The Comparison of the Effectiveness of Psychodrama, Reminiscence and Rational-Emotional and Behavioral Treatment on Death Anxiety in the Elderly

Document Type : Original Article

Authors

1 Department of Psychology and Counseling, Kermanshah Branch, Islamic Azad University, Kermanshah, Iran

2 Assistant Professor, Department of Psychology and counseling, Kermanshah Branch, Islamic Azad University, Kermanshah, Iran

3 Associate Professor, Department of Psychology and Counseling, Kermanshah Branch, Islamic Azad University, Kermanshah, Iran

4 ، Department of Psychology, Islamic Azad University, Kermanshah Branch

10.22126/jap.2020.5456.1436

Abstract

Given the growing number of elderly population, the importance of old age and the problems this age group faces in the society, such as death anxiety (DA), identifying and comparing interventions to improve elderlies’ mental health, treatment and rehabilitation seems required in elderly-related researches. Therefore, the present study aimed to evaluate the effectiveness of psychodrama, reminiscence and Allis’s rational-emotional and behavioral therapy (REBT) on DA in the elderly. It was a quasi-experimental study with pretest-posttest design and control group. The statistical papulation included all male elderly with DA residing in nursing homes in Kermanshah, Iran. At first, selected through convenience sampling was a center in which 40 elderlies were selected according to inclusion criteria and randomly divided to three experimental and one control groups. Psychodrama group received 12 sessions of 60 minutes within a period of one and half months, reminiscence group received 10 sessions of 90 minutes within a period of five weeks and REBT group received eight twice a week sessions within a period of one month. Templar’s short psychology and DA questionnaires were used to collect the required data. The results from univariate covariance analysis (ANCOVA) indicated that all three treatments were significantly effective in reducing DA (p < 0.05). Likewise, the results of LSD post hoc test showed the significant difference between psychodrama and reminiscence (p < 0.01) and between psychodrama and REBT (p < 0.01). Though the difference was not significant between reminiscence and REBT in decreasing of DA among elderly (p < 0.01). Hence, psychologists in elderly domain can utilize these interventions, specifically psychodrama, to reduce DA in aged people.

References
Abdollahzadeh, H., & Khabazi, M. (2017). Effectiveness of Integrative Reminiscence on Health anxiety, Death Depression and Perceived Stress in Elderly. Health Psycholigy, 6(22), 101-114. [Persian]
Afshari, A., Rezaei, R.., & Dadras, F. (2019). The effectiveness of structured reminiscence on reducing anxiety and depression in the elderlyAging Psychology, 5 (3), 201-215. [Persian]
Amani, R., Majzoobi, M. R., & Hamedani, K. H. (2020). The Construction and validation of the elderly reminiscence questionnaire. Aging Psychology, 5 (4), 333-345. [Persian]
Azeem, F., & Naz, M.A. (2015). Resilience, death anxiety, and depression among instionalized and non-institutionzlized elderly. Pakistan journal of psychological research, 30 (1), 111-130.
Barr, P., & Cacciatore, J. (2008). Personal fear of death and grief in bereaved mothers. Death Studies, 32(5),445-460.
Beauvais, A. M., Özbaş, A. A., & Wheeler, K. (2019). End-of-life psychodrama: Influencing nursing students’ communication skills, attitudes, emotional intelligence and self-reflection. Journal of Psychiatric Nursing, 10(3), 103-110.
‏Bordbar, F. T., Esmaeili, M., & Asadi, R. (2019). Prediction of death anxiety in the elderly based on personality types and mental health. Aging Psychology, 5 (3), 239-249. [Persian]
Blatner, A. (2007). The role of the meta-role: An integrative element in psychology. In C. Baim, J. Burmeister, & M. Maciel (Eds.), Psychodrama: Advances in theory and practice (pp. 53-65). Routledge.
Bryant, F. B., Smart, C.M., & King, S.P. (2012). Using the past to enhance the present: Boosting happiness through positive reminiscence. Journal of Happiness Studies, 6 (3), 227-260.
Crumb, L. (2019). Integrating feminist narrative therapy, person-centered therapy, and rational emotive behavioral therapy: A short-term case study. International Journal of Integrative Psychotherapy9, 56-72.‏
Felsman, P., Seifert, C.M., & Himle, J.A. (2019). The use of improvisational theater training to reduce social anxiety in adolescents. The Arts in Psychotherapy, 63, 111-117. https://doi.org/10.1016/j.aip.2018.12.001
Furer, P., & Walker, J.R. (2008). Death anxiety: Acognitive-behavioral approach. Journal of Cognitive Psychotherapy, 22(2), 167-182.
Moran, G. S., & Alon, U. (2011). Playback theatre and recovery in mental health: Preliminary evidence. The Arts in Psychotherapy38(5), 318-324.
‏Ghamari­ kivi, H., Zahed bablan, A., & Fathi, D. (2015). Effectivenss of grroup cognitive-behavioral therapy on death anxiety among the breavement elderly men. Quarterly Journal of Elderly Nursing, 1(4), 60-69. [Persian]

