اثربخشی گشتالت‌درمانی بر افسردگی، تمایزیافتگی، خودشناسی انسجامی و ویژگی‌های روان‌شناختی مثبت سالمندان

Elderly seems to be one of the most important stages of individuals’ life. Considering the growing number of elderly population, it appears necessary to have didactic and therapeutic interventions that affect their psychological well-being significantly and increase their life expectancy. Therefore, this research aimed to determine the effectiveness of gestalt therapy on depression, self-differentiation, integrative self-knowledge and positive psychological characteristics of the elderly in Isfahan. Iran.  It was a semi-experimental study with pretest-posttest and control group design along with a follow-up. The statistical papulation included all the elderly above 60-year old living in Isfahan. Two centers were selected among education retirees organization using convenience sampling and then, 40 elderly people were recruited purposefully according to eligibility criteria and assigned randomly into two groups of experimental and control with equal numbers in each group (20 members). The experimental group underwent gestalt therapy for 11 90-minute sessions, while the control group received no intervention during this period. Used to collect data were scales of elderly depression (Yesavage et al.), self-differentiation (Skowron & friedlander), integrative self-knowledge (Gorbani et al.) and positive psychological characteristics (Rashid). The collected data were analyzed using SPSS-23. The results of analysis of covariance (ANCOVA) demonstrated that gestalt therapy results in improvement of depression, self-differentiation, integrative self-knowledge and positive psychological characteristics in the elderly (p < 0.05). According to the findings of this research, gestalt therapy can be applied as an efficient pattern in counselling and psychotherapy centers to decrease depression and to improve self-differentiation, integrative self-knowledge and positive psychological characteristics for the elderly.

References
Afshari, A., Rezaei, R., & Dadras, F. (2019). The Effectiveness of structured reminiscence on anxiety and depression in the elderly. Journal of Aging Psychology, 5(3), 201-215. [Persian]
Agaziarati Farahani, Z., Zahrakar, K., & Azarmidokht, R. (2010). The Investigation of the effect of group gestalt therapy on mental health promotion of female students of Islamic Azad University, eslamshahr branch. Counseling Research, 31, 79-63. [Persian]
Alizadeh Bazrafshan, F., & Pourheidari, S. (2017). The investigation of psychological resilience of elderly and its relationship differentiation of self and meaning of life. The 8^th International Conference of Psychology and Social Sciences, 1-15. [Persian]
Arabzadeh, M. (2017). Relationship between basic psychological needs and mental vitality in the elderly. Iranian Journal of Ageing (Salmand), 12 (2), 17-179. [Persian]
Bahrant, F., SOdanT, M., & Mehrabi-zade Honarmand, M. (2010). The effect of gestalt therapy on self-esteem, depression and loneliness of depressed divorced women. Quarterly Journal of Women’s Studies Sociological and Psychological, 8(1), 129-145. [Persian]        
Brise, N., Camp, C., & Snclgar, R. (2012). Psychology data analysis by the application of SPSS. (A.Samadi & kh. Aliabadi, Trans.). Davarn Publication. (Original Language release date, 2006) [Persian]
Cacioppo, J. T., Hughes, M. E., Waite, L. J., Hawkley, L. C., & Thisted, R. A. (2006). Loneliness as a specific risk factor for depressive symptoms: cross-sectional and longitudinal analyses. Psychology and aging, 21(1), 140-151.
Ciucurel, C., & Iconaru, E. I. (2012). Association between metabolic syndrome and depression in elderly. Procedia-social and behavioral sciences, 33, 994-997.
Curvers, N., Pavlova, M., Hajema, K., Groot, W., & Angeli, F. (2018). Social participation among older adults (55+): Results of a survey in the region of South Limburg in the Netherlands. Health & social care in the community, 26(1), 85-93.
Dehdari, T., Delvarianzadeh, M., Ariaeean, N., khosravi, F., & Bahar, A. (2019). Nutritional status and its related factors in older people residing in nursing homes in semnan province, Iran, 2017. Iranian Journal of Ageing (Salmand), 14(2), 224-235. [Persian]
Emaminaeini, M., Bakhtiyari, M., Hatami, H., Khodakarim, S., & Sahaf, R. (2017).Depression and perceived social support in the elderly. Iranian Journal of Ageing (Salmand), 12(2), 192-207. [Persian]

Fakhar, F., Navayinezhad, S., & Foroughan, M. (2008). The Role of group counseling with logo-therapeutic approach on the mental health of older women. Iranian Journal of Ageing (Salmand), 3(1), 58-67. [Persian]  
Farokhzadian, A. A., & Mirderekvand, F. (2018). The effectiveness of self-compassion focused therapy on increase of psychological well-being and reduction of depression in the elderly. Journal of Aging Psychology, 3(4), 293-302. [Persian]
Fleiss, J. L., Levin, B., & Paik, M. C. (1981). The analysis of data from matched samples. Statistical Methods for Rates and Proportions. Third Edition, 373-406.
