The Effectiveness of Existential Group Therapy on Existential Anxiety and the Quality of Life of the Elderly

Document Type : Original Article

Authors

Dept. of Psychology, Faculty of Humanities, University of Science and Culture, Tehran, Iran

Abstract

Aging is a challenging period and the last stage of human life. Awareness of imminent death causes existential anxiety in the elderly. Therefore, the elderly must have the ability to respond to their basic existential problems. Existential psychotherapy, focusing on the ultimate concerns of humans, including death, loneliness, emptiness, and freedom, seems to be a suitable treatment for the elderly. Therefore, this study was conducted to determine the effectiveness of existential group therapy (EGT) on existential anxiety and the quality of life of the elderly. The method of the present study was quasi-experimental with a pretest-posttest design and a control group. The statistical population was made up of the elderly between 60 and 85 years old referred to the social work clinic of Aftab Zendi in Shemiranat country, Tehran, in the second quarter of 2019. The sampling of this research was based on convenience sampling method. In general, 24 people were eligible to participate in group therapy in the current research, who were selected after considering the inclusion criteria and were randomly assigned into the experimental and control groups. The group therapy consisted of 12 Ninety-minute sessions, performed online due to the spread of the Covid-19 disease. Used to measure the mentioned criterion variables were Massoudi Sani and Bahmani’s existential anxiety questionnaire and Weir and Sherbon’s quality-of-life questionnaire (short form). The analysis of research data was done using analysis of univariate covariance (ANCOVA) in SPSS-21 software. Results indicated that according to the scores in posttest, existential anxiety has decreased and there is no significant increase in the quality of life of the elderly. In other words, the results of the research figured out that EGT reduces the existential anxiety of the elderly and it is possible to benefit from EGT as an effective treatment to deal with the mood problems in the elderly.
References
Abad, Y., & Rashidi, H. H. (2022). The Effectiveness of Mindfulness-Based Cognitive Therapy on Rumination and Existential Anxiety in the Elderly Men. Aging. Psychology8(1), 1-10. https:// doi.org/ 10.22126/JAP.2022.7147.1580. [Persian]
Abdian, T., & banaee, E. (2021). The effectiveness of positive psychology of happiness and quality of life of elderly people in elderly care centers. Journal of Gerontology, 6 (1), 8-17. [Persian]
Abdollahpour, M., Hafezi, F., Ehteshamzadeh, P., Naderi, F., & Pasha, R. (2019) Comparing the Effectiveness of Narrative Therapy and ACT, in Quality of Life and Existential Anxiety on Elders. Quarterly Journal of Applied Psychological Research, 10(3)133-146. https://doi.org/ 10.22059/JAPR.2019.279683.643240. [Persian]
Armani, K. (2019). The Effectiveness of Group Logotherapy on Resiliency and Quality of Life of Students. Journal of Psychology New Ideas3(7), 1-14. [Persian]
Azhdari, A., Moradi, A., & karami, J. (2018). Effectiveness of existential group therapy on interpersonal relationships of elderly residents of nursing homes. Journal of Clinical Psychology Achievements, 4(2), 14-20. https://doi.org/10.22055/jacp.2022. 27287.1093 [Persian]
Bahrami, L., salianeh, M., Farsi, A., & Nikravan, A. (2017). The Effect of Mindfulness and Working Memory Training on Quality of Life in Active Elderly. Sports Psychology Studies, 6(21), 1-16. https://doi.org/10. 22089/spsyj.2017.4549.1477 [Persian]
Bruce, A., & Boston, P. (2011). Relieving existential suffering through palliative sedation: discussion of an uneasy practice. Journal of Advanced Nursing67(12), 2732-2740. https://doi.org/10.1111/j.1365-2648.2011.05711.x
Daryani, M. A., & Marashi, M. K. (2021). Feeling guilty and anxiety in the elderly: the role of existential concerns. Aging Psychology7(1), 29-41. https://doi.org/10.22126/jap.2021.5827.1480 [Persian]
FathiAshtiani, A., Mohammadi, B., &. FathiAshtiani, M. (2019) Psychological tests: personality and mental health, The second volume: evaluation of personality and mental health. Tehran: Besat Publication. [Persian]
Garrow, S., & Walker, J. A. (2001). Existential group therapy and death anxiety. Adultspan Journal3(2), 77-87. https://doi.org/10.1002/j.2161-0029.2001.tb00109.x.
