Effects of rational emotive behavior therapy on alexithymia, anxiety, depression and sleep quality of the elderly in nursing homes: a quasi-experimental study

Abstract Background Alexithymia, a subclinical cognitive-affective impairment, is prevalent in the elderly and increases the risk of mental disorders. There is a vast alexithymia treatment gap, with majority of the elderly in nursing homes lacking access to adequate mental health care. The study aimed to evaluate the effects of rational emotive behavior therapy (REBT) on alexithymia, anxiety, depression and sleep quality of the elderly in nursing homes. Methods This quasi-experimental study was conducted with two groups (the control group and intervention) from March to November 2021. This study enrolled 86 participants, two of whom were lost to follow-up; 42 received usual care (control group) and 42 received REBT based on usual care (intervention group) in nursing homes. The elderly in both groups were evaluated at baseline, within one-week post-intervention, and at 3-month follow-up. Generalized estimating equations were used by SPSS version 26 to assess the differential change in the outcomes between the two groups. Results The intervention group shows significantly greater improvement in alexithymia than the control group within one-week post-intervention ( β = -8.167, 95% CI = -10.965, -5.368, P < 0.001) and at 3-month follow-up ( β =-4.119, 95% CI = -7.171, -1.067, P = 0.008). Compared to the control group, the intervention group shows a significant improvement in sleep quality at 3-month follow‐up ( β = -2.048, 95% CI =-4.004, -0.091, P = 0.040). For depression and anxiety, no significant differences were found between the intervention and control groups. Conclusions REBT showed to be an effective method for improving alexithymia and sleep quality of the elderly in nursing homes. However, it failed to significantly alleviate anxiety and depression at least in a short-term trial. Refining this intervention may have a broader, more substantial impact on future research.