence theory to develop two standardized integrative and instrumental reminiscence interventions. Integrative reminiscence therapy aims at a constructive re-appraisal of interpretations and emotions to past self-defining events, whereas instrumental reminiscence uses memories for providing evidence of past successful coping and for identifying appropriate coping strategies. These interventions were implemented in a short-term group format and compared to an active socialization group as the control condition. Twenty-six older adults with moderate to severe depression constituted the sample. Evaluation of the clinical significance of the results showed that both reminiscence therapies led to significant improvements in the symptoms of depression at the end of the intervention. In the integrative group, 58% of clients demonstrated clinically significant improvement at post-test, yielding an effect size (ES) of 0.86. At follow-up three months later, 100% of integrative clients had improved clinically (ES=0.96). In the instrumental group, 56% of clients demonstrated clinically significant improvement at post-test (ES=0.81) and 88% improved at the follow-up (ES=0.89).