Reminiscence Therapy

Reminiscence therapy was introduced in the 1960s by Robert Butler, M.D., a psychiatrist who specialized in working with the geriatric population. He recognized that as people reach their later years, they may find it helpful to reminisce and evaluate their lives. He called this concept “life review”. This notion was consistent with Erik Erikson’s theory of lifespan development which conceptualizes the last stage of life as an attempt to put lives into perspective to find personal meaning. 

What is Reminiscence Therapy? 

Reminiscence therapy is difficult to define. There is no one agreed-upon way to conduct it. It can be performed over a few sessions or for many months. It can be done individually or in groups. It can be performed by a therapist in a structured therapy session or by a non-therapist in an informal manner. In fact, many people that employ it are staff in long-term care facilities that have no therapist training.

However, it is universally acknowledged that reminiscence therapy is targeted toward older adults, many of whom are experiencing symptoms of dementia. Further, it involves the prompted recall of memories from a person’s younger years. This is thought to facilitate improvements in cognition, connectedness, and mood. The goal is to improve the overall well-being of someone who may have become withdrawn and despondent due to the effects of aging and dementia. 

Types of Reminiscence Therapy 

In a comprehensive analysis of the subject, reminiscence therapy was categorized into one of four types:

1. Simple reminiscence involves individuals sharing general memories and stories from times past. In this type of reminiscence, the focus is on recalling primarily positive aspects of clients’ lives. As such, a therapist might want to avoid triggers for negative memories. More general prompts are likely used here, instead of specific memories from the person’s life. For example, a client may be reminded of movies and songs from when they were younger, as opposed to a specific event that occurred in their life. 

2. Life review is the type of reminiscence that Robert Butler popularized. It is a more structured form of reminiscence that usually involves individual sessions with a therapist. The therapist explores the specific life experiences of the client and helps the client evaluate how they fit into the overall meaning of their lives. These experiences may be both positive and negative. More personal prompts are used and the therapist needs to be prepared to deal with negative reactions to triggering memories.

3. Life review therapy is a more specific form of life review, where the client is having difficulty coping with certain events from their past. It attempts to reframe negative memories, promoting a more positive view of life. This is especially useful for individuals who feel depressed due to past actions or regrets. It is not recommended for untrained professionals. Think of it as cognitive therapy for memories. 

4. Life story work focuses on creating a narrative of someone’s life. It involves a complete reminiscence of all phases of a client’s life. Frequently, it results in the development of a “life story book”, a simplified autobiography, if you will. 

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Tips and techniques 

• Ask open-ended questions. Remember, the goal is to get clients to elaborate as they talk about their lives. Asking closed questions usually encourages short answers. For example, ask “how did you feel about this person?” versus “did you like them?”

• Use sensory prompts. Older adults, especially those with dementia, may have difficulty responding to questions. In that case, you want to prompt their recall using sensory triggers. You can use visual cues, such as photos or videos, or aural reminders, like songs. Smells and tactile cues are also welcome. Whatever works!

• Besides prompting recall, sensory props might also have other positive effects. For example,  music can reduce agitation associated with dementia. And photos of happy events tend to boost our mood. 

• People with dementia usually have difficulty remembering recent events but can recall memories from long ago. As a result, it is helpful to focus on the period of their lives from ages 10-40 years old.

• Involve family and close friends. Evidence suggests that reminiscence therapy may improve the quality of the relationship between dementia clients and caregivers. Plus, family members and friends can inform therapists about potential triggers before therapy begins. 

• Reminiscence therapy can trigger difficult emotions. It is recommended that trained therapists be employed if you are planning to address sensitive subjects. 

Strengths of reminiscence therapy

Not many treatments have been found effective with people suffering from dementia.

Although the evidence is not incredibly strong, reminiscence therapy has been found to improve the lives of clients in the following areas:

1. Withdrawal from daily activities is a huge concern for people with dementia. Reminiscence therapy has been found to improve their level of activity and engagement. 

2. Reminiscence therapy, in multiple studies, has helped clients show a significant improvement in cognitive functioning in community settings.

3. Elderly people report increased self-esteem and reduced symptoms of depression when undergoing reminiscence therapy. They also have a more positive overall life view. 

4. Reminiscing about positive memories appears to protect individuals against stress.

5. Reminiscence therapy is flexible. It can be performed by many different people in a variety of settings. 

Concerns with reminiscence therapy

1. Bad memories, as well as good ones, may be triggered by reminiscence. This can be especially problematic when the person performing the therapy is not a trained therapist and does not have the expertise to help the client effectively negotiate their feelings. 

2. The research on reminiscence therapy is tepid at best. This largely has to do with the lack of stability in its operationalization. Its administration is wildly different across settings and providers. A theoretically supported manualization of the therapy would be a positive move to increase its reliability and validity.

3. It does not work well with advanced dementia because recall and cognitive functioning are too severely compromised.

4. Reminiscence therapy needs more consistency in content and delivery. It is very difficult to define and, therefore, it is difficult to accurately measure its effectiveness. 

5. Insurance reimbursement is questionable if it is not administered by a licensed therapist in inpatient and outpatient settings.