Group Logotherapy - Improving Mental Wellness in Nursing Homes
Logotherapy was developed by psychiatrist and Nazi concentration camp survivor Viktor Frankl. In his landmark work, Man’s Search for Meaning, Frankl provides a psychiatrist’s perspective of the psychology of individuals facing extreme suffering and oppression (Frankl, 1984).
Based on his experiences, Frankl outlined a therapeutic system that focuses on purpose and meaning-finding to help clients respond to suffering (Rahgozar & Gimenez-Llort, 2020). In more recent years, logotherapy has also been applied at the group level in therapeutic practice.
The article “Effect of Logotherapy Group Counseling in Reducing Depression and Improving Life Satisfaction Among Elderly Males” by Mohammad H. Abood, Jehad M. Alaedin, Ahmed M. Mahanseh, and Nader F. Alzyoud published in the North American Journal of Psychology contributes to the research exploring the effectiveness of Frankl’s logotherapy. The article reports the findings of an experiment that “explored the effect of a logotherapy-based counseling group in reducing depression and improving life satisfaction among a sample of older adult male Jordanians living in care homes for the elderly” (Abood et al, 2020, page 63).
An Evidence-Based Therapeutic Intervention
The authors of the study cite some statistics to emphasize the significance of the study. To begin, the elderly population of Jordan stands at 5.4% and is “expected to increase to 15.3% by the years 2050 (Abood et al, 2020, page 63). Additionally, according to a 2017 report from the World Health Organization (WHO), depression is “one of the most prevalent problems of the elderly and the aged worldwide, with between 10 and 20% of the sector of the population suffering from depressive disorders” (Abood et al, 2020, page 64). Depression among the elderly in Jordan stands at the high end of this statistic with 22% experiencing mild depressive symptoms, 17% with moderate symptoms, and 5% showing severe depression (Aboud et al, 2020, page 64).
Given the needs among the elderly population and the all-too-common neglect of psychological symptoms during treatment among this cohort (Aboud et al, 2020, p.65) the researchers sought to determine if group logotherapy would be effective in alleviating the symptoms of geriatric depression. The researchers asserted a two-fold hypothesis: 1) that participation in group logotherapy would reduce depression in elderly men and improve their life satisfaction and 2) that at a one-month follow-up, the benefits of the therapeutic intervention would be sustained (Abood et al, 2020, page 69).
Logotherapy in Group Settings
To test this hypothesis, Abood et al selected a sample of 40 men from ages 65 to 69. The men were of varying educational levels, marital status, and family size. Most of the men were healthy but about 30% suffered from chronic diseases (mostly type 2 diabetes and cancer). The participants were assigned randomly to either the experimental or control group, with 20 in each group. The experimental group attended 12 group logotherapy sessions over 6 weeks. Before the course of therapy and after its completion, the participants were evaluated against the Geriatric Depression Scale (GDS) and the Satisfaction With Life Scale (SWLS) to determine the effects of the intervention. The control group was told that they had been placed on a waitlist and would be contacted at a future time to receive the therapy.
The group therapy sessions were “prepared in accordance with Frankl’s (1988) logotherapy concepts and techniques” (Abood et al, 2020, page 73). Each session had a different topic based on the therapeutic framework covering concepts such as “meaning of the problem”, “values awareness”, and “spiritual sources of meaning” (Abood et al, 2020, page 73). The sessions also included “the use of counseling techniques such as: modeling, role play, confrontation, self-exploration, and homework assignments” (Abood et al, 2020, page 73). In addition to the GDS and SWLS responses taken immediately after the logotherapy, the researchers arranged for participants to be tested again at a one-month follow-up.
Improvement in Life Satisfaction & Wellbeing
According to Abood et al, “there was a significant differential rate of change in both depression and Life Satisfaction Scale mean scores between the intervention and waitlist groups” (Abood et al, 2020, page 24). The reduction in depression for the experimental group was 12 points compared to only 1 point in the control group. The findings of the one-month follow-up showed that the scores on the psychometric measures had improved slightly. The researchers state that this result “reflects that the participants had maintained the therapeutic gains they achieved in the post-test and showed the continuation of this improvement” (Abood et al, 2020, page 75).
The team found that the research confirmed their hypothesis that group logotherapy sessions would decrease depression and improve satisfaction with life. Although satisfaction with life continued to improve at the one-month follow-up, the results of the depression scores did not confirm the second half of the hypothesis (that the therapeutic benefits would be sustained) was statistically significant for depression. There are some limitations to this study. The authors cite the limited demographic of the participants. Further research could be done to replicate these results in a more diverse cohort.
Of particular interest was the inclusion of reminiscence in the therapeutic model. The article states that “when they cognitively re-exposed themselves to their life stories by reminiscing, they were searching their memory schemas for things which would stimulate and activate self-recognition….endorsing their present actuality to enable adjustment to their original self, or to reach a meaningful state of self” (Abood et al, 2020, page 77). The therapeutic design used in this experiment could benefit many elderly individuals in nursing homes across the globe. Given the neglect of psychological wellbeing that often occurs in this group, group logotherapy could provide a low-cost solution to the needless suffering of many, offering relief to many in this vulnerable chapter of life.
References:
Abood, M. H., Alaedein, J. M., Mahasneh, A. M., & Alzyoud, N. F. (2020). Effect of Logotherapy Group Counseling in Reducing Depression and Improving Life Satisfaction among Elderly Males. North American Journal of Psychology, 22(1), 63-82. http://ezproxy.umgc.edu/login?url=https://www.proquest.com/scholarly-journals/effect-logotherapy-group-counseling-reducing/docview/2371367255/se-2?accountid=14580
Frankl, Viktor E. (1984) Man's Search for Meaning: An Introduction to Logotherapy. New York: Simon & Schuster, 1984. Print. Turabian (6th ed.).
Rahgozar, S., & Giménez-Llort, L. (2020). Foundations and Applications of Logotherapy to Improve Mental Health of Immigrant Populations in the Third Millennium. Frontiers in psychiatry, 11, 451. https://doi.org/10.3389/fpsyt.2020.00451
