Original Article

Effect of Strength-Based Narrative Therapy on Depression Symptoms and Quality of Life in the Elderly

Abstract

Background: Depression is a common psychological problem among the elderly. It undermines the elderly’s quality of life and imposes a heavy economic burden on society and families. Depression in this group must be addressed, but effective intervention therapies remain absent in existing studies. Strength-based cognitive behavior theory was combined with narrative therapy in this study. Its effect on depression in the elderly was verified through an intervention experiment.
Methods: From April to June 2024, 319 elderly people were recruited from Huoju Community in Changsha, Hunan Province, China to examine the factors influencing depression. A total of 85 of them with depression symptoms were included in a randomized intervention experiment and divided into two groups: 42 in the experiment group and 43 in the control group. The experiment group was intervened with strength-based narrative therapy, whereas the control group was given no targeted intervention.
Results: After the intervention, 1) the total depression score of the experiment group was significantly lower than that of the control group (P=0.001); 2) the mental state score of the control group decreased more significantly than that of the experiment group (P<0.05); and 3) the quality-of-life score of the experiment group was significantly higher than that of the control group at different time points (P<0.05).
Conclusion: Strength-based narrative therapy can effectively alleviate depression symptoms in the elderly, improve their mental state, delay their cognitive decline, and enhance their quality of life. It is an effective option to promote the elderly’s mental health.

1. Su D, Zhang X, He K, Chen Y (2021). Use of machine learning approach to pre-dict depression in the elderly in China: a longitudinal study. J Affect Disord, 282: 289-298.
2. Wang RQ, Lv DS, Chen LX, et al (2022). Multi-level model analysis of related factors of major depressive disorder in Inner Mongolia Autonomous Region. Chinese Ment Health J, 36(8): 643-649.
3. Duko B, Bedaso A, Ayano G (2020). The prevalence of depression among pa-tients with tuberculosis: a systematic re-view and meta-analysis. Ann Gen Psychia-try, 19: 30.
4. Prakash A, Jha RN, Kumari P (2019). Psy-chology of Depression in Elderly: A Review. EC Psychol Psychiatr, 8(4): 263-272.
5. Zhang L, Xu Y, Nie H, et al (2012). The prevalence of depressive symptoms among the older in China: a meta‐analysis. Int J Geriatr Psychiatry, 27(9): 900-906.
6. Stahnke B, Cooley ME (2022). End-of-Life Case Study: The Use of Narrative Ther-apy on a Holocaust Survivor with Life-long Depression. J Contemp Psychother, 52(3): 191-198.
7. Blinderman CD (2023). Considering narra-tive therapy in palliative care practice. Ann Palliat Med, 12(6): 1475479-1471479.
8. Stancer, R (2023). SAFE, a Manualised Ver-sion of Attachment Narrative Therapy De-signed for Families of Children with an Autism Diagnosis. In Attachment Narrative Therapy: Applications and Develop-ments (pp. 139-160). Cham: Springer In-ternational Publishing.
9. Jamshiddoust Miyanroudi F, Sheykhole-slami A (2023). The Effectiveness of Narrative Therapy on Cognitive Flexi-bility and Perceived Burdensomeness in People with Addiction Tendencies. Sci Quart Res Addict, 16(66): 25-46.
10. Qiu YY, Gao YP, Huang QY, et al (2023). Influence of narrative intervention based on story theory on psychosocial adaptation of AIDS patients. Chinese J AIDS & STD, 29(12): 1364-1365
11. Liu JY, Wang JJ, Luo Yuan, et al (2024). Ef-fectiveness of narrative exposure thera-py for post-traumatic stress disorder in children and adolescents: a Meta-analysis. Sichuan Ment Health, 37(2): 179-186.
12. Jørgensen C B, Behrmann J T, Blaabjerg J, et al (2024). Narrative therapy with chil-dren: A qualitative interview study with Danish therapists about the application of narrative practices. Couns Psychother Res, 24(1): 295-307.
13. Yu J (2020). Effect of Psychological Nurs-ing combined with Cognitive Behavioral Intervention on Sleep Disorder in El-derly Patients. Gu China Med, 18(16): 272-273.
14. He F, Song HJ, Zhang X, et al (2023). A randomized controlled study of strengths-based cognitive behavioral therapy on hope in adolescents with depression. Chinese Ment Health J, 37(9): 758-763.
15. Song HJ, He F, Ma J, et al (2023). The effect of strengths-based cognitive behavioral therapy on self-esteem in adolescent pa-tients with depression. Journal of Neurosci-ence and Mental Health, 23(7): 463-468.
16. Li WB, Xu MZ, Gao YL (2006). The validity and reliability of the six - item Hamilton Depression Rating Scale. Chinese J Nerv Ment Dis, 32(2): 117-120.
17. Hamilton M (1960). The Hamilton Depres-sion Scale—accelerator or break on an-tidepressant drug discovery. Psychiatry, 23(1): 56-62.
18. Meng XL, Mao DA, Liu T, et al (2012). Ap-plication of the Kazakh version of the Simplified Intelligent Mental State Ex-amination Scale. Chinese Ment Health J, 26(12): 941-942.
19. Xiao HM, Kuang HR (2014). Reliability and validity analysis of SF-12 scale in evalu-ating the quality of life of elderly people in China. Chinese J Gerontol, 34(4): 1018-1020.
20. Xu XY, Zheng XM, Zheng LL, et al (2021). The effect of stigma perception on anx-iety and depression and the chain me-diating effect of self-esteem and loneli-ness in patients with pulmonary tubercu-losis. China Prev Med, 22(10): 766-770.
21. Su BM, Chen XH, Liu RJ (2022). Observa-tion of the effect of mindfulness based stress reduction therapy combined with narrative therapy on improving the psy-chological state of post-stroke depres-sion patients. Electron J Pract Clin Nurs Sci, 25: 72-75.
22. Kam C, Vriend Fluit D (2023). Combining the enneagram and narrative therapy for adult ego development. Curr Psychol, 42: 406–415.
23. Li, M (2020). Narrative therapy, Buddhism, Taoism and Chinese medicine: An in-terview with Ming Li. Int J Narrat Ther Community Work, 1: 61-66.
24. Daundasekara SS, Arlinghaus KR, Johnston CA (2020). Quality of life: the primary goal of lifestyle intervention. Am J Life-style Med, 14(3): 267-270.
25. He F, Song HJ, Liu W, et al (2022). Interven-tion study of strengths-based cognitive behavioral therapy on adolescent de-pression. China J Health Psychol, 30(11): 1686-1692.
26. McQueen C, Hobbs C (2014). Working with parents: Using narrative therapy to work towards genuine partnership. Educ Child Psychol, 31(4): 9-17.
Files
IssueVol 54 No 1 (2025) QRcode
SectionOriginal Article(s)
Keywords
Narrative therapy Strength Elderly
Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Zhu S, Liao Q, Yuan H. Effect of Strength-Based Narrative Therapy on Depression Symptoms and Quality of Life in the Elderly. Iran J Public Health. 2025;54(1):124-132.