Life review of nursing home residents with depression : Qualitative study of experiences from behavioral therapists within a pilot study

Abstract

There is a need to develop and implement psychotherapeutic approaches to treatment for nursing home residents with depression. In addition to existing quantitative outcome studies, this qualitative study provides an in-depth look at therapists' work in providing outreach ambulatory cognitive-behavioral treatment with elements of a life review intervention in a pilot project. The goal was to generate action-guiding knowledge that can improve the care of nursing home residents with depression. The study provides a triangulation of data collection from participant observation and focused group interviews. The analysis of a group discussion with six psychotherapists and two supervisors followed the framework of grounded theory and included various discussions with experts from the fields of psychology, sociology and public health. Normalizing situations and managing current challenges appeared to be central therapeutic elements, whereas the purpose in life and coming to terms with the past were of minor importance. Preliminary results suggest that a modified version of cognitive-behavioral therapy using elements of simple reminiscence and individualized biographical work may be an effective treatment approach for nursing home residents with depression. Making the unique experiences of psychotherapists into the object of research opens up the possibility to bring about discussion of the benefits and limitations of psychotherapy under the real conditions of the healthcare and nursing system.