Rediscovering Wisdom in Older Adulthood: A Specific Narrative Therapy in Group Practice

Consistent with theories about the course of our lives and developmental change, older adults generally possess rich and valuable wisdom concerning many important aspects of life. However, whether they, their families and society can fully acknowledge this wisdom and convey it in a way that benefits them and future generations remains uncertain, due to physiological decline and increasingly ageist attitudes in society.

Narrative therapy (NT), an alternative solution to this challenge, views people as experts in their own lives who possess abilities, knowledge and beliefs that assist them in coping with difficult life situations. Through this practice, NT offers an effective means of rediscovering, recollecting and sustaining a wealth of life wisdom for personal life management, and transferring it to others in order to achieve a higher common good.

Dr CHOW Oi-wah Esther, Associate Professor of the Department of Social and Behavioural Sciences, City University of Hong Kong, collaborated with 19 community-based district elderly community centres across Hong Kong, Kowloon and the New Territories from 2016-18 in developing 26 “Life Wisdom” narrative groups.

The study aims to examine the effectiveness of NT practice in enhancing wisdom, improving a sense of mastery, hope, meaning of life and well-being among those older adults randomly assigned to the NT group, compared to the waitlist control group, after the NT group had completed an intervention (T1), and two months after the intervention (T2). Other than adopting a randomised waitlist controlled trial, the effects of this group-based intervention were also confirmed through in-depth interviews.

A total of 157 Hong Kong Chinese community-dwelling older adults aged 60 to 90 were recruited for the study, 78 of whom were randomly assigned to 13 intervention groups. Using a “Tree of Life” metaphor and narrative conversations, 352 life episodes were collected over a four-week period, recording difficult life circumstances which made them stronger. Two researchers were involved in analysing the transcripts independently, using thematic analysis.

Participants in the NT group showed significant improvements in the various outcome measures: sense of mastery (F = 3.54, p<.03), hope (F = 3.15, p < .03), meaning in life (F = 3.28, p < .02), wisdom (F = 7.21, p<.001) and wellbeing (F = 6.67, p<.001). Most improvements were sustained two months post-intervention. No adverse reaction was recorded in any of the cases mentioned at the study sites.

Adopting a social constructionism paradigm, NT offers an effective means for wisdom rediscovery and recollection, both for personal life management, and for reconstructing the meaning of life to overcome life transitions with others.

Wisdom has been associated with increased self-knowledge in the context of reviewing life lessons for personal growth and the common good. The participants reconnected to their core values of personal inner resources, such as belief, hope, love, competence, and commitment, in line with their preferred identities which emerged through narrative conversations.

These findings have significant theoretical and practical contributions for both the health and social care professions in developing a constructive perspective on late life development, and in grounding a new theory in understanding wisdom in older adulthood.