Remembering For Resilience: Brief Cognitivereminiscence Therapy Improves Psychological Resources And Mental Well-being in Young Adults Part 1

Abstract

Reminiscence-based interventions focus on the recall of autobiographical memories and reflective reasoning about these remembered experiences. 

The impact of intervention measures on memory is very significant and can help us improve memory and improve learning efficiency. Here are a few common interventions:

1. Regular life: Our body and brain need adequate rest and sleep and can only function better in a regular living environment. It is necessary to ensure that the daily work and rest time do not deviate too much and that the sleeping time every night should be fully guaranteed, which can help improve memory.

2. Balanced diet: Diet plays a key role in human health and memory. We should pay attention to the balance of our diet and eat more foods rich in nucleic acids, lecithin, and phospholipids, such as fish, mutton, eggs, soy products, green vegetables, etc.

3. Exercise: The human body's memory is closely related to physical health and exercise. Appropriate physical exercise can promote blood circulation, enhance cardiopulmonary function, contribute to the blood supply and material metabolism of the brain, and improve the effectiveness and longevity of memory.

4. Multiple memory methods: The memory effect has a lot to do with the methods used. A variety of memory methods can help us learn and remember more effectively, and achieve better results in information input, processing, and reproduction. For example, make more use of sound, touch, vision, and other senses to combine the knowledge you have learned with experience.

In short, interventions are very important for improving memory. We should pay attention to developing healthy living habits and learning methods, enhancing our brain health and flexibility, improving our cognitive level and long-term memory, and making our lives more positive and meaningful. It can be seen that we need to improve memory, and Cistanche deserticola can significantly improve memory because Cistanche deserticola is a traditional Chinese medicinal material that has many unique effects, one of which is to improve memory. The efficacy of minced meat comes from the various active ingredients it contains, including acid, polysaccharides, flavonoids, etc. These ingredients can promote brain health in a variety of ways.

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This study assessed the effect of a three-session, positive-memory version of cognitive-reminiscence therapy (CRT) on the psychological resources and mental well-being of young adults. The participants (N = 62, Mage = 24.6 [SD = 3.1], 71% females) were randomized to CRT or wait-list. 

Psychological resources (self-esteem, self-efficacy, meaning in life, and optimism), mental well-being (depression, anxiety, and stress symptoms), and theorized change processes (automatic negative thoughts, awareness of narrative identity, and cognitive reappraisal) were assessed. The results showed the CRT group was significantly higher on psychological resources at post-CRT (d = 0.75–0.80) and follow-up (d = 0.52–0.87) and mental well-being at postintervention (d = 0.71–1.30) and follow-up (d = 0.64– 0.98). 

The hypotheses regarding change processes were supported. Future research may use an active comparator and include a longer follow-up, given only short-term effects were assessed. Brief, positive-focused CRT is effective in increasing psychological resources and mental well-being in young adults.

KEYWORDS

automatic thoughts, awareness of narrative identity, cognitive reappraisal, cognitive reminiscence therapy, meaning in life, optimism, reminiscence therapy, self-efficacy, self-esteem, and young adults.

INTRODUCTION

Reminiscence-based interventions involve the recall of autobiographical memories (i.e. memories of personal experiences) of specific events and periods across the lifespan. In reminiscence-based interventions, these memories are reflected upon and considered for what can be learned about them and how they can be adapted or integrated into one's sense of self.
These reflections may be done independently, but often involve a guided review to construct a more rational, positive, and meaningful understanding of oneself and one's life. 

Reminiscence-based interventions can be thought of as a general approach through which other therapeutic modalities or techniques, such as cognitive behavioral, narrative, or problem-solving therapies can be delivered or integrated (Webster et al., 2010; Westerhof et al., 2010). 

Reminiscence-based interventions are effective across a diverse range of outcomes, such as meaning in life, self-efficacy, depressive symptoms, positive well-being, and cognitive functioning (Pinquart & Forstmeier, 2012), and populations including depressive symptoms in clinically depressed individuals (Westerhof & Saltzman, 2019), people with dementia (Park et al., 2019) and chronic physical disease (Pinquart & Forstmeier, 2012).

The vast majority of studies to date on reminiscence-based interventions have involved older adult populations. This has been driven by the notion that perceiving one's life as coherent and meaningful is predominantly a psychosocial development task of older adulthood (Butler, 1963; Erikson, 1959).
However, Hallford and Mellor (2013) have argued that young adults also have the developmental task of interpreting and evaluating their lives as coherent and meaningful and equally stand to benefit from reminiscence-based approaches in achieving this. 

This is backed by evidence that young adults draw on autobiographical memory more frequently than older adults for identity continuity and problem-solving (Webster, 1993; Webster & McCall, 1999) that these adaptive uses of reminiscence predict decreases in depressive symptoms in young adults (Hallford et al., 2013; Hallford & Mellor, 2016a, 2016b, 2016c) and young adults report positive effects on self-concept, affect and psychological resources such as self-efficacy and meaning in life following brief reminiscence activities (Hallford & Mellor, 2016b; James & Bhar, 2016).

Based on this reasoning, Hallford and Mellor (2016a) evaluated a particular type of reminiscence-based therapy, cognitive-reminiscence therapy (CRT; Watt & Cappeliez, 2000), to treat help-seeking young adults with clinically significant depressive symptoms. CRT involves a review of various life domains across six sessions (e.g. turning points, stressful experiences, etc.), during which cognitive therapy (Beck et al., 1997) and stress and coping models and techniques (Billings & Moos, 1981) are incorporated to help challenge negative beliefs about the self and one's experiences and develop more realistic, positive and adaptive interpretations of life events. 

