What is the general feedback about the optimism intervention?

The quantitative and qualitative responses from the feedback questionnaire are described below.

a) Quantitative feedback

All participants gave feedback about the present study by responding to a series of questions on a 5-point Likert scale from 1 (strongly disagree) to 5 (strongly agree). Table 18 shows the descriptive statistics and comparisons of the treatment group and control group responses. On average, participants agree that the interventions/tasks were easy to complete and that they would recommend others try the

interventions/tasks. However, on average, they neither agreed nor disagreed that the interventions were enjoyable, helpful, and increased their level of optimism.

Table 18.

Descriptive statistics for optimism intervention feedback

Feedback items M SD

The treatment intervention was easy to complete 3.60 0.69

The treatment intervention was enjoyable 3.42 0.77

The treatment intervention was helpful 3.25 0.83

The treatment intervention increased my level of optimism 3.29 0.76 I would recommend other older people try the treatment intervention 3.58 0.77

Beliefs and helpfulness

There are significant positive correlations between the belief in whether older people can change their patterns of thinking and three variables: 1) whether they believed the treatment intervention was helpful [r = .27, n = 107, p < .01], 2) whether they believed the treatment intervention increased their level of optimism [r = .30, n = 106,

p < .01], and 3) whether they would recommend the treatment intervention to other older people [r= .40 n = 106, p < .01]. There is a moderate-sized positive correlation between participants’ belief that self-help is useful for older people and the belief that the current treatment was helpful [r = .45, n = 104, p < .01].

b) Qualitative feedback

Most (79%; n = 44) of the treatment group participants wrote between one and eight sentences at the end of the feedback questionnaire expressing their thoughts on what was good about the study and how it could be improved. The following themes were found.

Positive feedback

Fifty percent (n = 28) of the treatment group believed the treatment intervention was helpful. Statements were made regarding an increase in mood, for example, “it made me feel better and more confident or forgiving”. The following are ways in which it was perceived as helpful.

Reflection about reactions to events

Thirty-four percent of participants stated that the intervention increased their awareness of how they reacted to, accepted, or coped with different events in their lives, according to the severity of the event. Others commented that it also improved the way they coped with negative reactions. For example, “I looked at my feelings in a more clinical way instead of an emotional way” and, “It made me look at alternative interpretations. Perhaps decreased self-blame”. One participant stated that it provoked her to increase her use of coping strategies that she had previously followed without much thought or analysis.

Focusing on the positive

Twenty participants stated that the intervention helped them to be more positive and content with situations; “It seems to have increased my positive attitude and optimism”. It was commonly stated that it made participants feel grateful for what they have. Other comments included, “it drew my attention from being too much focused on the disappointment, to other more pleasantly rewarding preoccupations and activities”, and “it emphasised that being positive and optimistic is important and one should strive to take this approach with every unpleasant situation”.

Recommendation to other people

Eleven participants affirmed that they would recommend the intervention to others; “I think anyone taking the study would benefit. I can only repeat that I feel changed for the better”.

Helpful for others with a negative outlook on life

Nine participants stated that although they did not believe that the intervention helped them personally, they believed that “the treatment intervention has undoubted merit” and it would be beneficial for those with psychological difficulties. In particular, one believed “if you did have low self-esteem it would no doubt be beneficial”, another stated “it may be effective for lonely, depressed, or house-bound people, or those in retirement homes/villages”, and yet another participant thought that, “this study may help people in the early stages of grieving”. One participant stated that, “going through has helped me to understand how some people (e.g., friends) can feel”.

Negative / constructive feedback

Three people stated that the intervention was not effective; “it was not sufficient to change my state of mind”. One of them stated that, “few people would be able to be objective about difficulties and most of us cope in our own way”, and perceived that it would not be useful if the bad events were minor. A number of reasons were given for why it was unhelpful:

Perception of pre-existing optimism

Thirty-nine percent (n = 22) of participants in the treatment group stated that they already had a positive/optimistic attitude before the study, and did not believe that the intervention changed this attitude in a significant way; “My level of optimism has always been very high. Perhaps the treatment has reinforced it”.

Older people are “set in their ways”

Seventeen percent (n = 10) believed that older people cannot change due to the combination of genes, personality, and past experience. One participant, however, stated the opposite, “older people can change their thinking with new information and encouragement”.

Other specific problems with the treatment intervention

Four participants stated that it was difficult to find negative/bad events in their lives, four believed that it was difficult to decide on answers in the Likert scale, particularly when the examples/situations were either absent or hypothetical (such as in the CERQ and OAASQ, respectively). Participants thought the questions should be more concrete and detailed while the response options should be simplified. One participant stated that, “not many older people would be motivated enough to complete this treatment intervention. It is easier to answer these questions orally, rather than by reading and writing answers. Too much like school exams perhaps. Others may think differently”.

Qualitative observations/Informal comments over the phone

Observations and informal comments may also help to explain the intervention’s effectiveness. Most participants stated they were happy to be rung during the process.

It appeared that guidance over the phone was helpful, particularly to clarify instructions and normalise the difficulty in completing the task.

Many participants found it hard to identify events in their lives, especially when they were termed “good” and “bad” events; however, they found it easier when they were termed “best” and “worst” events. Some made comments that they do not experience many major events in life, but when probed, they often came up with a number of seemingly ‘major’ events such as funerals or diagnosis of illness. Therefore, it appeared that they minimized the severity of the events and accepted them as part of normal aging, and instead looked for the positive (e.g., going to the funeral was a good chance to say goodbye and to catch up with the family). Some participants found the process of collecting an even amount of good and bad events useful as it put things into perspective (more good events than bad).

Comments were made about the difficulty in generating alternative causes for events, perhaps because they were thinking concretely and not taking credit for their part in good events (e.g., stating that they ‘organised a birthday party’ only because it was that ‘person’s birthday’ (concrete reason), rather than reasons such as being kind or caring). However, some participants stated that the Tips Sheet with examples of alternative causes was useful, and found that the intervention forms became easier with practice. Some believed the intervention was interesting and enjoyed the stimulation.

A number of people stated that they would not think to seek ‘psychotherapy/treatment’ if they were struggling with problems. Instead, they stated that they are resilient (e.g., due to past experiences including WWII and the depression) and that they ‘have’ to accept events, ‘have’ to cope, and ‘have’ to be positive, especially when others rely on them.

CHAPTER EIGHT - DISCUSSION