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Common Uses of Validation Therapy and How it Works

Higher Education Articles July 29, 2013

Validation therapy is a unique approach to dementia and other cognitive disorders. Unlike most other types of cognitive therapy, its primary aim is not to correct patients’ misperceptions of themselves and the world. Instead, it aims to help patients connect with the outside world by validating their inner experiences.

While today, it is primarily used with dementia patients, it has other uses as well. It can be used with Alzheimer’s disease and other cognitive disorders as well. The question most people have, though, is how this therapy is different from other types.

How Validation Therapy Works

Dementia patients typically hold on to their ability to feel emotions longer than they do their other mental facilities. In other words, emotions are typically the last thing to go in dementia patients. Since validation therapy makes its connection through the emotions, it is a valuable technique that works even when others are no longer useful.

Dementia sufferers do not operate in “consistent time.” Instead, one minute they may be living in the past, one moment in the present, and living in an imagined future half a minute later. This makes it difficult to help the patient or for that matter, even communicate.

But a therapy type that centers more on emotions and on validating the patients’ experience is one that can be applied at any time. It is always in the moment. This validation applies as much to the patient’s inner experiences–be they factually true or not–as much as it does to their contact with the world outside of their heads.

The same principle also works with other cognitive difficulties. But how exactly do practitioners practice therapeutic validation with patients?

Steps in Validation Therapy

Center Yourself

The technique used by Naomi Feil, who created this therapeutic technique, is to focus on a spot about two inches below your navel. Concentrate on this spot as you breathe in deeply through your nose and exhale through your mouth. Take these breaths slowly and try to concentrate solely on these breaths and nothing else. It is recommended that you do this eight times.

Focus on the Facts

Dementia sufferers are often scared of their feelings. Instead of focusing on questions like “How do you feel?” or “Why did you do this?”, it is more important to ask questions like, “What happened?” or “How did this happen?”. Focusing on the Who, What, Where, How, and When is important at this stage.

Repeat the Patient’s Ideas Back to Him or Her

Dementia sufferers, as well as others who experience cognitive difficulties, usually find this comforting. Once they feel more comforted and safe, they are much more likely to “go with the program” when it comes to other types of therapy. Repeat back to the patient what he or she just told you, but in your own words. Try and match their speaking speed and tone of voice. This will help you get through to them on the mental and emotional plane they already inhabit.

Let the Patient Express Their Emotions

It’s often best to let them do this in the extreme. Rather than ask them, “Is your bed uncomfortable,” you can ask them, “Is this the hardest bed you’ve ever slept on?” This kind of expression allows the patient to feel better through venting. It also helps them feel like they are being listened to and understood.

Talk about the Opposite of Exceptional Complaints

This is an effective technique to use when the patient is complaining of something that clearly is not happening.
For example, a patient who feels that an unasked-for medication is put in her cup every morning. You might ask her, “Are there any mornings when the medicine isn’t put in your cup?” This will help get the patient to imagine reality in more realistic modes of thought.

Get the Patient to Reminisce

Reminiscing can be a good way to center the patient back in the real world. Asking patients questions like, “Have you always heard the angels speaking to you?” can help a patient to remember a time when she did not hear those voices. “Always” and “never” questions can be extremely useful here.

Maintain Eye Contact

While you should by no means stare your patient down, you should definitely make eye contact with him or her on a regular basis. Eye contact and other forms of nonverbal communication on the part of the patient are usually good signs that validation therapy is working.

Other steps in validation therapy include speaking in a low, calm voice; matching the person’s mode of speaking and emotive affects; and using touch when appropriate.

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