I’m starting to work on desk based reasearch for TWAM’s Outreach team. The aim is to see whether we can gain insights into the digital storytelling work that they are doing with people living with dementia from existing literature. Following a suggestion from Zoe, I started looking at a form of therapy known as Validation Therapy this lead to a few review papers from the immensely helpful Cochrane Database of Systematic Reviews…
Both the review papers comment on the relative paucity of high quality studies on these forms of therapy involving randomised trials with control groups, therefore they are cautious of drawing strong conclusions from the available data.
Barton & Wright note that validation therapy (VT) is not theoretically grounded but makes appeal to theory to justify the approaches it takes. (This tallies well with the document from the VTI, although there is one sentence in the VTI document that hints at a harried and paranoid author justifying their work to sceptical “scientists and academics”.) Notwithstanding the aforementioned caveat, they found that the data does not show statistically significant therapeutic differences that can be attributed to the particular nature of validation therapy. What is interesting is that they highlight the common ground that validation therapy shares with other humanistic / person-centred therapeutic techniques.
This may be an interesting avenue to pursue – what elements of therapeutic techniques have the Outreach team embodied in their digital storytelling sessions? Indeed, what therapeutic elements are embedded in object handling? This begins to link back to the wider literature on well-being.
The review by Woods (2005a), again notwithstanding caveats about data quality, suggests that the available data shows stronger evidence for the positive impact of reminiscence therapy on mood/behaviour, cognitive strength and relationships. However, the review also suggests that there is a diversity of practice within reminiscence therapy and the data does not allow for a more nuanced understanding of which elements/aspects of these practices have greater (or lesser) positive impacts on the participants. One of the interesting points that the authors make is about the nature or type of memories that these sessions evoke – they suggest that the memories / stories told in the sessions are those which have already been well rehearsed (over the course of a person’s lifepath?). They also suggest that if the memories evoked are consistently of the very distant past then this might create some cognitive issues when the person is confronted by the dissonance between the re-experienced memories and the current state of their life without there being a coherent personal narrative that links the 2.
The protocol is interesting as it highlights the existence of a separate set of techniques, under the label of ‘cognitive stimulation’, which is intended to help people living with dementia to cope with their present lives and focus on that aspect of cognitive functioning rather than returning to the past.
Barton, N. M. & Wright, P. (2003) ‘Validation therapy for dementia (Review)’, Cochrane Database of Systematic Reviews, Issue 3. Art. No.: CD001394. DOI: 10.1002/14651858.CD001394.
VTI (n.d.) What is Validation, Available at http://www.vfvalidation.org/web.php?request=what_is_validation [Last accessed 09/09/11]
Woods, B., Spector, A.E., Jones, C.A., Orrell, M. & Davies, S.P. (2005a) ‘Reminiscence therapy for dementia (Review)’, Cochrane Database of Systematic Reviews, Issue 2. Art. No.: CD001120. DOI: 10.1002/14651858.CD001120.pub2.
Woods, B., Spector, A.E., Prendergast, L., Orrell, M. (2005b) ‘Cognitive stimulation to improve cognitive functioning in people with dementia (Intervention Protocol)’, Cochrane Database of Systematic Reviews, Issue 4. Art. No.: CD005562. DOI: 10.1002/14651858.CD005562.