Narrative Group Interventions to Rediscover Life Wisdom Among Hong Kong Chinese Older Adults: A Waitlist RCT Study

Abstract Objectives: To recognize, and rejuvenate the life wisdom of Hong Kong Chinese older adults, a new strength- and meaning-based Narrative Therapy (NT) in practice is developed, with two objectives: to examine its effectiveness in enhancing wisdom; and to test the longer-term effects at 2 and 8 months respectively. Method: A waitlist randomised controlled trial (RCT) design was used. A total of 157 older adults were recruited, 82 of which was randomly assigned to 12 intervention groups to receive four 2-hour NT sessions using the ‘Tree of Life’ metaphor, to assess perceived wisdom at baseline (T1), at the end of treatment (T2), and at two (T3) and 8 months after treatment (T4). Results: Participants in the NT group showed significant improvements in the wisdom outcome measure [F(2.726, p = 0.041)]. As such, the results of latent growth curve models with time-invariant covariates for impact of NT on wisdom scores suggested significant effects two months after treatment (T3) with controlled the effects of age, gender and educational level [TML(11) = 17.306, p = 0.098, RMSEA = 0.079, CFI = 0.960]. Most improvements were sustained at 2- and 8-months post intervention. No adverse reaction was recorded in any of the cases mentioned at all study sites. Conclusion: The findings have significant theoretical contributions for professional social work practice to ground a new theory in understanding wisdom in older adulthood, develop a new clinical practice that appreciate and celebrate life wisdom, and a practice guide to be disseminated among health and social care practitioners.

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Narrative Group Intervention to Rediscover Life Wisdom among Hong Kong Chinese Older Adults: A Single-Blind Randomized Waitlist-Controlled Trial

Innovation in Aging ◽

10.1093/geroni/igab027 ◽

2021 ◽

Author(s):

Esther Oi Wah Chow ◽

Sai-Fu Fung

Keyword(s):

Older Adults ◽

Hong Kong ◽

Narrative Therapy ◽

Group Intervention ◽

Controlled Trial ◽

Intervention Group ◽

Social Work Practice ◽

Control Group ◽

Older Chinese ◽

Over Time

Abstract Background and Objectives We developed a new group practice using strength- and meaning-based Narrative Therapy (NT) for older Chinese living in Hong Kong (HK), to enhance their life wisdom. This paper reports on the intervention and its short- and longer-term effectiveness. Research Design and Methods A randomized waitlist-controlled trial (RCT) was conducted. A total of 157 older adults were randomly recruited, of whom 75 were randomly assigned to the intervention group which received four two-hour bi-weekly NT sessions using the ‘Tree of Life’ (ToL) metaphor. The others were placed on a waitlist. Perceived wisdom was assessed using the Brief Self-Assessed Wisdom Scale (BSAWS). Assessment occurred at baseline (T0), end of treatment (T1), and four (T2) and eight months later (T3). Over-time effects of NT on wisdom scores were assessed using latent growth curve models with time-invariant covariates for impact. Results The intervention (NT) group showed significant, sustainable over-time within-group improvement in perceived wisdom. Moreover, compared with the control group, the NT group showed significant immediate improvements in perceived wisdom [F(2.726, p = 0.041)], which were maintained at all follow-up points. This effect remained after controlling for age, gender and educational level [TML(11) = 17.306, p = 0.098, RMSEA = 0.079, CFI = 0.960]. No adverse reaction was recorded. Discussion and Implications NT underpinned by a ToL methodology offers a new theory to understand, promote and appreciate perceived wisdom in older Chinese living in HK. It contributes to psychotherapy and professional social work practice for older Chinese.

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