Reminiscence Therapy in Depression Treatment in the Elderly: History
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Subjects: Computer Science, Artificial Intelligence
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Arshia Khan

Reminiscence therapy is a mechanism to help someone remember events from their life. It is often used as a therapy tool for reducing depression, calming behavioral and psychological symptoms of dementia, or affecting mood of the elderly. Although its most common use is for the elderly and people affected with dementia or depression, it has also been used with people of all ages, including children. The reminiscing process can take place in a group or individually or by using technological devices such as mobile devices or robots. It is marked by remembering notable events from the past.

  • aging
  • dementia
  • therapy
  • elderly

1. History of Reminiscence Therapy

Reminiscence therapy, described as “a non-pharmacological intervention involving the prompting of past memories, often with artifacts such as old photographs or music”, has been applied to help relieve depression, behavioral and psychological symptoms of dementia, address the social and emotional needs of people with dementia, offer “therapeutic benefits such as the facilitation of social interactions or the increase of self-esteem” [1]. Reminiscence therapy (RT) has been in use for decades. Although no research papers clearly identify the origin of reminiscence therapy, mentions of it have been seen as far back as the early 60s. A majority of the papers gave a positive tribute to this therapy mechanism. Butler was one of the first to discuss reminiscence therapy [2]. He described it as a “universal occurrence in older people of an inner experience or mental process of reviewing one’s life.” Erikson’s theory of life cycle argues the final stage of life (closer to death) requires mankind to “master the developmental conflict of the final stage of life which provides the primary motivation for reminiscence in old age” [3].
Over a period of time, various changes have been made in reminiscence therapy interventions. Recent trends have led to the employment of integrating technology into reminiscence therapy. Technology integration in reminiscence therapy has been used in a range of applications depending upon the type of technology that was being used. On the high end, robot-like systems have been used to conduct reminiscence therapy such as Hugvie, a humanoid shaped pillow, which presents a physical entity that the elderly can interact with and talk to [4]. Additionally, more high functioning robots have been recently used such as MARIO, a much larger humanoid robot, capable of video, speech, as well as interacting with those around it with its multiple sensors [5]. Another higher end robot with less capability is Zenbo Junior, a smaller robot that sits on a table and is capable of video and speech [6]. Robotic solutions are still a work in progress as of now and are continuing to be developed in hopes that they may help provide a more personalized experience. On the other hand, low end technologies are as simple as using digital photos and videos for sharing among individuals with dementia for therapy [7]. Additional technologies include VR (virtual reality), mobile applications, video streaming, and an internet-based recommender for caretakers. VR applications are mostly used for digital image viewing, both static and panoramic pictures, as a way of immersing the elderly in a memory [8]. Other uses include haptic feedback along with VR (replicating the sense of touch) as a way of furthering the immersion of the reminiscence therapy [9]. The use of android devices and applications also are being implemented as ways to facilitate reminiscence therapy. Such solutions include a media viewer of videos and photos providing a way of facilitating reminiscence to multiple elders simultaneously [10]. Current trends continue to push towards more and more technology integrations, foretelling the future of further inquiries of technological assistance in reminiscence therapy.

2. Reminiscence Therapy in the Treatment of Depression

Reminiscence therapy is “a reflective, narrative process that encourages senior adults to mentally access and tell their personal stories” [3][11]. It is used mostly as a support and counsel to seniors. Seniors recall themselves at a younger age which invokes happy memories (and sometimes sad) that allow them to socialize about or reflect upon. The interventions are usually for a period of time, ranging from short workshops with one session to longer periodical sessions over the course of weeks or months. Reminiscence therapy comes in two forms: individually and in groups, but recently technologically driven interventions are being explored as supplemental or even primary forms of intervention.

