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An Innovative Therapeutic Recreation Intervention
Nancy Richeson, Ph.D., CTRS
Autobiographical writing offers many benefits.
Carolyn Heilbrun, the author of Writing a Women's Life wrote, "We are the
stories we tell." We tell ourselves stories of the past, make fictions
or stories of it, and these narrations become the past, the only part of our
lives that is not submerged." An understanding about the way in which we
think and who we are can be gained from writing down our life stories. May Sarton
stated, "Everything I've every written is to understand something, some
idea, some emotion." What we have learned about our lives can be shared
with others. Harriet Lerner wrote, "We need to bear witness. Stories will
be told, remembered, and recorded. The more of us who share our stories, the
more the capacity for telling our stories is renewed in all of us." Life
story writing can teach us to express ourselves in unique ways. Isak Dinesen
stated, "All sorrows can be borne if you put them into a story or tell
a tale about them." There are many meaningful ways to communicate our stories.
Denis Ledux wrote, "A life story is a gift one generation bestows upon
Autobiographical Writing as an Innovative Therapeutic
In addition to the above inspirational passages, the gift of recording one's
life story has gained respect and acceptance in university and clinical circles
alike. For example, psychologists are beginning to understand the value of personal
narratives in understanding growth and development (Atkinson, 1995). Robert
Butler (1998) noted that the process of reviewing one's life is part of the
normal aging process and takes place internally by the conscious returning to
past experiences, reviewing unresolved conflicts and reintegrating these thoughts
into a deeper understanding of oneself. This process then leads to self-awareness,
and self-acceptance, hence a more meaningful view of one's life. Even though
Butler did not originally conceive life review as part of a process done one-to-one,
or in a group that is facilitated by therapists, the theoretical connection
to autobiographical writing is clear. The purpose of this article is to present
information on how Therapeutic Recreation Specialists can provide a meaningful
intervention using autobiographical writing as the tool.
Autobiography is a formal written story of a person's
life that can consist of shorter written exercises that focus on one event or
memory in a person's life (Atkinson, 1995). An approach to writing autobiographically,
based on the theory of life reviewing, was originated by Birren and Duetchmann
in their book titled, Guiding Autobiography Groups for Older Adults: Exploring
the Fabric of Life. The authors stated "autobiographical writing is a way
for older adults to review their lives by following a proven series of evocative
themes and responding to questions designed to promote reflection" (p.2).
The autobiographical writing groups are facilitated by a leader who sequentially
presents the themes in order to gently guide the participants into their memories
and past experiences (Birren & Dutchman, 1991).
Even though the authors present a formalized group
process they also suggest that the format can be adapted in a number of ways
to benefit a wide variety of individuals. For instance, the use of poetry and
music could be incorporated into their writings. Also, items such as food, fragrances,
jewelry, and pictures can be used to evoke memories. Therefore, the autobiographical
writing method as developed by Birren and Duetchman can be adapted to fit the
needs of a variety of individuals in many settings such as; independent, assisted
living, and skilled nursing facilities as well as community based agencies.
For these reasons the autobiographical writing group would make a unique intervention
for any therapeutic recreation program serving older adults.
The expected outcomes of autobiographical writing
groups are increased self-esteem, self-awareness, and a greater sense of life
satisfaction and well-being. The above outcomes are all important for older
adults looking for meaning in their lives and places to share their experiences
verbally and in writing, thus enabling them to leave written legacies.
Two Examples of Autobiographical Writing as
an Innovative Therapeutic Recreation Intervention
When I was completing my doctoral training in Gerontology I fulfilled the practicum
requirement by developing, implementing, and evaluating two autobiographical
writing programs. The purpose was to become familiar with the intervention of
autobiographical writing and to try-out an outcome measure that might be appropriate
for this type of group. The first program used a pre-experimental design, the
one-group pretest-posttest (Campbell & Stanley, 1963). The participants
were a small group (n = 6) of older women (ages ranged from 67 to 105) living
in low-income housing. I evaluated the program using the outcome tool, the Positive
and Negative Affect Scale (PANAS), as a pretest and posttest measure of well-being
(Watson, Clark, & Tellegen, 1988). The second program used a pre-experimental
design, the one-shot case study (Campbell & Stanley, 1963). The intervention
was implemented with a 67 year old woman living with cancer.