Flint, S. W., Lam, M. H. S., Chow, B., Lee, K. Y., Li, W. H. C., Ho, E.,Yang , L., & Yung, N. K. F. (2017). A systematic review of recreation therapy for depression in older adults. Journal of Psychology and Psychotherapy, 7(2), 1-7.
Frouzande, Z., Mami, Sh., & Amani, Q. (2020). The effectiveness of group logotherapy on resiliency, depression and quality of life in elderly. Journal of Gerontology, 4(4), 19-29. [Persian]
Ghasemi Pirbalouti, M., Shariat, A., & Ghazanfari, A. (2019). A Meta-Analysis of exercise therapy on reducing depression among older adults in Iran. Quarterly Journal of Health Psychology, 8(30), 69-80. [Persian]
Ghorbani, N., Cunningham, C. J. L., & Watson, P. J. (2010). Comparative analysis of integrative self-knowledge, mindfulness, and private self-consciousness in predicting responses to stress in Iran. International Journal of Psychology, 45(2), 147-154.
Ghorbani, N., Watson, P. J., & Hargis, M. B. (2008). Integrative Self-knowledge scale: Correlations and incremental validity of a cross-cultural measure developed in Iran and United States. The Journal of Psychology, 142(4), 395-412.
Ghorbani, Z., Banijamali, Sh., Ameri, F., Khosravi, Z., & Dehshiri, Gh. (2015). Investigating psychometric properties of the Persian version of positive psychotherapy inventory. Positive Psychology Research, 2(2), 15-26. [Persian]
Ghorbanian, E., Mohammadlo, H., Rasooli, R., khoshpoor, F., Samarisafa, J., & kargarbarzi, H. (2017). Psychometric properties of the marital satisfaction questionnaire of the elderly and its components prediction through sexual inventory and mental health in the elderly in the one and six district of province Tehran. Journal of Gerontology, 1(3), 31-40. [Persian]
Hariri, M., & Khodami, N. (2011). A study of the efficacy of teaching happiness based on the Fordyce method to elderly people on their life expectancy. Procedia-Social and Behavioral Sciences, 30(Supplement C), 1412-1415.
Holsti, L. R. (2019). Content analysis of humanity and social sciences. (N. Salarzadeh Amiri, Trans.) Alame Tabatabaee University Publication. [Persian]
Hosseini, M., & Aftabsavar, D. (2015). The investigation of the effect of group gestalt therapy on increasing the differentiation of students.The Conference of Consistent Development in Educational Sciences and Psychology. Cultural and Social Studies, 1-9. [Persian]
Jabarouti, R., Shariat, A., & Shariat, A. (2014). Effect of Persian classic poetry on the level of stress hormone in retired academicians. Jornal of Poetry Therapy, 27(1), 25-33.
Javanmardi, F., Naeimi, E., & Moatamedy, A. (2020). The effectiveness of mindfulness model on improving intimate attitudes and elderly depression. Journal of Aging Psychology, 6(1), 39-52. [Persian]  
Khodabakhsh Pirkalani, R., Ramezan Saatchi, L., & Maleki Majd. M. (2018). The effectiveness of mindfulness-based cognitive therapy (MBCT) on depression, death anxiety and life expectancy in elderly women. Journal of Geronntology, 3(2), 11-20. [Persian] 
Lee, H. C. B., Chiu, H. F. K., Kwok, W. Y., Leung, C. M. (1993). Chinese elderly and the GDS short form: A preliminary study. Clinical Gerontologist: The journal of Aging and Mental Health, 14)2), 37-42.
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 happiness. Transformational Psychology: Iranian Psychologists, 9(4), 189-2020. [Persian]
Malakouti, K., Fathollahi, P., Mirabzadeh, A., Salavati, M., & Kahani, S. (2006). Validation of geriatric depression scale (GDS-15) in Iran. Research in Medicine, 30(4), 361-369. [Persian]
Malette, J., & Oliver, L. (2006). Retirement and existential meaning in the older adult: A qualitative study using life review. Counselling, Psychotherapy and Health, 2(1), 30-49.
McDonald, W. M., Petrides, G., Aaronson, S. T., & Posse, P. R. (2018). The Assessment and management of treatment resistant depression in the elderly. The American Journal of Geriatric Psychiatry, 26(3), S52-S53.
