Copyright 2007 by Health Professions Press, Inc. All rights reserved.

CONTENTS

FOREWORD by Faith Gibson INTRODUCTION

Overview of the Handbook The Therapeutic Listener

xi 1 2 2 5 5 9 12 12 13

BACKGROUND
The Beginning: Marjorys Story Eriksons Model Butlers Observations About Reminiscence and Life Review The Growth of Life Review The Structured Life Review Process

P A R T I FUNDAMENTALS OF STRUCTURED LIFE REVIEW THE STRUCTURED LIFE REVIEW PROCESS

Goals of the Life Review The Life Review Form (LRF) LRF Questions Questions and Reviewers Questions and Structure for the Life Review Questions and Eriksons Life Stages Schedule Flexibility Weekly Visits The Process Unique Characteristics of the Life Review Process 17 18 18 19 19 20 20 21 21 22 22 23

v
Copyright 2007 by Health Professions Press, Inc. All rights reserved.

vi

Contents

Structure Duration Individuality Evaluation Additional Considerations About Life Review Hard Work Self Repetition Power and Control Supervision Confidentiality Audiotaping Life Review with Relatives

23 25 26 27 28 29 30 31 32 34 34 36 37 39 39 40 49 53 54 60

THE PARTICIPANTS
Therapeutic Listener Interviewing Techniques Counseling Skills Life Reviewers Types of Reviewers Conclusion

P A R T I I CONDUCTING THE STRUCTURED LIFE REVIEW VISIT 1: GETTING STARTED

Visit 1: Listener Guidelines Meeting the Prospective Life Reviewer Full Disclosure Written Agreement Audiotaping Business Cards Tests and Measures Assessing the Environment Privacy Light Noise Level Temperature Seating Arrangement Assessing the Life Reviewer Patterns and Habits Functional Abilities Medications Speech Hearing Vision Chronic Illness Reviewer File Next Visit
Copyright 2007 by Health Professions Press, Inc. All rights reserved.

63 63 63 64 65 65 66 66 67 68 68 69 70 70 71 71 72 73 73 74 74 75 75 76

Contents

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VISIT 2: CHILDHOOD
Visit 2: Listener Guidelines Preliminary Tasks Personal Issues for the Life Reviewer Eriksons Model: Childhood Trust Autonomy Mistrust and Shame Using the Life Review Form Beginning the Process First Question Order of Memories Responsive Comments Counseling Skill: Acceptance Interviewing Techniques Attentive Behavior Repetition Reframing Reviewer Types Storyteller Reluctant Reviewer End Visit 2 Summarize Session Next Visit

77 77 78 78 78 79 79 80 81 81 83 84 85 86 86 87 87 88 90 90 91 92 92 92 95 95 96 96 97 97 98 99 100 101 102 103 104 105 105 106 107 108 110 110 110

VISIT 3: ADOLESCENCE
Visit 3: Listener Guidelines Preliminary Tasks Clarify Visit 2 Eriksons Model: Childhood and Young Adolescence Initiative and Industry Guilt and Inferiority Using the Life Review Form Questions About Adolescence Probing Questions Questions About School Questions About Feelings Counseling Skill: Caring Interviewing Techniques Responding Reflecting Feelings Unique Life Review Characteristic: Structure Reviewer Type: The External Reviewer End Visit 3 Summarize Session Next Visit

Copyright 2007 by Health Professions Press, Inc. All rights reserved.