The first group met once a week for 2 hours over
a 4 week time period. There were always healthy snacks, juice, and coffee provided.
The first session followed a format that included a brief orientation activity,
trailed by a short presentation of that weeks writing theme. Next, a learning
activity was completed that stimulated the participant's memories and facilitated
a five minute writing spree. The rationale was to provide the group members
with some thoughts and writing ideas so that they could spend the next week
writing their two to three page short story. The subsequent weeks followed the
above format, but the participants were encouraged to verbally share their written
stories with the group. Since this group did not have access to a computer I
volunteered to word process their stories resubmitting them the following week.
I chose the themes for this group based on research conducted by Birren and
Duetchman. The themes were "the major branching points in my life",
"my family", and "my major life work or career."
The evaluation tools did not suggest that any statistically
significant differences occurred, but a slight increase in positive affect was
noted. I was optimistic considering the small sample size, short intervention
period, and the limited research methodology that had been implemented.
The second program was a one-to-one intervention.
The point of developing a second type of intervention was to establish a variety
of methods that would facilitate the process of life reviewing through writing
autobiographically. I originally planned to meet with Virginia in her home once
a week for 2 hours over a 4 week period, but her chemotherapy session interrupted
our time, therefore, extending our work to 4 sessions over a 6 week time period.
The first week we discussed the possibility of
working with her to write down some of her life stories. She agreed and we began
by going through volumes of photo albums. These were used to stimulate her memory
and facilitate story ideas. She had many thoughts. We talked about her cancer
and how it was affecting her life. This was the first week her hair had begun
to fall out, but her color looked good and her spirit was bright. After the
first meeting the first story idea was generated - a story about her grandchild
The following week Virginia read her story out
loud and I listened intently. She shared pictures and memories of Andrew. She
had many funny stories about Andrew and she chose a few pictures to place with
her story. Next, she made a list of possible story ideas for the following week
and we reviewed her picture albums and talked more about her life.
Since she had completed a story I agreed to word
process the written work and create a Life Story book for her. The Life Story
book would have her stories and the pictures she had chosen. She then read her
latest story titled, "Mother of the Bride." She reminisced about her
daughter's engagement and wedding day. The next story proposal "My Heritage,"
was developed again from looking through her family albums. She began to view
this process positively and stated she enjoyed writing down her life stories
and feeling creative again.
The next visit was cancelled due to chemotherapy
treatments, but we met the following week. Virginia was visibly tired and not
as talkative as in past weeks. She was worried about being physically able to
complete the next story, but I assured her that she could take her time with
her writing. She did complete the last week's story, which was a detailed description
of her family's heritage. We reviewed the story and discussed her life as a
For a second time our meeting was cancelled due
to chemotherapy treatments. The next appointment was to be our last, as she
felt too tired to continue. This had been a hard week for her and she did not
feel well, but completed a story titled, "Den Mother - Brownie Leader."
We read the story, discussed which pictures should go into her Life Story book
and set a date for when her book would be completed. Virginia died a year after
completing these stories. Her legacy continues in her book, dedicated to her
grandchild Andrew, titled - The Stories of My Life.
I evaluated this intervention by recording her
thoughts and moods each time we meet as these related to the goal, a sense of
self-awareness and self-acceptance, the view that her life had meaning. Her
comments included " I enjoyed writing these stories, It is amazing how
much I have done in my life. I have tried my very best to raise my family the
best way I knew how." Although this method of research design has limited
scientific value the work done here has promise and Andrew can remember his
Grandmother through her stories and pictures.