Hamamci, Z. (2006). Integrating psychodrama and cognitive behavioraltherapy to treate moderate deppretion. The Arts in Psychotherapy, 33(3), 199-207.

Hoeltrerhoff, M. (2010). Resiliance against death anxity in relationship to post-traumatic stress disorder and psychiatric co-morbidity (Doctoral disseratation, University of plymouth).
Hofer, J., Busch, H., Au, A., Poláčková Šolcová, I., Tavel, P., & Tsien Wong, T. (2020). Reminiscing to teach others and prepare for death is associated with meaning in life through generative behavior in elderlies from four cultures. Aging & Mental Health24(5), 811-819.
‏Johnson, D. (2012, July). Psychodrama and the Elderly. In FORUM. FrancoAngeli Editore. https://doi.org/10.3280/FORU2012-005012
‏Jo, K.H., & An, G.J. (2018). Effects of a group reminiscence program on self-forgiveness, life satisfaction, and death anxiety among institutionalized older adults. Korean Journal of Adult Nursing, 30(5), 546-554.
Jones, E.D., & Beck-Little, R. (2012). The use of reminisce therapy for the treatment of depression in rural –dwelling older adults. Issues in Mental Health Nursing, 23(3), 279-290.
Jones, E.D. (2013). Examination of reminiscence therapy for depressed older women residing in a Long-term care facility using the Nursing Intervention classification. Journal of Gerontological Nursing, 29(7), 27-33.
Jong, j., Ross, Ph,T., Chang, S.H., Simon, N., & Halberstadt, J. (2018). The religious correlates of death anxity: a systematic review and meta-analysis. Religion, Brrain & Behavior, 8(1), 4-20.
Jo Rody, L. (2018). How drama therapy can help people with autism. Verywell Health Newsleter. http://www. very wellhealth. com/how-can-drama-therapy-help-people -with-autism-260295.
Kaya, F., & Deniz, H. (2020). The effeces of using psychodrama on the psychological wellbeing of university students. Perspect­ Psychiatric Care,1-8. https://doi.org/10.1111/ppc.12510
King, D.B. (2019). Functions of reminiscence in later life: Predicting change in the physical and mental health of older adults over time. Aging Ment Health, 23 (2), 246-254.
Majzoobi, M. R., Momeni, Kh., Amani, R., & Hojjat Khah, M. (2012). The Effectiveness of structured group reminiscence on the enhancement  of the elderlyes life quality and happines. Transformational Psychology: Iranian Psychologists, 9 (4), 189-202. [Persian]
Mckenzie, E. L., Brown, P. M., Mak, A. S., & Chamberlin, P. (2017). Old and ill: Death anxiety and coping strategies influencing health professionals well-being and dementia care. Aging & Mental health, 21 (6), 634-641.
Momeni, K., & Delfan, Z. R. (2018). The Effectiveness of optimist memory telling on death anxiety and the sense of aging in elderly. International Journal of Behavioral Sciences, 12 (2), 69-75.
Moudi, GH., Bijani, A., Tayebi, M., & Habibi, S. (2017). Relationship between death anxiety and mental health status among nurses in haspitals affiliated to babol university of medical sciences. journal of Babol University Medical Sciences, 19 (2), 47-53.
Oguzhanoglu, N. K., & Osman, O. (2005). Elderly, nursing homes and life voyages: a psychodrama group study. Turk Psikiyatri Dergisi, 16(2), 124-132.
