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Over recent decades, Emotion-Focused Therapy, aging, and forgiveness have garnered significant attention in the field of psychology. However, there is a lack of studies on Emotion-Focused Therapy and forgiveness specifically tailored for older adults. This article describes a protocol to assess the feasibility and acceptability of a Randomized Controlled Trial of Emotion-Focused Therapy for the resolution of emotional injury in individuals over the age of 65 in the context of interpersonal offenses. The study is structured as a two-arm, parallel-group randomized trial with a waiting list control. We propose recruiting a sample of 70 participants, randomly assigned to either an immediate intervention group, which will receive Emotion-Focused Therapy over twelve weekly sessions, or a control group that will receive the same therapy after a twelve-week waiting period. Data will be collected in the beginning, middle, and at the end of therapy, and in two planned follow-ups (three and six months after therapy). Once this protocol is implemented, if the therapy proves to be feasible, acceptable, and shows promising results, the findings will inform a large-scale randomized clinical trial to advance the understanding of psychotherapy.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| 35 participants randomly assigned to the EFT intervention | Experimental | The research will include 35 individuals aged 65 years or older, of both genders, who meet the study's inclusion criteria. Therapy sessions will be conducted individually and in person, in offices suited for psychological practice. Participants residing in senior housing will have the option, subject to agreement with their institution, to have sessions conducted in their facilities. Each session will last one hour and occur weekly over a three-month period, resulting in a total of 12 sessions per participant, in accordance with the EFT protocol for resolving emotional injuries established by Meneses and Greenberg (2019) and adjusted for this population/purposes by Almeida and Cunha (2024); |
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| 35 participants include in a control group (CG). | No Intervention | 35 participants included in a control group (CG), in the form of a waitlist. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Emotion-Focused Therapy | Other | This feasibility protocol is a two-arm, parallel, double-blinded, RCT aimed at informing a future trial assessing the effectiveness of EFT in resolving emotional injuries in older adults in the context of interpersonal offenses. |
| Measure | Description | Time Frame |
|---|---|---|
| Enright Forgiveness Inventory-EFI | EFI is a self-report measure designed to measure the level of forgiveness in response to a specific offense. The EFI consists of 60 items divided into three 20-item subscales that assess affect, behavior, and cognition related to forgiveness, using a 6-point Likert scale. Scores range from 60 to 360, with higher scores indicating higher levels of forgiveness. | From enrollment to the end of treatment at 12 weeks |
| Letting Go (assessed through the Letting Go Measure; Greenberg et al., 2008): | The Letting Go is a self-report instrument comprising a single item that evaluates the extent to which individuals have released their negative emotions toward the injurer. Responses are measured on a Likert scale ranging from 1 to 5. | From enrollment to the end of treatment at 12 weeks |
| The Unfinished Business Feelings and Needs Scale (UFB FN-Greenberg et al., 2008;) | The Unfinished Business Feelings and Needs Scale (UFB FN-Greenberg et al., 2008; Singh, 1994) consists of a 6-item scale designed to measure the extent to which an individual who has experienced an unfair situation feels acceptance and empathy toward the person who has harmed them, utilizing a 5-point Likert scale. | From enrollment to the end of treatment at 12 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| The European Portuguese World Health Organization Quality of Life Assessment in Older Adults (WHOQOL-OLD) | The European Portuguese World Health Organization Quality of Life Assessment in Older Adults (WHOQOL-OLD) (Power et al., 2005; Vilar et al., 2016) comprises 28 items classified on a five-point scale and encompassing seven domains: sensory, autonomy, activities, social, death, intimacy, and family life (Vilar et al., 2016). |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Bernardo Almeida Bernardo Dr, PhD | Contact | 00351911795393 | A037791@umaia.pt | |
| Carla Cunha Alexandra Dr, PhD | Contact | ccunha@umaia.pt |
| Name | Affiliation | Role |
|---|---|---|
| Carla Cunha Alexandra Dr, PhD | University of Maia | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Av. Carlos Oliveira Campos - Castelo da Maia 4475-690 Avioso S. Pedro | Maia | Castelo Da Maia | 4475-690 | Portugal |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 36996129 | Background | Buzgova R, Kozakova R, Bobcikova K, Zelenikova R. Predictors of life satisfaction in elders living at home in the Czech Republic. PLoS One. 2023 Mar 30;18(3):e0283772. doi: 10.1371/journal.pone.0283772. eCollection 2023. | |
| 33925790 | Background | Lopez J, Serrano MI, Gimenez I, Noriega C. Forgiveness Interventions for Older Adults: A Review. J Clin Med. 2021 Apr 26;10(9):1866. doi: 10.3390/jcm10091866. |
| Label | URL |
|---|---|
| The present study explores how resentment and forgiveness can affect older people and how resentment can be alleviated or intensified over time. The investigation is based on a qualitative methodology, using life history interviews, carried out in two mo | View source |
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| ID | Term |
|---|---|
| D000071441 | Emotion-Focused Therapy |
| ID | Term |
|---|---|
| D011613 | Psychotherapy |
| D004191 | Behavioral Disciplines and Activities |
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| From enrollment to the end of treatment at 12 weeks |
| The Geriatric Depression Scale-15 (GDS-15; Matos et al., 2019; Yesavage & Sheikh, 1986) | The Geriatric Depression Scale-15 (GDS-15; Matos et al., 2019; Yesavage & Sheikh, 1986) is specifically designed for screening depressive symptoms in older adults. It consists of 15 straightforward questions, each requiring a simple Yes or No response. The scale ranges from zero (indicating no depressive symptoms) to 15 points (representing the highest severity of depressive symptoms), with each affirmative response scored as 1 point. The cut-off points are defined as follows: 0 to 4 for the absence of depressive symptoms, 5 to 8 for mild symptoms, 9 to 11 for moderate symptoms, and 12 to 15 for severe symptoms. | From enrollment to the end of treatment at 12 weeks |
| Background | Band-Winterstein T, Eisikovits Z, Brownell P, King A. Introduction: exploring older women's perspectives on lifetime abuse. J Elder Abuse Negl. 2024; 36(2):91-92. 10.1080/08946566.2024.2332141. |
| Background | Toussaint LL, Worthington EL, Williams DR, eds. Forgiveness and Health: Scientific Evidence and Theories Relating Forgiveness to Better Health. Springer; 2015. doi: 10.1007/978-94-017-9993-5. |
| Background | Greenberg LJ, Warwar SH, Malcolm WM. Differential effects of Emotion-Focused Therapy and psychoeducation in facilitating forgiveness and letting go of emotional injuries. J Couns Psychol. 2008; 55(2):185-96. doi: 10.1037/0022-0167.55.2.185. |
| Background | Almeida, B., Cunha, C. Time, resentment, and forgiveness: Impact on the well-being of older adults. Trends in Psychology. 2023. https://doi.org/10.1007/s43076-023-00343-2 |
| Background | Enright RD, Fitzgibbons RP. Forgiveness therapy: An empirical guide for resolving anger and restoring hope. American Psychological Association; 2015. doi: 10.1037/14526-000. |
| Background | Meneses CW, Greenberg LS. Forgiveness and letting go in Emotion-Focused Therapy. American Psychological Association; 2019. doi: 10.1037/0000144-000. |
| Background | Worthington EL, Wade NG, eds. Handbook of forgiveness. 2nd ed. Routledge; 2020. |