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

Innov Aging. 2021 Aug 2;5(3):igab027. doi: 10.1093/geroni/igab027. eCollection 2021.

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 was conducted. A total of 157 older adults were randomly recruited, of whom 75 were randomly assigned to the intervention group which received four 2-hr biweekly NT sessions using the "Tree of Life" metaphor. The others were placed on a waitlist. Perceived wisdom was assessed using the Brief Self-Assessed Wisdom Scale. Assessment occurred at baseline (T0), end of treatment (T1), and 4 (T2) and 8 months later (T3). Overtime 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 overtime within-group improvement in perceived wisdom. Furthermore, when compared to the control group, the NT group showed significant immediate improvements in perceived wisdom [F(2.726, p = .041)], which were maintained at all follow-up points. This effect remained after controlling for age, gender, and educational level (T ML(11) = 17.306, p = .098, root mean square error of approximation = 0.079, comparative fit index = 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.

Keywords: Latent growth curve models; Narrative therapy; Randomized controlled trial; Tree of Life; Wisdom.