Ghavi, S., Mahdi, S., Golmohammadi, B., Karimi, N., Robab, S., & Rahmi, M. (2014). Investigating the effect of whole-body vibration training and mental training on the balance of elderly men. Iranian Journal of Ageing, 9(4), 306-330. [Persian]
Ghodsbin, F., Ahmadi, Z. S., Jahanbin, I., & Sharif, F. (2015). The effects of laughter therapy on general health of elderly people referring to jahandidegan community center in Shiraz, Iran, 2014: a Randomized Controlled Trial. International Journal of Community Based Nursing and Midwifery, 3(1), 8-31.
Hajiazizi, A., H. Bahmani, B., Mahdi, N., Manzari Tavakoli, V., & Barshan, A. (2017). Effectiveness of Group logotherapy on death anxiety and life expectancy of the elderly living in boarding houses in Kerman. Iranian Journal of Ageing12(2), 220-231https://doi.org/10.21859/sija-1202220. [Persian]
Husaini, B. A. Cummings, S. Kilbourne, B. Roback, H. Sherkat, D. Levine, R. & Cain, V. A. (2004). Group therapy for depressed elderly women. International Journal of Group Psychotherapy, 54(3), 295-319. https://doi.org/10.1521/ijgp.54.3.295.40340
Khodadadi Sangdeh, J. (2013). The effectiveness of group psychotherapy in an existential way to increase the quality of life of students. (Master's thesis). Advisory group. Faculty of Humanities. Tehran Teacher Training University. [Persian]
Khodadadi Sangade, J., Etemadi, A., & Alavi Kamoos. E. (2016). The Effectiveness of Existential Group Psychotherapy on Student’s mental health. Cognitive and Behavioral Science Research, 4(2), 119_130. [Persian]
Koochakzadeh, S., Heydari, H., & Yazdifeyzabadi, V., & Shkibaiee, A. (2021). Does Population Aging Affect Income Inequality in Iran? Iranian Journal of Ageing, 16(3), 396-411. https://doi.org/ 10.32598/sija.2021.16.3.3113.1. [Persian]
Logan, S. L., Gottlieb, B. H., Maitland, S. B., Meegan, D., & Spriet, L. L. (2013). The Physical Activity Scale for the Elderly (PASE) questionnaire; does it predict physical health. International Journal of Environmental Research and Public Health, 10(9), 3967-3986. https://doi.org/10.3390/ijerph10093967
LeMay, K. & Wilson, K. G. (2008). Treatment of existential distress in life threatening illness: a review of manualized interventions. Clinical psychology review, 28(3), 472-493. https://doi.org/10.1016/j.cpr.2007.07.013
Marsa, R., Bahmani, B., Naghiyaee, M., & Barekati, S. (2017). The Effectiveness of cognitive-existential group therapy on reducing demoralization in the Elderly. World Family Medicine Journal: Incorporating the Middle East Journal of Family Medicine, 99(5588), 1-8.
Masoudisani, R., Bahmani, B., Asgari, A., Khanjani, M., Paknia, N., (2013). Construction, validity and reliability of the existential anxiety questionnaire (QFEA). Scientific Journal of Clinical Psychology and Personality, 13(2), 151-162. https://doi.org/10.22070/13.2.151. [Persian]
Moziri, A. (2012). The effect of existential group therapy on reducing death anxiety in the elderly, (Master's Thesis), Counseling Department, Faculty of Human Sciences, University of Welfare and Rehabilitation Sciences. [Persian]
Murayama, Y., Ohba, H., Yasunaga, M., Nonaka, K., Takeuchi, R., Nishi, M., & Fujiwara, Y. (2015). The Effect of intergenerational programs on The Mental health of elderly adults. Aging & mental health, 19(4), 306-314. https://doi.org/10.1080/13607863. 2014.933309
Nasirnia Samakosh, A., & Yousefi, N. (2022). The Effectiveness of Acceptance and Commitment Therapy on Death Anxiety, Happiness and Resilience in the Elderly. Aging Psychology, 8(2), 161-149. https://doi.org/10.22126/JAP.2022.7918.1630. [Persian]
Ohta, R., Sato, M., Kitayuguchi, J., Maeno, T., & Sano, C. (2021). The association between the self-management of mild symptoms and quality of life of elderly populations in rural communities: A Cross-sectional study. International journal of environmental research and public health, 18(16), 8857. https://doi.org/10.3390/ijerph18168857
Sadeqhizade, N., Sadeghizade, N., & Hoseini, B. (2017). Effectiveness of existential analysis therapy group on purpose in life in women with dependent personality disorder. Women and Family Studies, 9(36), 89-101. [Persian]
Sadri, D. E., & Ramezani, S. (2016). Effectiveness of existential therapy on loneliness and death anxiety in the elderly. Aging Psychology, 2(1), 1-12. [Persian]
Sadridarmirchi, E., Ramezani, Sh., (2016). Effectiveness of existential therapy on feelings of loneliness and death anxiety in the elderly, Aging Psychology, 2 (1), 1-12. [Persian]
