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Life Transitionz

What:A programme addressing the mental health and wellbeing of older persons.

Why:To understand and manage psychological issues resulting from the ageing process and age-related events.

How:Weekly sessions that include strategies for successful aging, communication, social interaction, personal development and healthy lifestyles.

Target:Older persons who do not meet the access criteria for public health psychology services, and do not have the financial resources to afford the full cost of referral to a private psychologist.

Where:Waikato region.

Successful aging programme

"I ... think that it needs to go nationwide and ... it's about how we position it to do that."
Colleen Hyde, CEO PsychoDynamix, registered psychologist.

The profile

Life Transitionz is a programme for older persons aged 65 years and over. It aims to educate people who are getting older about the psychological issues associated with ageing, such as anxiety, depression, loss, grief and how to maintain quality of life. The programme takes a holistic multidisciplinary approach. It is delivered by a team of psychologists, general practitioners, nutritionists and fitness trainers. The programmes approach is based in cognitive behaviour therapy. The programme runs once a week for six to eight weeks, depending on the specific needs of participants.

Life Transitionz was developed by PsychoDynamix Ltd, a private practice that provides psychological services to people living in Thames and the surrounding area. The creators of the programme are Colleen Hyde, registered psychologist and owner of PsychoDynamix, and Gina Rickards, a registered psychologist and the main driver and facilitator of the programme.

Life Transitionz is run in the Coromandel, Waikato and Hauraki regions. It is funded by the Waikato Primary Health Organisation (Waikato PHO). Since its inception in 2005, Life Transitionz has been delivered to 11 groups of older people from diverse backgrounds including New Zealand European, Pacific, Maori, Chinese, and Cambodian.

Colleen and Gina presented their work with Life Transtitionz at the New Zealand Psychological Society conferences in 2007 and 2008 and at the AgeWise seminar, 2009.

‘...all of the people from the programme have been incredibly different ethnicities, ages, occupations, just totally different. Yet we share a lot of things in common. "
Gina Rickards, registered psychologist.

The beginnings


Colleen opened the PsychoDynamix practice in Thames during 1997. She quickly became aware that a significant number of older people were presenting at the centre with a variety of problems, including difficulties managing loneliness and age-related complications. Colleen and Gina looked into the community approaches for dealing with ageing. They found that while there were lots of programmes addressing physical health issues such as nutrition, keeping fit, or managing chronic illnesses, such as diabetes, there weren't any programmes tackling psychological issues related to aging.

Realising this could be an important gap in elderly care in the region they approached AgeWise at Thames Hospital in 2004, who confirmed the need. Colleen and Gina continued to meet with AgeWise as well as with hospital community health nurses, rest home managers, the regional hospital manager, GreyPower and other relevant stakeholders. A committee was established to find the optimal approach to address the issue, avoiding any duplication of services already available in the community.

In parallel with their organisational and individual psychological work, Colleen and Gina researched the international literature which supported the need for adequate psychological services. For example, in 1999 the American Psychological Association has predicted a 25 per cent increase of depression and anxiety in the older population over the next decade.

As a result of both regional consultations and the literature review, Colleen and Gina decided to develop the Life Transitionz programme. Twelve months were spent on developing the concept and framework for Life Transitionz. During this time Colleen and Gina searched for the most appropriate format for the programme, adjusting it to the ability of the participants to actively engage in structured sessions and adapting it for varying cultural backgrounds. Initially the programme was delivered for 2.5 hours over eight weeks with follow up assessments at one, three, six, and 12 months. Later the format was changed to six 3 hour sessions and two follow up assessments at three and nine months.

Waikato PHO health promotion funding enabled the development and continues to support the programme.

Participants in the programme

The process

"...the information we took home was very good because what you couldn't take in at the meeting, you could absorb when you got home ...."
Ena Wickenden, programme participant.

Participants are referred to the programme through various channels including general practitioners (GPs), community nurses, district health nurses, community mental health centres, geriatricians, rest homes and self referrals. Advertisements in local media were also used to reach broader communities and specific population targets, such as Chinese and Cambodian people.

After receiving the referral, Gina or Colleen contact potential participants and arrange face-to-face interviews. The interviews are usually conducted in the potential participant's home so living arrangements can also be assessed. During the interview, potential participants are asked about their physical health and given some psychometric tests to ensure the programme will be appropriate for them. Gina or Colleen also explain the content and structure of the programme and provide information about the venue where it will be conducted. While people with severe psychological disorders or poor physical health (for example, suffering heart failure) cannot attend the workshops, having a physical disability (such as deafness, poor mobility or blindness) is not an obstacle.

After the interview process future participants are sent invitation letters to attend the initial session of the programme. A requirement of any venue is full disability access. People with hearing impairments are encouraged to sit at the front of the room or to bring along a support person. Gina's mother was deaf, which gives her a unique skill in modulating her voice to adjust to individual's needs. People with visual impairment are accompanied either by their guide dog or a support person. Interpreters are organised for groups for whom English is not a first language.

On the first week all participants are given pedometers to establish baseline physical activity levels. These are worn for the entire programme to encourage an increase in mobility and fitness.