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Contents

VISIT 4: YOUNG ADULTHOOD

Visit 4: Listener Guidelines Preliminary Tasks Pivotal Session for Reviewer Clarify Visit 3 Closure on Childhood Unfinished Business Eriksons Model: Adolescence to Young Adulthood Identity vs. Role Confusion Intimacy vs. Isolation Using the Life Review Form Customize Questions Examine Past Decisions Clearer Adult Memories Counseling Skill: Unconditional Positive Regard Interviewing Techniques Sharing Behavior Paraphrasing Unique Life Review Characteristic: Duration Reviewer Type: The Creative Reviewer End Visit 4 Summarize Session Next Visit

111 111 111 112 113 113 114 115 115 116 117 118 119 121 121 122 122 123 124 125 125 125 125 127 127 127 128 128 128 130 131 131 133 134 135 136 136 137 138 138 140 140 140

VISIT 5: OLDER ADULTHOOD

Visit 5: Listener Guidelines Preliminary Tasks Clarify Visit 4 Eriksons Model: Older Adulthood Generativity vs. Stagnation Using the Life Review Form Work and Family Relationships Outside Interests Forgotten Memories Counseling Skill: Empathy Interviewing Techniques Self-Disclosure Encouragement to Talk Unique Life Review Characteristic: Individuality Reviewer Type: The Denying Reviewer End Visit 5 Summarize Session Next Visit
Copyright 2007 by Health Professions Press, Inc. All rights reserved.

Contents

ix

VISIT 6: SUMMARY AND EVALUATION

Visit 6: Listener Guidelines Preliminary Tasks Clarify Visit 5 Eriksons Model: Oldest Adulthood Acceptance Denial Using the Life Review Form Flexibility Gaining Insight Repetition Self-Examination Revisiting Key Events Counseling Skill: Congruence Interviewing Technique: Summarizing Unique Life Review Characteristic: Evaluation Reviewer Type: The Bleeding Reviewer End Visit 6 Summarize Session Next Visit

141 141 142 142 143 143 145 146 146 146 148 149 149 150 151 152 154 155 155 155 157 157 157 158 158 158 159 161 161 162 163 163 164 166 166 167 167 168 168 168 170 170

VISIT 7: INTEGRATION
Visit 7: Listener Guidelines Preliminary Tasks Clarify Visit 6 Eriksons Model: Oldest Adulthood Integrity Despair Using the Life Review Form Encourage Understanding Review Significant Successes Again Reframe Difficult Times Again Establish a Future Emphasis Counseling Skills: Review All Interviewing Techniques Integrating Review of Techniques Unique Life Review Characteristics: Consider All Four Together Reviewer Type: Recognize Your Reviewers Type End Visit 7 Summarize Session Consider Referrals Next Visit

Copyright 2007 by Health Professions Press, Inc. All rights reserved.

Contents

VISIT 8: CLOSURE AND OUTCOMES

Visit 8: Listener Guidelines Professional Referrals Contact Information Thank You Note and Other Cards Assessment and Findings Tested Outcomes Reviewer Feedback Observed Outcomes Summary

171 171 172 172 173 174 174 174 175 180

P A R T I I I USES AND OUTCOMES OF THE STRUCTURED LIFE REVIEW VARIED USES FOR THE STRUCTURED LIFE REVIEW
Newly Relocated Depression Prevention Substance Abuse Recovery Dying Bereavement Dementia Dementia Caregivers People with Dementia Other Potential Reviewers 183 184 184 185 186 186 187 188 188 192 193 201

ANNOTATED BIBLIOGRAPHY REFERENCES APPENDIXES

Appendix A Checklist for the Life Review Process Appendix B Life Review Form (LRF) Appendix C Sample Agreement Appendix D Baseline Assessment of Reviewer Appendix E Test of Physical Function Appendix F Test of Psychosocial Function (Mood Scale)

203 207 213 215 217 219 221 223 225

ACKNOWLEDGMENTS ABOUT THE AUTHORS INDEX

Copyright 2007 by Health Professions Press, Inc. All rights reserved.