Onyechi, K. C. N., Onuigbo, L. N., Eseadi, C., Ikechukwu-Ilomuanya, A. B., Nwaubani, O. O., Umoke, P. C.,  Agu, F. U., Otu, M. S., & Utoh-Ofong, A. N. (2016). Effects of rational-emotive hospice care therapy on problematic assumptions, death anxiety, and psychological distress in a sample of cancer patients and their family caregivers in Nigeria. International journal of environmental research and public health13(9), 929.‏
Nooripourliavli, R., Alikhani, M., Hosseinian, S., Soheilizadeh, S., & Mohammadifar, M. A. (2016). The Effectiveness of group reminiscence on happiness and life expectancy in elderly.Journal of Aging Psychology, 1(3), 147-156. [Persian]
Poordad, S., Momeni, K., & karami, J. (2019). Death anxiety and its relationship with social support and gratitude in older adults. Iranian Journal of Ageing, 14 (1), 26-39. [Persian]
Prosen, S., & Jendričko, T. (2018). A Pilot study of emotion regulation strategies in a psychodrama group of psychiatric patients. Journal of Creativity in Mental Health, 14 (1), 2-9.
Roger, J.S., Michele, Y.W., Sue, R., Gail, J., & Josephine, M.C. (2016). Knowing, planning for and fearing death: Do adults with intellectual disability and disability staff differ? Journal of Reserch in Developmental Disabilities, 49 (12), 47-59.
Rosner, R. (2011). Albert Ellis’ Rational-Emotive Behavior Therapy. Adolescente Psychiatry, 1(1), 82-87.
Safarzadeh, S. (2019). The Effectiveness of group reminiscence on defeat, gratitude and optimism feelings in the elderly women in nursing homes.Journal of Aging psychology, 5(1), 27-40. [Persian]
Semenova, V., & Stadtlander, L.M. (2016). Death anxiety, depression, and coping in family caregivers. Journal of Social, Behavioral, and Health Sciences, 10(1), 34-48.
Simon, D. (2014). Death Anxiety in Palliative Care.Palliative Medicine Care, 1 (1), 1-2.
Syed Elias, S.M., Neville, C., & Scott, T. (2015). The Effectiveness of group reminiscence Thrapy for loneliness,anxeity and deprestion in older adults in long-term care: A systematic review. Geriatric Nursing, 36(5), 1-9.
Tavakoli, G., Dehnavi, S. R., & Montajabian, Z. (2020). The Effectiveness of positive psychotherapy on pain perception and death anxiety in the elderly. Aging Psychology, 5(4), 321-332. [Persian]
Testoni, I. (2019). When death enters the theater of psychodrama: Perspectives and strategies of psychodramatist. Journal of Loss and Trauma, 24 (5-6), 516-532.
Turner, M.J., Ewen, D., & Barker, J.B. (2018). An Idiographic single-case study examining the use of rational emotive behavior therapy (REBT) with three amateur golfers to alleviate social anxiety. Journal of Applied Sport Psychology, 32 (2), 186-204.
Turner, M.J., & Davis, H.S. (2018). Exploring the effects of rational emotive behavior therapy on the irrational beliefs and self-determined motivation of triathletes. Journal of Applied Sport Psychology, 31(3), 253-272.
Yen, H.Y., & Lin, J. (2018). A Systematic review of reminiscence therapy for older adults in Taiwan. Journal of Nursing Research, 26(2), 138-150.
Zareh, M. & Shafie Abadi, A. (2007). Comparison of the effectiveness of rational-emotional, behavioral group counseling and the method of mental counseling in increasing general health and emotional expression of female clients.Women's Research (Women's Studies), 1(21), 25-41. [Persian]