How to Begin an Autobiographical Writing Group
Therapeutic Recreation professionals working with older adults who are interested
in developing autobiographical writing groups can begin by reviewing the literature
in reminiscence, life-reviewing, and autobiographical writing. An excellent
place to start would be Birren and Deutchman's book. Also, Dattilo's Leisure
Education Program Planning: A Systematic Approach book will be useful. Dattilo's
text will provide you with a guideline of how a group/educational sessions can
be developed and implemented. Be creative in using orientation and learning
activities that promote discussion and interest. The use of poetry and guided
imagery is useful to center the group members and focus on their thoughts and
feelings. A helpful book that has many activities that could be useful for autobiographical
writing groups is, Journal to the Self by Kathleen Adams. Providing wrap-up
activities to your sessions that are meaningful to the group will solidify their
interest in completing their writing assignments. Soliciting family members
to assist with recording their loved one's stories would be a great way involve
family in this processes. In fact, Barry (1988) in his research on autobiographical
writing discovered an unexpected outcome of strengthened family connection.
Families shared stories and helped their older relatives in the writing and
Therapeutic recreation specialists can assist older
adults in reviewing their lives. This may result in strengthening ego-identity
and in the process leaving a written legacy for future generations to enjoy
and share. While there has been limited research in autobiographical writing
groups, the outcomes presented here look promising and more research using sound
research methodology should be implemented.
Adams, K., (1990). Journal to the self: Twenty-two paths to personal growth.
New York, New York: Warner Books, Inc.
Atkinson, R., (1995). The gift of stories: Practical and spiritual applications
of autobiography, life stories, and personal mythmaking. Westport, Connecticut:
Bergin & Garvey.
Barry, J. (1988, September - October). Autobiographical writing: An effective
tool for practice with the oldest old. Social Work, 449-451.
Birren, J., Detuchman, D. (1991). Guiding autobiography groups for older adults:
Exploring the fabric of life. Baltimore, Maryland: John Hopkins University Press.
Butler, R., Lewis, M., Sunderland, T., (1998). Aging and mental health. (5th
Ed.) Boston, Massachusetts: Allyn and Bacon.
Campbell, D.T., Stanley, J. (1963). Experimental and quasi-experimental designs
for research. Boston, Massachusetts: Houghton Mifflin Company.
Dattio, J., ( 1999). Leisure education program planning: A systematic approach.
Andover, Massachusetts: Venture Publishing.
Dinesen, I. (1918). Letters from Africa: 1914-1931. Chicago, Illinois: University
of Chicago Press.
Heilbrun, C. (1988). Writing a woman's life. New York, New York: .W.W. Norton.
LeDoux, D., (1993). Turing memories into memoirs. Lisbon Falls, Maine: Soleil
Lerner, H., (1993). The dance of deception. New York, New York: Harper Perennial.
Sarton, M. (1973). Journal of Solitude, New York, New York: W.W. Norton.
Watson, D., Clark, L., & Tellegen, A. (1988). Development and validation
of brief measures of positive and negative affect: The PANAS scales. Journal
of Personality and Social Psychology, 54(6) 1063-1070.
Nancy Richeson received her Ph.D. in Gerontology in 2001. She is currently teaching
at the University of Southern Maine.
Nancy Richeson, Ph.D., CTRS
University of Southern Maine
Recreation and Leisure Studies
G-26 Masterton Hall
96th Falmouth Street
P.O. Box 9300
Portland, Maine 04104-9399
(207) 780-4646 (work phone)
(207) 780 - 5654 (work fax)
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I want to show how writing my autobiography healed me! I feel I should do a PhD about it! Any ideas?
Eurydice Iliaki kosmos_AT_cha.forthnet.gr
Chania, Crete, Greece KOSMOS Language School - Sunday, April 22, 2007 at 12:42:31 (CDT), IP Address: 19516743123
I thought the first half of what I have read was encouraging. I plan on reading the rest as soon as I have some down time. I have been trying to get done with my Autobiography for at least 13 years. I haven't been as diligent in these passed 13 years as I would have liked. I have been battling with bi-polar,severe depression and post tramatic stress disorder all of which I have built my story on. I just hope now that I am back to working on my book that there will be more support and opportunites to get a book deal unlike in the pass where it seemed almost impossible to get someone interested in my work until I became frustrated and eventually stop trying but I'm back world. I am determine now that I know more about who I am and how this illness tried to destroy my life. I am taking my life back this book will be sad but it will be a success story at the end Im hoping that it will help someone get control over their illness.
