Confronting Mortality at the End of Life: The Role of Existential Psychotherapy and Emotion Regulation Therapy in Reducing Death Anxiety Among Older Adults Residing in Nursing Homes
Keywords:
Death Anxiety, Existential Psychotherapy, Emotion Regulation Therapy, Older Adults, Nursing Homes, AgeingAbstract
Purpose: The present study aimed to compare the effectiveness of existential psychotherapy and emotion regulation therapy in reducing death anxiety among older adults residing in a nursing home.
Methods and Materials: This applied quasi-experimental study used a pretest–posttest design with a follow-up assessment and a control group. The statistical population consisted of older adults aged 65–85 years residing in a nursing home in Tehran, Iran, in 2026. Using convenience sampling, 60 eligible participants were selected and randomly assigned to existential psychotherapy, emotion regulation therapy, and control groups, with 20 participants in each group. The two intervention groups each received eight group sessions based respectively on Yalom’s existential psychotherapy framework and Gross’s emotion regulation model, whereas the control group received no study intervention. Death anxiety was assessed using the Templer Death Anxiety Scale at pretest, posttest, and follow-up. Data were analyzed using repeated-measures analysis of variance, Greenhouse–Geisser correction where appropriate, and Bonferroni-adjusted post hoc comparisons at a significance level of .05.
Findings: Repeated-measures analysis showed a significant main effect of time on death anxiety, F = 30.29, p < .001, partial η² = .35, and a significant time × group interaction, F = 7.72, p < .001, partial η² = .21, whereas the main effect of group was not significant, F = 1.62, p = .21, partial η² = .054. Bonferroni comparisons indicated significant reductions from pretest to posttest (MD = 1.51, p < .001) and from pretest to follow-up (MD = 1.50, p < .001), with no significant difference between posttest and follow-up (MD = 0.02, p = 1.00). At follow-up, death anxiety was significantly lower in the existential psychotherapy group than in the control group (MD = 2.85, p = .02).
Conclusion: Both interventions were associated with reductions in death anxiety over time, while existential psychotherapy demonstrated the clearest sustained advantage over the control condition at follow-up.
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References
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Copyright (c) 2025 Maryam Mehdipour (Author); Shahnaz Mohammadi; Mansooreh Fazilati (Author)
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