Comparison of the Effectiveness of Forgiveness Therapy and Structured Reminiscence Writing on Interpersonal Emotion Regulation, Perceived Rejection, and Sense of Coherence among Nursing-Home Older Adults

Abstract

This study aimed to compare the effectiveness of forgiveness therapy and structured reminiscence writing on interpersonal emotion regulation, perceived rejection, and sense of coherence among older adults residing in nursing homes. This quasi-experimental study used a pretest-posttest design with a one-month follow-up, including two experimental groups and one control group. The statistical population consisted of older adults residing in nursing homes in Arak, Iran, during 2025–2026. Forty-five eligible participants were selected through convenience sampling and randomly assigned to three groups of 15: forgiveness therapy, structured reminiscence writing, and control. The forgiveness-therapy group received five sessions, while the structured reminiscence-writing group received eight sessions; the control group received no intervention. Data were collected using the Interpersonal Emotion Regulation Questionnaire, the Perceived Rejection Scale, and the 13-item Sense of Coherence Scale. Data were analyzed using multivariate analysis of covariance, univariate ANCOVA, Bonferroni post hoc tests, and paired-samples t tests in SPSS version 26. Multivariate ANCOVA indicated a significant overall group effect on the combined dependent variables, F(3,38)=15.110, p<0.001, η²=0.544. Significant group effects were also found for interpersonal emotion regulation, F(2,41)=9.369, p=0.001, η²=0.314; perceived rejection, F(2,41)=13.639, p<0.001, η²=0.400; and sense of coherence, F(2,41)=8.261, p=0.001, η²=0.287. Bonferroni comparisons showed that both interventions significantly improved interpersonal emotion regulation and reduced perceived rejection compared with the control group, while no significant differences were observed between the two interventions for these outcomes. Both interventions significantly improved sense of coherence; however, structured reminiscence writing was significantly more effective than forgiveness therapy (p=0.041). Most intervention effects remained stable at the one-month follow-up. Both forgiveness therapy and structured reminiscence writing can be effective psychological interventions for improving interpersonal emotion regulation, reducing perceived rejection, and enhancing sense of coherence among nursing-home older adults, although structured reminiscence writing appears to provide an additional advantage in strengthening sense of coherence.