Seyednoohi, F., & Ghodsi, P. (2022). Predicting psychological well-being of the elderly based on emotion regulation strategies, quality of attachment to God, and existential anxiety. Islamic Studies and Psychology, 3(2), 7-15. https://doi.org/10.30471/PSY.2023.8623.2008. [Persian]
Shirali, S., & DashtBozorgi Z. (2019). Effect of existential group therapy on distress tolerance, existential anxiety, meta-worry and health worry in elderly women with cardiovascular disease. Cardiovascular Nursing, 4 (7), 24-33. [Persian]
Suri, R. (2010). Working with the Elderly: An Existential—Humanistic Approach. Journal of Humanistic Psychology, 50(2), 175-186. https://doi.org/10.1177/0022167809335687
Taghipour, B., & Barzegaran, R. (2019).The effectiveness of group existencetherapy on self-compassion and resilience of mothers with children with intellectual disability. Knowledge & Research in Applied Psychology, 20 (2), 100_109 https://doi.org/10.30486/jsrp.2019.665339. [Persian]
Tang, S. T., Chang, W. C., Chen, J. S., Chou, W. C., Hsieh, C. H., Chen, C. H. (2016). Associations of prognostic awareness/ acceptance with psychological distress, existential suffering, and quality of life in terminally ill cancer patients' last year of life. PsychoOncology, 25(4), 455-462. https://doi.org/10.1002/pon.3943.
Tsimbos, C. (2010). An assessment of socio-economic inequalities in health among elderly in Greece, Italy and Spain. International Journal of Public Health, 55(1), 5-15. https://doi.org/10.1007/s00038-009-0083-1
Van Bruggen, V., Vos, J., Westerhof, G., Bohlmeijer, E., & Glas, G. (2015). Systematic review of existential anxiety instruments. Journal of humanistic psychology55(2), 173-201. https://doi.org/10.1177/0022167814542048.
Yalom, I. D. (1980). Existential Psychotherapy (Vol. 1). New York: Basic books.
Yarahmadi, M., dehdari, T., Borhaninejad, V., & Abolghasemi J. (2020). The relationship between gerotranscendence and existential anxiety in the elderly in Kerman city in 2020. Journal of Gerontology, 7 (3), 37-44. [Persian]
YousefiAfrashteh, M., & Rezaei, Sh. (2021). The Spirituality and Quality of Life in the Elderly: The Mediating Role of Self-Compassion and Sense of Cohesion. . Aging Psychology, 7(2), 137-151. https://doi.org/10.22126/JAP.2021.6358.1526

Keywords

Main Subjects


References
Abad, Y., & Rashidi, H. H. (2022). The Effectiveness of Mindfulness-Based Cognitive Therapy on Rumination and Existential Anxiety in the Elderly Men. Aging. Psychology8(1), 1-10. https:// doi.org/ 10.22126/JAP.2022.7147.1580. [Persian]
Abdian, T., & banaee, E. (2021). The effectiveness of positive psychology of happiness and quality of life of elderly people in elderly care centers. Journal of Gerontology, 6 (1), 8-17. [Persian]
Abdollahpour, M., Hafezi, F., Ehteshamzadeh, P., Naderi, F., & Pasha, R. (2019) Comparing the Effectiveness of Narrative Therapy and ACT, in Quality of Life and Existential Anxiety on Elders. Quarterly Journal of Applied Psychological Research, 10(3)133-146. https://doi.org/ 10.22059/JAPR.2019.279683.643240. [Persian]
Armani, K. (2019). The Effectiveness of Group Logotherapy on Resiliency and Quality of Life of Students. Journal of Psychology New Ideas3(7), 1-14. [Persian]
Azhdari, A., Moradi, A., & karami, J. (2018). Effectiveness of existential group therapy on interpersonal relationships of elderly residents of nursing homes. Journal of Clinical Psychology Achievements, 4(2), 14-20. https://doi.org/10.22055/jacp.2022. 27287.1093 [Persian]
Bahrami, L., salianeh, M., Farsi, A., & Nikravan, A. (2017). The Effect of Mindfulness and Working Memory Training on Quality of Life in Active Elderly. Sports Psychology Studies, 6(21), 1-16. https://doi.org/10. 22089/spsyj.2017.4549.1477 [Persian]
Bruce, A., & Boston, P. (2011). Relieving existential suffering through palliative sedation: discussion of an uneasy practice. Journal of Advanced Nursing67(12), 2732-2740. https://doi.org/10.1111/j.1365-2648.2011.05711.x
Daryani, M. A., & Marashi, M. K. (2021). Feeling guilty and anxiety in the elderly: the role of existential concerns. Aging Psychology7(1), 29-41. https://doi.org/10.22126/jap.2021.5827.1480 [Persian]
FathiAshtiani, A., Mohammadi, B., &. FathiAshtiani, M. (2019) Psychological tests: personality and mental health, The second volume: evaluation of personality and mental health. Tehran: Besat Publication. [Persian]
Garrow, S., & Walker, J. A. (2001). Existential group therapy and death anxiety. Adultspan Journal3(2), 77-87. https://doi.org/10.1002/j.2161-0029.2001.tb00109.x.