Terraine Hodges terrainehodges*sbcglobal.net
Country Club Hills, Il USA Friday, November 12, 2004 at 22:49:13 (CST)
Hi Nancy. I loved your article. I also would like to implement a biograhpical therapeutic writing group at the nursing home I work at. However, I am concerned that with the process of life review some negative and or traumatic memories may surface with some of residents, do you have any suggestions of how to deal with this if it comes up?
Sarah Langley-Smith sarah.langley*specialty-care.com
Toronto, ON> Canada Specialty-Care Monday, July 19, 2004 at 20:05:59 (CDT)
I liked the article, what I am wondering is there any way I can find a therapy writing group? I am seeing a client who is interested in this, my search has just started and am wondering if you can help. Thank you, Sue
Susan Parcell Sue.Parcell*advocatehealth.com or sunsetdr579*yahoo.com
Chicago, IL USA Illinois Masonic M/C Community Connections program Tuesday, May 18, 2004 at 18:30:45 (CDT)
http://www.newswriting.net has audio broadcasts on writing your oral history, life story, with DNA details for future generations, author of 35 books on similar subjects.
USA Tuesday, July 01, 2003 at 18:00:41 (CDT)
Tuesday, July 01, 2003 at 17:59:41 (CDT)
Nancy, Your article is interesting and I've printed it for my own file. I want to introduce you to my new book, WRITING YOUR STORY...A JOURNEY OF SELF DISCOVERY, which is published by Lulu,Inc. You can see the book online at www.lulu.com. The book/manual is designed as a guide for people (writers, nonwriters, instructors and others who work with people who will benefit from storywriting). There is a section for instructors/group leaders. It's based on my 15 plus years teaching in a variety of settings.
I look forward to any feedback you'd like to provide.
Thank you. JOAN BARRY, MSW
I'd appreciate any feedback.
JOAN BARRY sosbarry*aol.com
Fair Oaks, CA USA JOAN BARRY CONSULTANT Wednesday, May 21, 2003 at 17:39:09 (CDT)
Excuseme, Could you tell me about Therapeutic Recreation ,Please. What does it mean? about Who? Where?
step .... Thank you so much
Miss Siriluck Soros fencing_trek*hotmail.com
Bangkok, Thailand Kasetsart University Monday, February 03, 2003 at 21:15:08 (CST)
This could also be applied to geneological research as well as the autobiography.
Miriam Smith mesmith1*lsu.edu
Baton Rouge, LA USA LSU Tuesday, October 22, 2002 at 12:33:20 (CDT)
Hello, my name is Elise Hennigan. I will be going into my senior year of high school next fall, and I am currently working to attain a Gold Award in Girl Scouts. Those of us who are attempting to earn this award volunteer many hours of our time and construct a detailed plan for a project that will serve the needs of our community. I have chosen to focus on the beneficial aspects of reading and writing, especially for those who are not physically well. I read your article about your work with older people. I hope that you might be willing to give me some advice for my project with children.
I am working with Dr. Rachael Hunt at the Child Life Center at UCLA Medical Center in Torrance. My plan is to provide this aid by recording books on tape and creating booklets that let the child patients explore their feelings and emotions during this trying part of their life. I would like to ask if you could help give me ideas for how to get children writing about their experiences and feelings. Can you suggest some simple ways I could get young patients started on this?
Thank you very much for your time in reading this letter, and your consideration of helping my cause.
Elise Hennigan (firstname.lastname@example.org)
Elise Hennigan kapio*aol.com
Palos Verdes, CA USA senior in high school doing GS Gold Award Monday, August 12, 2002 at 12:04:23 (CDT)