INTRODUCTION
Life Review [is] a naturally occurring universal mental process characterized by the progressive return to consciousness of past experiences and unresolved conflicts. ROBERT N. BUTLER

esearch has demonstrated that a structured review of ones life is helpful, even therapeutic, especially for older people. This Handbook shows you how an effective Therapeutic Listener can conduct the Structured Life Review process. This process will help a variety of people (Life Reviewers) to review and reconcile their lives. This Handbook is a comprehensive guide for conducting a Structured Life Review and for training you to be a Therapeutic Listener. The Life Review is a form of reminiscing a natural human activity. We all do it; we tell stories we have lived, both good and bad, long and short. Experts say this is good for us. The potential therapeutic benefits from a Structured Life Review are many: reconciling ones past life, finding forgiveness, reducing depression, reconnecting with friends or family, increasing life satisfaction, and increasing self-esteem, among others. Although these results particularly help older people, other people affected by traumatic or significant events (family deaths, prolonged hospitalization, hospice, divorce, entrance to a nursing home, being fired, planning retirement, etc.) can realize those benefits as well. This all-inclusive Handbook teaches the professional as well as the layperson how to conduct a Structured Life Review. Use it as a guide.

1
Copyright 2007 by Health Professions Press, Inc. All rights reserved.

Introduction

Overview of the Handbook

This Handbook begins with the background of the Life Review process and then is divided into three parts, followed by an annotated bibliography, references, appendixes, and index. The three parts focus on: preparation, application, and uses of the Structured Life Review process. Part I, Fundamentals of Structured Life Review, prepares you for conducting the Life Review. Part I includes: 1. The background for the Structured Life Review process 2. The foundation of a Structured Life Review 3. The use of specific counseling skills and interviewing techniques 4. The use of questions from the Life Review Form (LRF) in Appendix B 5. The relative roles of the Therapeutic Listener and the Life Reviewer Part II, Conducting the Structured Life Review, applies what is presented in Part I to actual sessions of the Life Review, an 8-week process. Each of the chapters in Part II discusses each of the visits of the Structured Life Review process. Abbreviated guidelines for the Therapeutic Listener appear in a box at the beginning of each chapter. Each chapter:
n Applies n Focuses

helpful interviewing techniques and necessary counseling skills

n Relates to one or more stages of Eriksons developmental model (Eight Stages of Man) n Provides

on key questions from the LRF detailed information on the various types of Reviewers whom you will encounter

One hour per week is the recommended time per visit. Depending on circumstances, you may vary the length and the number of visits each week. Part II also contains helpful examples and excerpts from actual Life Reviews to guide you. Italic type is used for Reviewer comments in these excerpts to indicate that they are actual quotes, whereas bold italic type is used for actual Therapeutic Listener responses and remarks from past Life Reviews. Each chapter also contains recommended questions from the LRF to ensure that you get the Reviewers reminiscing about all the key stages of their lives. Part III, Uses and Outcomes of the Structured Life Review, completes the Handbook by presenting many applications and purposes of the Life Review with diverse populations. An annotated bibliography is also provided as background material for understanding this Structured Life Review process and for future research.

The Therapeutic Listener

Who can be a good Therapeutic Listener? Anyone! Anyone can guide a Life Review who has a reasonable education, the diligence and intelligence to read and practice the instructions in this Handbook, and the ability to learn the skills and techniques required of a caring, attentive Listener. Conceptually, Life Review is simple. Practically, however, it is

Copyright 2007 by Health Professions Press, Inc. All rights reserved.

Introduction

complex. You, as the Therapeutic Listener, must learn and practice good listening habits, good counseling skills and techniques, and good Life Review practices. You must identify and deal with a variety of Life Reviewers to guide each one through a successful Structured Life Review process. There is a lot to learn and apply. This Handbook will teach you. We suggest you study this whole Handbook in advance and then review the particular chapter related to each particular session as you go through an actual Life Review. Note that in front of each application chapter, we have provided a summary of that chapter in the form of Listener Guidelines. This overview of the chapter can guide you in preparing for that particular session and ensuring you cover everything during that visit. Almost everyone can benefit from the Structured Life Review process. Prospects are everywhere. We discuss specific potential reviewers and the benefits they gain in the last chapter. The process is pleasant for both participants. This is important work and you can bring therapeutic benefits to many people. We wish you success!

Copyright 2007 by Health Professions Press, Inc. All rights reserved.