Ghavi, S., Mahdi, S., Golmohammadi, B., Karimi, N., Robab, S., & Rahmi, M. (2014). Investigating the effect of whole-body vibration training and mental training on the balance of elderly men. Iranian Journal of Ageing, 9(4), 306-330. [Persian]
Ghodsbin, F., Ahmadi, Z. S., Jahanbin, I., & Sharif, F. (2015). The effects of laughter therapy on general health of elderly people referring to jahandidegan community center in Shiraz, Iran, 2014: a Randomized Controlled Trial. International Journal of Community Based Nursing and Midwifery, 3(1), 8-31.
Hajiazizi, A., H. Bahmani, B., Mahdi, N., Manzari Tavakoli, V., & Barshan, A. (2017). Effectiveness of Group logotherapy on death anxiety and life expectancy of the elderly living in boarding houses in Kerman. Iranian Journal of Ageing12(2), 220-231https://doi.org/10.21859/sija-1202220. [Persian]
Husaini, B. A. Cummings, S. Kilbourne, B. Roback, H. Sherkat, D. Levine, R. & Cain, V. A. (2004). Group therapy for depressed elderly women. International Journal of Group Psychotherapy, 54(3), 295-319. https://doi.org/10.1521/ijgp.54.3.295.40340
Khodadadi Sangdeh, J. (2013). The effectiveness of group psychotherapy in an existential way to increase the quality of life of students. (Master's thesis). Advisory group. Faculty of Humanities. Tehran Teacher Training University. [Persian]
Khodadadi Sangade, J., Etemadi, A., & Alavi Kamoos. E. (2016). The Effectiveness of Existential Group Psychotherapy on Student’s mental health. Cognitive and Behavioral Science Research, 4(2), 119_130. [Persian]
Koochakzadeh, S., Heydari, H., & Yazdifeyzabadi, V., & Shkibaiee, A. (2021). Does Population Aging Affect Income Inequality in Iran? Iranian Journal of Ageing, 16(3), 396-411. https://doi.org/ 10.32598/sija.2021.16.3.3113.1. [Persian]
Logan, S. L., Gottlieb, B. H., Maitland, S. B., Meegan, D., & Spriet, L. L. (2013). The Physical Activity Scale for the Elderly (PASE) questionnaire; does it predict physical health. International Journal of Environmental Research and Public Health, 10(9), 3967-3986. https://doi.org/10.3390/ijerph10093967
LeMay, K. & Wilson, K. G. (2008). Treatment of existential distress in life threatening illness: a review of manualized interventions. Clinical psychology review, 28(3), 472-493. https://doi.org/10.1016/j.cpr.2007.07.013
Marsa, R., Bahmani, B., Naghiyaee, M., & Barekati, S. (2017). The Effectiveness of cognitive-existential group therapy on reducing demoralization in the Elderly. World Family Medicine Journal: Incorporating the Middle East Journal of Family Medicine, 99(5588), 1-8.
