Enriched with thought-provoking quotes, case examples and dialogue from life review interviews, this no frills, honest handbook guides one through the nuts and bolts of carrying out the structured life review approach developed by the authors. It describes a person-centered approach, drawing upon the practical application of counseling skills developed by Rogers (Reference Rogers1961). In this sense, however, it has its limitations for the experienced clinician familiar with person-centered working or for those in training seeking to understand the approach within the context of broader psychological theories and applications of life review.
Born out of years of practical application and research stretching back to the 1970s, largely with individuals over the age of 50 years, the Structured Life Review Form (LRF), which is usefully provided in the appendix, is a series of questions prompting recall from childhood through to the present. The questions are structured in such a way as to guide the person through reviewing their lives (referred to as “reviewers” by the authors) in line with Erik Erikson's eight stages of psychosocial development. Erikson's framework describes developmental tasks that people accomplish to some extent at least, so that one is able to reach the final life stage of integrity or acceptance of one's life as it was lived. The authors assert that their research has found that structured life review can help the person review unsuccessful stages yet still reach integrity through reconciliation achieved during the process. Life review in their opinion “provides an opportunity for reviewers to disprove past negative evaluations, to reinterpret the past, and to verify who they are in the present”.
In terms of its layout, the book is divided into three parts. Part I describes the fundamentals such as the goals of the approach, the characteristics that set it apart from other forms of reminiscence approaches, important considerations such as supervision and confidentiality and a description of interviewing and counseling skills. In part II, chapters are devoted to each of the eight visits outlined to complete the process. Specific counseling techniques of relevance to each visit are discussed in terms of how they address each of Erikson's life stages. Part III provides ideas aimed at those for whom the application of this method could be useful.
The structure of the chapters allows for a clear description of the whole process from the first to the last visit, with helpful reminders to provide a bridge between each session. The authors outline a structured ending by preparing the reviewer in the final three sessions. A strength also lies in the emphasis upon obtaining qualitative and quantitative outcome measures to determine the impact of the approach. The authors’ vast experience is apparent in their attention to detail and their description of the different ways in which reviewers tell their story. Space is devoted to exploring how and why reviewers might tell their stories in different ways without due consideration to wider explanatory psychological theories.
Inherent within the book's limitations however, is not necessarily the approach itself but the inconsistent advice given at times. For example, in one vein the authors highlight best practice by suggesting that therapeutic listeners have weekly supervision, yet in the same paragraph suggest that therapeutic listeners should turn to the internet for support from other interested listeners in the absence of peers or supervisors. In one area the authors emphasize the importance of confidentiality, privacy and increased effectiveness being achieved by a stranger delivering the approach, whereas in another it is suggested that a sheltered housing staff member might apply the proposed approach with a new resident. Furthermore, given that the book is intended for non-professionals and professionals alike, an intricate amount of detail is provided in some areas but one is left wanting to hear more in others. For example, one might want to gain more of a background to Erikson's model and have more advice around explaining the approach to reviewers when obtaining informed consent.
The authors emphasize that their structured life review approach differs from formal psychotherapy. According to the authors, the former only discusses issues raised by the reviewer, whereas in the latter “the therapist often decides the topic to be addressed, asks intimate questions, prodding clients until they begin to reveal and understand themselves”. One could argue that this is not only a misrepresentation of psychotherapy but also offers a confusing distinction between the proposed life review and formal psychotherapy, especially since the process that the authors advocate actively prompts individuals to talk about all aspects of their life from childhood to the present and cues the reviewer to evaluate and make sense of their emotions in response to their memories.
Arguably, the authors undermine the complexity of their therapeutic intervention with such bold assertions that “anyone who learns the life review process through studying [the] handbook can be an effective therapeutic listener”. As the proposed intervention prompts recall from childhood through to adulthood, there is a danger that inadequately trained therapeutic listeners could guide reviewers through emotionally processing early trauma such as loss of a child/parent and/or childhood abuse. The authors usefully advise when further psychotherapeutic work might be appropriate and suggest making ongoing referrals. However, surely one could argue that a therapeutic listener embarking upon this work in the first instance should at least be undergoing psychotherapeutic training and receiving weekly supervision to ensure safe practice. This, in turn, could maximize gains achieved by reviewers from participating in the proposed evidence-based therapeutic intervention.
Written in accessible language and enlivened with dialogue from life review interviews, this handbook presents a welcome addition in describing the application of a structured life review approach. It is very detailed and repetitive at times in explaining the application of a person-centered approach, which may be helpful for those learning the art of therapeutic listening. In that sense it may be most useful for those in psychotherapeutic training or clinicians wishing to familiarize themselves with counseling techniques within the context of this structured life review approach.