Keywords


References
Abdollahzadeh, H., & Khabazi, M. (2017). Effectiveness of Integrative Reminiscence on Health anxiety, Death Depression and Perceived Stress in Elderly. Health Psycholigy, 6(22), 101-114. [Persian]
Afshari, A., Rezaei, R.., & Dadras, F. (2019). The effectiveness of structured reminiscence on reducing anxiety and depression in the elderly. Psychology of Aging, 5 (3), 201-215. [Persian]
Amani, R., Majzoobi, M. R., & Hamedani, K. H. (2020). Construction and validation of a questionnaire for the elderly. Psychology of Aging, 5 (4), 333-345. [Persian]
Azeem, F., & Naz, M.A. (2015). Resilience, death anxiety, and depression a mong instionalized and non-institutionzlized elderly. Pakistan journal of psychological research, 30 (1), 111-130.
Barr, P., & Cacciatore, J. (2008). Personal fear of death and grief in bereaved mothers. Death Studies, 32(5),445-460.
Beauvais, A. M., Özbaş, A. A., & Wheeler, K. (2019). End-of-life psychodrama: Influencing nursing students’ communication skills, attitudes, emotional intelligence and self-reflection. Journal of Psychiatric Nursing, 10(3), 103-110.
‏Bordbar, F. T., Esmaeili, M., & Asadi, R. (2019). Prediction of death anxiety in the elderly based on personality types and mental health.Psychology of Aging, 5 (3), 239-249. [Persian]
Blatner, A. (2007). The role of the meta-role: An integrative element in psychology. In C. Baim, J. Burmeister, & M. Maciel (Eds.), Psychodrama: Advances in theory and practice (pp. 53-65). Routledge.
Bryant, F. B., Smart, C.M., & King, S.P. (2012). Using the past to enhance the present: Boosting happiness through positive reminiscence. Journal of Happiness Studies, 6 (3), 227-260.
Crumb, L. (2019). Integrating feminist narrative therapy, person-centered therapy, and rational emotive behavioral therapy: A short-term case study. International Journal of Integrative Psychotherapy9, 56-72.‏
Felsman, P., Seifert, C.M., & Himle, J.A. (2019). The use of improvisational theater training to reduce social anxiety in adolescents. The Arts in Psychotherapy, 63, 111-117. https://doi.org/10.1016/j.aip.2018.12.001
Furer, P., & Walker, J.R. (2008). Death anxiety: Acognitive-behavioral approach. Journal of Cognitive Psychotherapy, 22(2), 167-182.
Moran, G. S., & Alon, U. (2011). Playback theatre and recovery in mental health: Preliminary evidence. The Arts in Psychotherapy38(5), 318-324.
‏Ghamari­ kivi, H., Zahed bablan, A., & Fathi, D. (2015). Effectivenss of grroup cognitive-behavioral therapy on death anxiety among the breavement elderly men. Quarterly Journal of Elderly Nursing, 1(4), 60-69. [Persian]
Hamamci, Z. (2006). Integrating psychodrama and cognitive behavioraltherapy to treate moderate deppretion. The Arts in Psychotherapy, 33(3), 199-207.
Hoeltrerhoff, M. (2010). Resiliance against death anxity in relationship to post-traumatic stress disorder and psychiatric co-morbidity (Doctoral disseratation, University of plymouth).
Hofer, J., Busch, H., Au, A., Poláčková Šolcová, I., Tavel, P., & Tsien Wong, T. (2020). Reminiscing to teach others and prepare for death is associated with meaning in life through generative behavior in elderlies from four cultures. Aging & Mental Health24(5), 811-819.
‏Johnson, D. (2012, July). Psychodrama and the Elderly. In FORUM. FrancoAngeli Editore. https://doi.org/10.3280/FORU2012-005012
‏Jo, K.H., & An, G.J. (2018). Effects of a group reminiscence program on self-forgiveness, life satisfaction, and death anxiety among institutionalized older adults. Korean Journal of Adult Nursing, 30(5), 546-554.
Jones, E.D., & Beck-Little, R. (2012). The use of reminisce therapy for the treatment of depression in rural –dwelling older adults. Issues in Mental Health Nursing, 23(3), 279-290.
Jones, E.D. (2013). Examination of reminiscence therapy for depressed older women residing in a Long-term care facility using the Nursing Intervention classification. Journal of Gerontological Nursing, 29(7), 27-33.
Jong, j., Ross, Ph,T., Chang, S.H., Simon, N., & Halberstadt, J. (2018). The religious correlates of death anxity: a systematic review and meta-analysis. Religion, Brrain & Behavior, 8(1), 4-20.
Jo Rody, L. (2018). How drama therapy can help people with autism. Verywell Health Newsleter. http://www. very wellhealth. com/how-can-drama-therapy-help-people -with-autism-260295.
Kaya, F., & Deniz, H. (2020). The effeces of using psychodrama on the psychological wellbeing of university students. Perspect­ Psychiatric Care,1-8. https://doi.org/10.1111/ppc.12510