Mohamadzadeh, M., Rashedi, V., Hashemi, M., & Borhaninejad. (2018). Relationship between activities of daily living and depression among older adults maneh and samalghan. Iranian Journal of Ageing (Salmand), (Accepted). [Persian]
Mokhber, N. (2013). Depression in elderly age. Ghatreh Publication. [Persian]
Momeni Maklavani, S., Foroughan, M., Yonesi, J., & Doladtshahe, B. (2017). The Efficacy of group counseling by using gestalt techniques on morale and loneliness of older adults living in nursing homes. Iranian Journal of Psychiatric Nursing, 5(1), 30-38. [Persian]   
Monirpour, N., Attari, B., & Zargham, M. (2019). Explaining forgiveness in the elderly through gratitude, happiness and acceptance with the mediating role of self-empowerment. Quarterly of Counseling Culture & Psychotherapy, 10 (39), 123-156. [Persian]       
Motamedi, A., Mostafapour, V., & Farokhi, H. (2018). The Effectiveness of hope group therapy on enhancement of happiness and quality of life in elderly women in tasouj. Iraninan of Aging Psychology, 3(4), 243-252. [Persian]      
Mui, A. C. (1996). Geriatric depression scale as a community-screening instrument for elderly Chinese immigrants. International Psychogeriatrics, 8(3), 445-458.
Najaflouee, F. (2007). The role of »differentiation of self« in marital relations. Quarterly Journal of New Thoughts on Education, 2(4), 27-37. [Persian]
Normohammadian Taj Abadi, M., Karimi, M., Mirzaie Shamsabad, H., & Manzari Takeli, V. (2018). The effectiveness of group gestalt therapy on hope and loneliness in older women. Middle Eastern Journal of Disability Studies, 8(53), 1-7. [Persian]
O'Leary, E., Sheedy, G., O'Sullivan, K., & Thoresen, C. (2003). Cork older adult intervention project: outcomes of a gestalt therapy group with older adults. Counselling Psychology Quarterly, 16(2), 131-143.
Pezent, G. D. (2011). Exploring the role of positive psychology constructs as protective factors against the impact of negative environmental variables on the subjective well-being of older adults. Texas A&M University.
Punyakaew, A., Lersilp S., & Putthinoi, S. (2019). Active ageing level and time use of elderly persons in a Thai suburban community. Occupational Therapy International, 1-8.
Rahimi, N., & Afsharinia, K. (2017). Prediction of psychological resilience based on degree of differentiation and frustration tolerance in the elderly. Journal of Aging Psychology, 3(2), 127-136. [Persian]   
Rashid, T. (2015). Positive psychotherapy: A strength-based approach. The Journal of Positive Psychology, 10(1), 25-40.
Rasoolian, S., & Dasht Bozorgi, Z. (2018). The relationship between religious adherence, authentic personality, post-traumatic growth and flexibility with wisdom in elderly through the mediation of self-coherence. Journal of Aging Psychology, 3(4), 229-241. [Persian]
Saadati, H., Younesi J., Foroghan, M., & Lashani, L. (2013). Effectiveness of gestalt therapy on happiness of elderly people. Iranian Journal of Ageing (Salmand), 8(2), 7-15. [Persian]        
Seligman, M. E. (2011). Flourish: A Visionary new understanding of happiness and well-being. Policy, 27(3), 60-68.
Seydi, M.S., Mohebi, Z., & Rezaee, Kh. (2015). The mediating role of elderly abuse in the relationship between generativity and ego integrity. Journal of Aging Psychology, 1(2), 49-56. [Persian]
Shahbazi, M. R., Foroughan, M., Salman Roghani, R.S., & Rohgozar, M. (2016). The relationship between disability and variables of depression, cognitive status, and morale among older people. Iranian Journal of Aging (Salmand), 11(1), 132-141. [Persian]
Shariat, A., Ghamarani, A., & Abedi, A. (2014). Meta analysis of psychological interventions’ effectiveness on the rate of depression among elderly Iranians in 2000-2010. Iranian Journal of Aging (Salmand), 9(1), 46-53. [Persian]
Shekaryazi, O., & Hayati, S. (2015). Comparative study of quality of life (quality of their communication and elderlies’ personality characteristics) among the elderly living in nursing home and in their family case study: elderly living in uremia. The Journal of Sociology Studies, 8(28), 77-94. [Persian]
Skowron, E. A., & Friedlander, M. L. (1998). The differentiation of self-inventory: Development and initial validation. Journal of Counseling Psychology, 45(3), 235-246.
Suchitra, S., Rajeswari, H., Indira, A., & Kalavathi, B. (2016). Effectiveness of gestalt therapy on level of alcohol dependence among adults in selected villages, Nellore. International Journal of Applied Research, 2(8), 784-793.
Sutipan, P., Intarakamhang, U., & Macaskill, A. (2017). The impact of positive psychological interventions on well-being in healthy elderly people. Journal of Happiness Studies, 18(1), 269-291.
Taghvaeenia, A., & Delavarizadeh, S. (2017). The effectiveness of group logotherapy on the increase of psychological well-being of the elderly retired women. Journal of Aging Psychology, 2(2), 115-124. [Persian]
Yesavage, J. A., Brink, T. L., Rose, T. L., Lum, O., Huang, V., Adey, M., & Leirer, V. O. (1982). Development and validation of a geriatric depression screening scale: a preliminary report. Journal of Psychiatric Research, 17(1), 37-49.