A participant in the programme

Life Transitionz is run in mixed groups in terms of gender and age. The programme is tailored to different cultures and the groups are monocultural - New Zealand European, Chinese, Maori, Cambodian or Pacific Island people. The number of participants can vary from six up to 20+. Most of the groups are run in weekly 3 hour sessions, for six weeks. Those groups that require interpreters are run for 4 hours over the six week period. Sessions usually include morning tea or lunch. Gina facilitates all the groups along with specialists who are contracted to run certain sessions, such as occupational therapists, sports coaches, GPs, life coaches, nutritionists and tai chi instructors.

"I must admit I had a lot of satisfaction."
Ray Jones, programme participant.

The sessions include various topics:

  • thought of the day
  • myths and facts of aging
  • physical exercise sessions - ‘Upright and Active' fitness trainers
  • mental fitness tasks - keeping mentally active
  • grief issues
  • life transitions and change, including setting goals, applying personal plans and reporting back
  • how to assess and improve self-esteem
  • mood issues, including anxiety, depression and attitude
  • sleep problems and solutions
  • nutrition, including keeping a food diary and consulting with a nutritionist
  • GP question time
  • elderly abuse
  • monitoring pedometer records.

After completing the programme, participants have regular follow ups to assess the sustainability of changes made.

The unique approach

"... we need to learn about the psychological vulnerabilities of aging
and not be scared to talk about them."
Gina Rickards, registered psychologist.
  • The format of this programme is unique in New Zealand.
  • The programme has multicultural applicability.
  • Life Transitionz is a bridge for older persons of different cultures to adjust to their adoptive country, to address possible traumatic experiences in their home countries and to improve intra-familiar relationships. For example, when working with the Cambodian group, the need for input on post-traumatic stress was identified and addressed. Participants from the Chinese groups expressed their need for the facilitators' input on relationships with their children and grandchildren, who have integrated into the Kiwi culture.

Participants in the programme

The results

"I think the things we gained were really there in our minds, but it just needed someone to stir them up and bring them out.", Jean Driver, programme participant.

Life Transitionz was formally evaluated in 2006 by Waikato PHO. It also undergoes ongoing internal evaluation. The latest evaluation was a general update with regards to Chinese migrants (Cohort 2) and Cambodian migrants, conducted during 2009.

As at the end of August 2009, 126 people (83 females and 43 males) completed the programme, representing a total of 11 groups. At the post-programme tests all participants reported that they interacted with more people, most felt good about themselves (98.4 per cent) and most felt more positive (94.2 per cent). Many felt better able to manage life changes (74.3 per cent) and to deal with the grief (74.3 per cent). Feedback in relation to the programme itself indicated that most participants considered the facilitator effective (95.4 per cent) and most felt comfortable about expressing their views in a group (94.5 per cent). A large number of participants had been able to put the course material into practice (83.5 per cent).

On psychological assessment it was found that overall:

  • 70 per cent of participants reported increased self-esteem
  • 66 per cent reported a decrease in depressive symptoms
  • 74 per cent reported lowering of anxiety symptoms
  • 81 per cent reported a reduction in worry about physical health
  • 58 per cent reported improved quality of life.

Cultural differences did not significantly influence the participants' responses.

Additionally there has been strong anecdotal evidence of the positive effects of the programme on participants' wellbeing. They reported becoming more aware of diet and nutrition, exercising more, sleeping better, gaining confidence, communicating better with others and making new friends. Those who were migrants to New Zealand reported becoming more familiar with the ‘Kiwi lifestyle', participating in activities typical for New Zealand older persons, such as bowling and cooking ‘kiwi style' food. One group was run on a local Marae, which resulted in involvement of the participants' whanau as an additional positive outcome.

"...regardless of race, we are just the same. We still have problems like they have problems ..."
Jean Driver, programme participant.

Many participants have also kept in contact with each other after completion of the programme in an informal way, exchanging emails, meeting for coffee or meals, attending the gym or going swimming together. The Christmas party for all participants in all groups has become part of the programme's tradition, bringing everyone together and building the social support network. For those who are lonely, with no family living close by, such social interaction provides an opportunity to meet their friends and to have emotional outlet to deal with loneliness.

Participants in the programme

"Everyone's opinion, as broad and different as it is, is valid."
Gina Rickards, registered psychologist.

The lessons learnt

"I must admit a lot of the information, I didn't know about ... before, and quite a lot of it was useful information to me and I learned a lot, but I think from my point of view above all it was friendship that came out of it.",Ray Jones, programme participant.
  • Addressing the psychological and physical issues of aging has positive effect on the quality of life of older persons.
  • Tailoring the programme to different cultural need is important factor for achieving the goals of the Life Transitionz.
  • The therapeutic relationships between the facilitators, guest speakers and participants are a key ingredient for the success of the group.
  • Social aspects of the programme play a major role in the sustainability of LifeTransitionz.
  • While the main focus of the programme is psychological, the multi-disciplinary approach plays a significant role in its effectiveness.
  • Life Transitionz is equally effective across a range of cultures.

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Page last updated: 7 November 2008