King, D.B. (2019). Functions of reminiscence in later life: Predicting change in the physical and mental health of older adults over time. Aging Ment Health, 23 (2), 246-254.
Majzoobi, M. R., Momeni, Kh., Amani, R., & Hojjat Khah, M. (2012). The Effectiveness of structured group reminiscence on the enhancement  of the elderlyes life quality and happines. Transformational Psychology: Iranian Psychologists, 9 (4), 189-202. [Persian]
Mckenzie, E. L., Brown, P. M., Mak, A. S., & Chamberlin, P. (2017). Old and ill: Death anxiety and coping strategies influencing health professionals well-being and dementia care. Aging & Mental health, 21 (6), 634-641.
Momeni, K., & Delfan, Z. R. (2018). The Effectiveness of optimist memory telling on death anxiety and the sense of aging in elderly. International Journal of Behavioral Sciences, 12 (2), 69-75.
Moudi, GH., Bijani, A., Tayebi, M., & Habibi, S. (2017). Relationship between death anxiety and mental health status among nurses in haspitals affiliated to babol university of medical sciences. journal of Babol University Medical Sciences, 19 (2), 47-53.
Oguzhanoglu, N. K., & Osman, O. (2005). Elderly, nursing homes and life voyages: a psychodrama group study. Turk Psikiyatri Dergisi, 16(2), 124-132.
Onyechi, K. C. N., Onuigbo, L. N., Eseadi, C., Ikechukwu-Ilomuanya, A. B., Nwaubani, O. O., Umoke, P. C.,  Agu, F. U., Otu, M. S., & Utoh-Ofong, A. N. (2016). Effects of rational-emotive hospice care therapy on problematic assumptions, death anxiety, and psychological distress in a sample of cancer patients and their family caregivers in Nigeria. International journal of environmental research and public health13(9), 929.‏
Nooripourliavli, R., Alikhani, M., Hosseinian, S., Soheilizadeh, S., & Mohammadifar, M. A. (2016). The Effectiveness of group reminiscence on happiness and life expectancy in elderly.Journal of Aging Psychology, 1(3), 147-156. [Persian]
Poordad, S., Momeni, K., & karami, J. (2019). Death anxiety and its relationship with social support and gratitude in older adults. Iranian Journal of Ageing, 14 (1), 26-39. [Persian]
Prosen, S., & Jendričko, T. (2018). A Pilot study of emotion regulation strategies in a psychodrama group of psychiatric patients. Journal of Creativity in Mental Health, 14 (1), 2-9.
Roger, J.S., Michele, Y.W., Sue, R., Gail, J., & Josephine, M.C. (2016). Knowing, planning for and fearing death: Do adults with intellectual disability and disability staff differ? Journal of Reserch in Developmental Disabilities, 49 (12), 47-59.
Rosner, R. (2011). Albert Ellis’ Rational-Emotive Behavior Therapy. Adolescente Psychiatry, 1(1), 82-87.
Safarzadeh, S. (2019). The Effectiveness of group reminiscence on defeat, gratitude and optimism feelings in the elderly women in nursing homes.Journal of Aging psychology, 5(1), 27-40. [Persian]
Semenova, V., & Stadtlander, L.M. (2016). Death anxiety, depression, and coping in family caregivers. Journal of Social, Behavioral, and Health Sciences, 10(1), 34-48.
Simon, D. (2014). Death Anxiety in Palliative Care.Palliative Medicine Care, 1 (1), 1-2.
Syed Elias, S.M., Neville, C., & Scott, T. (2015). The Effectiveness of group reminiscence Thrapy for loneliness,anxeity and deprestion in older adults in long-term care: A systematic review. Geriatric Nursing, 36(5), 1-9.
Tavakoli, G., Dehnavi, S. R., & Montajabian, Z. (2020). The Effectiveness of positive psychotherapy on pain perception and death anxiety in the elderly. Psychology of Aging, 5(4), 321-332. [Persian]
Testoni, I. (2019). When death enters the theater of psychodrama: Perspectives and strategies of psychodramatist. Journal of Loss and Trauma, 24 (5-6), 516-532.
Turner, M.J., Ewen, D., & Barker, J.B. (2018). An Idiographic single-case study examining the use of rational emotive behavior therapy (REBT) with three amateur golfers to alleviate social anxiety. Journal of Applied Sport Psychology, 32 (2), 186-204.
Turner, M.J., & Davis, H.S. (2018). Exploring the effects of rational emotive behavior therapy on the irrational beliefs and self-determined motivation of triathletes. Journal of Applied Sport Psychology, 31(3), 253-272.
Yen, H.Y., & Lin, J. (2018). A Systematic review of reminiscence therapy for older adults in Taiwan. Journal of Nursing Research, 26(2), 138-150.
Zareh, M. & Shafie Abadi, A. (2007). Comparison of the effectiveness of rational-emotional, behavioral group counseling and the method of mental counseling in increasing general health and emotional expression of female clients.Women's Research (Women's Studies), 1(21), 25-41. [Persian]