Theoretically, the aim is to recall and/or interpret experiences consistent with adaptive beliefs about the self, others, and the world. This includes beliefs of oneself as being capable, of having intrinsic value and being valued by others, of having meaningful and cohesive experiences, and of the world being a navigable place. 

These modified autobiographical memories are reconsolidated and theoretically integrated into adaptive global mental representations about the self, others, and world (i.e. schema; e.g. I am worthwhile, I can cope with challenges) and act as evidence for them. Through this process, the improvement of psychological resources of self-esteem, self-efficacy, meaning in life, and optimism are targeted as a means of alleviating depressive symptoms. 

While these are unlikely the only psychological resources that are affected through this process, they are consistent with the theorized processes of change (Watt & Cappeliez, 2000) that have been shown to mediate the associations between frequency of reminiscence and mental well-being (Hallford et al., 2013; Hallford & Mellor, 2016a, 2016b, 2016c). 

A longer treatise on how this process is theorized to occur, and examples of such, can be found in Hallford and Mellor (2021). Consistent with prior research in older adults (Watt & Cappeliez, 2000), CRT caused large, significant reductions in depressive symptoms over time, as well as large increases in the targeted psychological resources. In addition to quantitative outcomes, interviews conducted with the young adults indicated that they found this autobiographical-based intervention to be acceptable, appropriate, and beneficial (Hallford et al., 2019).

In the present study, we set out to extend upon this work in several ways. First, we aimed to replicate previous findings that CRT can have effects on this younger population and examine if it can enhance psychological resources in young adults who may not necessarily have elevated depressive symptoms. 

That is, can a reminiscence-based intervention be beneficial for self-esteem, self-efficacy, meaning in life, and optimism in a community sample of young adults? These psychological resources are known contributors to overall psychological well-being and are prophylactic against depressive symptoms (e.g. Hallford & Mellor, 2016b; Holden, 1992; Mascaro & Rosen, 2008; Paradise & Kernis, 2002; Scheier & Carver, 1985; Sowislo & Orth, 2013; Steca et al., 2014). Therefore, if CRT is effective in a community sample, then it would bolster confidence in this intervention approach in younger populations and demonstrate that it can enhance, rather than only remediate issues with, psychological resources. 

In theory, this approach is generalizable to non-clinical samples as the processes upon which it is presumed to work (see above) are common to people across the spectrum of mental health or illness, and meta-analyses indicate that it does improve positive well-being among community samples not selected for health conditions (Pinquart & Forstmeier, 2012). It may then have utility for a range of therapeutic targets in subclinical or healthy youth populations, such as improving self-esteem, confidence, or existential angst or anxiety. 

Given the target population was not those with clinical depression, it was determined that the sessions would focus primarily on positive past experiences rather than negative experiences and themes such as guilt, regret, or shame, which are characteristics of depression (American Psychiatric Publishing, 2016). Positive past experiences that relate directly to the psychological resources of interest might be easily accessed in a community sample, for example, times of pride, success, and meaning. 

Therefore, these were the focus of sessions rather than on redressing or reframing negative experiences. Further, as previous research shows that the majority of change in psychological resources occurs after only three sessions of CRT (Hallford & Mellor, 2016a), we opted to provide this number of sessions.

Second, we aimed to extend the understanding of variables that contribute to change in CRT. Young adults who engaged in CRT reported two key processes that, to the author's knowledge, have not yet been quantitatively studied in reminiscence-based interventions (Hallford et al., 2019). The first was reappraising or changing their views of events and themselves. 

This was consistent with the facilitator's goal of helping the young adults to understand and interpret their experiences in different ways and to challenge unhelpful beliefs or assumptions that might have arisen about themselves, their lives, others, or the world. In the current study, we assessed whether participants reported changes in the frequency of negative thoughts about the self and the frequency with which they reappraised their thoughts. The second process identified by young adults was the increased awareness of a narrative or story about their lives. 

They reported that reviewing experiences from their life and linking these experiences together gave an overarching sense of continuity and meaning. This awareness meant that they could identify themes about their lives and themselves and comprehend a purpose for their actions and decisions. 

In the current study, we assessed participants' self-reported awareness of narrative identity, that is, perceiving life stories derived from past experiences that form part of one's identity.

Third, we aimed to evaluate this approach for young adults using an online, teleconference format. This format for talking-based interventions provides significant advantages in terms of accessibility and convenience for participants and often fewer resources for providers. 

Most published evaluations of reminiscence-based interventions have been of in-person formats (Pinquart & Forstmeier, 2012), with some exceptions (Westerhof et al., 2019). Given the steady uptake of online mental health therapy and the strong evidence for its effectiveness in this format (e.g. Ahern et al., 2018; Berryhill et al., 2018), we reasoned it was appropriate to generate further evidence of online delivery of reminiscence-based interventions.

The overall aim of this study was to examine the outcomes of a brief, reminiscence-based intervention on the psychological resources of young adults and evaluate the effects on other adaptive processes associated with change. 

It was hypothesized that the CRT group would have significantly higher self-esteem, self-efficacy, meaning in life, and optimism than the control group immediately after the CRT sessions and at follow-up. It was also hypothesized that the CRT group would report a significantly lower frequency of negative automatic thoughts, greater use of cognitive reappraisal, and a higher awareness of life stories. 

Although the participants were not recruited based on poor mental well-being, we reasoned that the sessions may have the effect of increasing mental well-being, and therefore, it was hypothesized that the CRT group would report lower depressive, anxiety, and stress symptoms.

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