Benchmarks for within-Group Outcome Evaluations of Reminiscence and Life Review Therapy in Alleviating Depression Among the Elderly

Background and Purpose: Over the past four decades evidence has accumulated supporting the effectiveness of reminiscence and life review therapy in alleviating depression among the elderly, as summarized in five systematic reviews. Compared to other interventions for depression among the elderly, reminiscence and life review therapy can be provided by individuals without advanced degrees, is non-stigmatizing, and elderly people enjoy them. However, there is no guarantee that providers of this therapeutic approach will implement it properly and effectively, and few practitioners in research settings have the resources to conduct randomized controlled trials to evaluate their efforts. Alternatively, practitioners can guide their decisions about the adequacy of the way they are providing either intervention by calculating a within-group effect size based on pre to post improvement and then comparing it to the average within-group effect sizes from RCTs (randomized controlled trials) supporting the intervention’s effectiveness. The primary purpose of this study was to develop these within-group effect sizes, or benchmarks, for comparison.

Methods: Five systematic reviews and a search of recent RCTs up through 2016 was conducted to identify articles for inclusion. Eligible studies (n=25) were RCTs that have provided the empirical support for reminiscence and life review therapy in alleviating depression among the elderly. Within-group effect sizes (Glass’s δ) were calculated by dividing the difference between the mean pretest and posttest scores of the treated group by the pretest standard deviation of that group. To account for small sample sizes of some RCTs, each effect size was adjusted by calculating Hedge’s g. Effect sizes were then averaged across studies using an established formula for within-group benchmarks (Minami et al., 2008).

Results: Results will include description of studies and descriptive statistics on the central tendency and dispersion of one-group effect sizes in RCTs for reminiscence and life review  therapy, as well as for waitlist control groups and for treatment as usual control groups. For example, we found that the aggregate within-group effect sizes (g_Hedges) for the life review recipients and for the waitlist controls were .598 and -0.20, respectively. Using Cohen’s (1998) standards for strong (0.80 and above), medium (about 0.50), and weak (0.20 and lower) d’s, these data reflect medium to strong average effect size improvement in depression for reminiscence and life review therapy and some worsening among controls.  

Conclusions and Implications: Our results provide benchmarks to which providers of reminiscence and life review therapy can compare their within-group effect sizes as a basis for guiding practice decisions about their implementation of either intervention. The presentation will also provide a framework for conducting similar meta-analyses that can provide benchmark effect sizes for other target problems to which agencies can compare their one-group effect sizes as a basis for guiding practice decisions about their adaptions of research supported treatments.