Dec 22nd 2022
Validation therapy was designed by Naomi Feil, a social worker who primarily worked with older adults. She specifically designed this therapy for use with adults over 80 years old with Alzheimer’s or other types of dementia and cognitive impairment.
Feil states that there are four stages of cognitive impairment :
Validation therapy focuses on the needs of the person in each of these stages, informing caregivers how to use empathetic and helpful communication to allow the patient to express their needs and emotions. The idea behind this approach is to promote dignity, independence, and self-awareness, improve communication and self-worth, and reduce stress, withdrawal, and the need for physical restraint .
Validation therapy is designed to improve trust between the person with dementia and the caregiver, to improve communication and understanding. If the caregiver can understand the intention behind speech and actions, and what is trying to be expressed, then they can effectively attend to the needs of their patient .
Validation therapy provides the caregiver with the tools required to accept their patient’s reality and respond with empathy, validating their experiences.
The premise of this therapy is based on 14 verbal and non-verbal techniques that can improve communication and understanding, helping the caregiver acknowledge and empathize with their patient’s feelings . This then allows the patient to express themselves freely, thereby helping to reduce painful emotions.
The overall aim of this therapy is to increase self-worth, alertness, communication, social skills, sense of reality, and sense of humor, by reducing negative emotions and experiences. This then also helps to reduce behaviors such as crying, pacing, withdrawal, and aggression .
A summary of the 14 validation techniques outlined by Naomi Feil  are as follows:
Research suggests that the use of Validation therapy has helped many dementia patients to cope with emotional distress, particularly with reducing agitation, which then reduces the need for medicinal intervention .
Similarly, it has been found to improve the ability for professional caregivers to respond to the emotional needs of their patients, which reduces patient’s feelings of depression and unwanted behaviors such as aggression .
The use of Validation therapy improves the relationship between the caregiver and their patient, which reduces feelings of caregiver burden and potential abuse towards patients, as well as expressions of anxiety and aggression from patients .
There are several other therapeutic activities and interventions used in the treatment of dementia, each of which focuses on individual aspects of cognitive decline. Some of these therapies are as follows :
Cognitive stimulation therapy involves the use of social, physical, recreational, and cognitive activities to stimulate the brain and promote social engagement.
Reminiscence therapy involves the use of either a structured or simple conversation with the person with dementia, to encourage them to recall their long-term memories and experiences from their past. This can help improve mood, communication, and cognitive abilities.
Reality orientation can be an individual or group therapy, designed to help the person with dementia orientate to time, place, and person, helping to reduce confusion. This should be done carefully and should avoid countering any fixed delusions, since this can cause anger and frustration.
Typically, cognitive rehabilitation and training is only utilized in the earlier stages of dementia, as it can be distressing for those who are severely impaired. It is designed to assist in the improvement of functioning and provide strategies to cope with distress, by practicing various techniques. It can be provided by speech-language pathologists, psychotherapists/counselors, occupational therapists, and neurofeedback providers.
Family intervention can help to provide support for families caring for a loved one with dementia, by providing a clearer understanding of the condition, symptoms, and behaviors, techniques to manage and support their loved one, and reduce their feelings of caregiver burden.