Meaning reconstruction 70 years later: Processing older adults’ unfinished business in a drama therapy group.

Abstract

Unfinished business (UB), when individuals appraise their relationship with others or themselves as incomplete or unresolved, entails difficult emotions such as regret, remorse, and guilt. UB is often associated with bereavement and is considered to be a predictor of complicated grief. Here we report two case studies describing the processing of the sudden death of a significant other in the context of a randomized controlled study of 12-week drama therapy groups for older adults. The intervention followed the format of Playback Theater, an improvised form of theater based on personal stories, and a life review paradigm. A mixed-methods approach explored the course of individual therapy within the group and potential mechanisms of change. The participants completed mental health questionnaires in a pre-post-follow-up design. The qualitative data included video recordings and postintervention interviews. One participant reported a clinically significant (CS) change in depressive symptoms and psychological well-being on the post and follow-up measurement indices. The second reported a CS change in self-esteem and relationship satisfaction at the end of the intervention, but not at followup. The findings suggest that the drama therapy contributed to the resolution of UB through restorative work in the three domains defined in meaning reconstruction theory: the "event story" of the loss, the "back story" of the relationship with the deceased, and the "personal story" of self. The results point to the need for additional research on meaning reconstruction in the context of drama therapy and encourage the broader application of performative techniques to treat complicated bereavement. Clinical Impact StatementQuestion: We report the analysis of two cases to shed light on the ways in which group drama therapy can contribute to the processing of unfinished business (UB) related to the sudden death of a significant other in the distant past. Findings: Two case studies describing how potential change factors in drama therapy contributed to the resolution of UB related to sudden death, through restorative work in the three domains defined in meaning reconstruction theory. Meaning: The results encourage the broader application of drama-based techniques to treat complicated bereavement. Next Steps: The changes illustrated in the current cases argue for additional research on meaning reconstruction in drama therapy.