Masoudisani, R., Bahmani, B., Asgari, A., Khanjani, M., Paknia, N., (2013). Construction, validity and reliability of the existential anxiety questionnaire (QFEA). Scientific Journal of Clinical Psychology and Personality, 13(2), 151-162. https://doi.org/10.22070/13.2.151. [Persian]
Moziri, A. (2012). The effect of existential group therapy on reducing death anxiety in the elderly, (Master's Thesis), Counseling Department, Faculty of Human Sciences, University of Welfare and Rehabilitation Sciences. [Persian]
Murayama, Y., Ohba, H., Yasunaga, M., Nonaka, K., Takeuchi, R., Nishi, M., & Fujiwara, Y. (2015). The Effect of intergenerational programs on The Mental health of elderly adults. Aging & mental health, 19(4), 306-314. https://doi.org/10.1080/13607863. 2014.933309
Nasirnia Samakosh, A., & Yousefi, N. (2022). The Effectiveness of Acceptance and Commitment Therapy on Death Anxiety, Happiness and Resilience in the Elderly. Aging Psychology, 8(2), 161-149. https://doi.org/10.22126/JAP.2022.7918.1630. [Persian]
Ohta, R., Sato, M., Kitayuguchi, J., Maeno, T., & Sano, C. (2021). The association between the self-management of mild symptoms and quality of life of elderly populations in rural communities: A Cross-sectional study. International journal of environmental research and public health, 18(16), 8857. https://doi.org/10.3390/ijerph18168857
Sadeqhizade, N., Sadeghizade, N., & Hoseini, B. (2017). Effectiveness of existential analysis therapy group on purpose in life in women with dependent personality disorder. Women and Family Studies, 9(36), 89-101. [Persian]
Sadri, D. E., & Ramezani, S. (2016). Effectiveness of existential therapy on loneliness and death anxiety in the elderly. Aging Psychology, 2(1), 1-12. [Persian]
Sadridarmirchi, E., Ramezani, Sh., (2016). Effectiveness of existential therapy on feelings of loneliness and death anxiety in the elderly, Aging Psychology, 2 (1), 1-12. [Persian]
Seyednoohi, F., & Ghodsi, P. (2022). Predicting psychological well-being of the elderly based on emotion regulation strategies, quality of attachment to God, and existential anxiety. Islamic Studies and Psychology, 3(2), 7-15. https://doi.org/10.30471/PSY.2023.8623.2008. [Persian]
Shirali, S., & DashtBozorgi Z. (2019). Effect of existential group therapy on distress tolerance, existential anxiety, meta-worry and health worry in elderly women with cardiovascular disease. Cardiovascular Nursing, 4 (7), 24-33. [Persian]
Suri, R. (2010). Working with the Elderly: An Existential—Humanistic Approach. Journal of Humanistic Psychology, 50(2), 175-186. https://doi.org/10.1177/0022167809335687
Taghipour, B., & Barzegaran, R. (2019).The effectiveness of group existencetherapy on self-compassion and resilience of mothers with children with intellectual disability. Knowledge & Research in Applied Psychology, 20 (2), 100_109 https://doi.org/10.30486/jsrp.2019.665339. [Persian]
Tang, S. T., Chang, W. C., Chen, J. S., Chou, W. C., Hsieh, C. H., Chen, C. H. (2016). Associations of prognostic awareness/ acceptance with psychological distress, existential suffering, and quality of life in terminally ill cancer patients' last year of life. PsychoOncology, 25(4), 455-462. https://doi.org/10.1002/pon.3943.
Tsimbos, C. (2010). An assessment of socio-economic inequalities in health among elderly in Greece, Italy and Spain. International Journal of Public Health, 55(1), 5-15. https://doi.org/10.1007/s00038-009-0083-1
Van Bruggen, V., Vos, J., Westerhof, G., Bohlmeijer, E., & Glas, G. (2015). Systematic review of existential anxiety instruments. Journal of humanistic psychology55(2), 173-201. https://doi.org/10.1177/0022167814542048.
Yalom, I. D. (1980). Existential Psychotherapy (Vol. 1). New York: Basic books.
Yarahmadi, M., dehdari, T., Borhaninejad, V., & Abolghasemi J. (2020). The relationship between gerotranscendence and existential anxiety in the elderly in Kerman city in 2020. Journal of Gerontology, 7 (3), 37-44. [Persian]
YousefiAfrashteh, M., & Rezaei, Sh. (2021). The Spirituality and Quality of Life in the Elderly: The Mediating Role of Self-Compassion and Sense of Cohesion. . Aging Psychology, 7(2), 137-151. https://doi.org/10.22126/JAP.2021.6358.1526