3. Interpretations of Reminiscence Therapy

There have been various interpretations of reminiscence therapy mechanisms utilized in the addressing of depression in the past. Some of these interpretations are group reminiscence therapy [12][13][14][15][16][17][18][19][20][21], autobiographical [22], psychologist-driven therapy [23], structured [24], standard [25], brief dynamic therapy [26], cognitive-behavior therapy [26][27], interpersonal psychotherapy [28], creative [29], companion robot [5], robot guided [6], digital [10], group art [30], individual [31][32], music [33], integrative [34][35][36], internet based video therapy [37], Lifebook [38], life review [39], mediation model [40], mobile solution [41], negative therapy (rumination) [42][43], photo [44], video [7], psychosocial [45], robotic assistive [4], tablet-based [46], transmissive [47], ubiquitous devices [48], virtual avatar [49], virtual reality [9], web interface based [50], and more. Some of the variations mentioned above have only been used once in a specific study, while group therapy has been the most widely used type of reminiscence therapy.
Given the variety in translation and application of reminiscence therapy, there are many different treatments to choose from. For instance, one approach could be constructive reappraisal of the past in a group using integrative reminiscence [21]. There is also transmissive reminiscence therapy (TRT) where seniors pass their skills to the younger generation, as shown in a study with college students and institutionalized senior adults [11]. Spiritual or internal reflections such as meditation have also been used as a way of calming one’s mind and reflecting on one’s life with a more focused method. Individual reminiscence therapies used religious songs, which lifts moods and spirit of individuals [32]. Music therapy has been shown to provide great supplemental effectiveness when tied to other forms of therapy as well. Further exploration into therapy involved bringing in healthcare professionals to give opinions and help design an effective intervention [50]. Psychologist-driven reminiscence therapy is a pre-planned activity of relaxation and exercises for group reminiscence [23]. More complicated therapies such as interpersonal psychotherapy [28] are being used as a more focused version of intervention. Cognitive-behavior and psychosocial therapies [26][27][44] are also being used to change moods in a more positive way. These studies use additional psychological tools to further improve the effectiveness. There is also creative reminiscence therapy which uses the medium of drawings, poems, and other creative media [21][29]. Some therapies also include Lifebook and life review that goes over the individual’s life as a whole [37][38]. Along with life review, autobiographical reminiscence helps with the recall of their own personal memories [22]. Some studies are exploring the effects of negative reminiscence, or rumination, as a way of understanding what effects reminiscence can have [42].
Additionally, there are adaptations of traditional reminiscence therapy techniques with technology-based methods. Although technology is being used in assistive technologies, it is designed based on technology and not taking user needs and usability in account [51]. Internet-based video and regular video-based reminiscence therapies are starting to be used [7][36]. Video-based solutions can either include video calls for virtual group reminiscence or past videos for virtual individual reminiscence. Mobile solutions to reminiscence therapy are also starting to be deployed [40], as well as tablet-based applications and other ubiquitous devices which are integrated into different methods of reminiscence therapy [45][47]. These applications of reminiscence therapy use prior techniques such as individual reminiscence to facilitate the interventions and reduce the workload for caregivers. Web-based applications are also used as a supplemental tool for caregivers in keeping track of and preparing for reminiscence therapies [49]. Other technology-based therapies include Virtual Reality reminiscence therapy, which uses a virtual reality headset to provide a more immersive reminiscence for individuals by showing panoramic scenes or pairing virtual reality with haptic feedback (physical stimuli that recreate feeling of touch) to facilitate the experience [9][43]. Robot interaction, integration, and design add a more humanoid integration of technology [4][5][6]. These robotic interactions are still being explored and designed, but the current studies produced provide a starting point for robot-based reminiscence therapies. Other humanoid technologies are also being developed and used to provide a more social experience such as virtual avatars [48]. These avatars are able to interact with individuals through a screen and act as facilitators for the therapy. Additional techniques are continuing to be developed and explored and will most likely start blending different methods of reminiscence to create stronger and more effective interventions.

4. Results of the Applications of Reminiscence Therapy

The plethora of interventions used are successful in improving overall quality of life and reducing depressive symptoms. Individual reminiscence helped reduce depression symptoms and provide a more positive mental state. Group reminiscence therapy also showed positive effects for personal quality of life, self-esteem, and reducing overall depressive symptoms. However, group reminiscence may only provide short term effects. This trend is also shown across each different type of intervention, in that they only provide short term effects, and therefore must be continuously used in order to remain effective. Integrative reminiscence therapy also shows positive results; however, it must be constructed carefully otherwise it can have few to no significant effects [33].

This entry is adapted from the peer-reviewed paper 10.3390/jal2010004

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