INTRODUCTION
A person's life is characterized by social transitions
that disrupt personal relationships and cause loneliness. Loneliness can happen
to anyone, both teenagers and adults. Almost everyone has experienced
loneliness, but the feeling differs from one individual to another (Alwisol, 2014). Moreover, loneliness means mental and
emotional states, especially feelings of isolation and a lack of meaningful
relationships with others (Dayakisni & Hudaniah, 2009). Loneliness is an
emotional and cognitive reaction to having fewer and more unsatisfying
relationships than the person wants (Nurlayli & Hidayati, 2014). Loneliness is a
pervasive problem among older people with strong relationships that exist on
social support, mental and physical health, and cognition (Nurhayati, 2018). When examining loneliness in the elderly,
it is essential to consider it a subjective experience distinct from social
isolation and social support (Widya, 2016).
Loneliness is related to psychological problems and dissatisfaction with family
and social relationships (Amalia, 2013).
Based on some of the definitions above, it can be concluded that loneliness
means a mental and emotional state due to feelings of alienation and unpleasant
conditions that a person perceives as a result of not fulfilling the need for
social relationships or interpersonal relationships.
Growing old makes individuals experience fear because they
believe that with age, they will lose physical function and the pleasant
aspects of life (Zulfina, 2014). At this time, environmental factors are
pretty influential on psychological factors such as tension and stress in the
elderly. According to Santrock, Sumiharti, Sinaga, Damanik, and Chusairi (2002), there are two views on
the definition of elderly or older people, namely the views of westerners and
Indonesians. The view of western people who are classified as elderly are
people who are 65 years old and over, where this age will distinguish someone
who is still an adult or a progressive person. While the views of Indonesians
are generally used as the maximum working age, aging characteristics are
starting to appear. The elderly are part of the process of growth and
development because humans do not suddenly become old but go through stages of
development starting from infants, children, adolescents, adults, and become
old. This is normal with predictable physical and behavioral changes as they go
through certain stages. A person's life is characterized by social transitions
that disrupt personal relationships and cause loneliness. Loneliness can happen
to anyone, both teenagers and adults. Almost everyone has experienced
loneliness, but the feeling differs from one individual to another. Brehm and Kassin argue that loneliness is a lack of social
relationships resulting from dissatisfaction with existing social relationships
(Dayakisni & Hudaniah, 2009).
Loneliness is a pervasive problem among older people with
strong relationships based on social support, mental and physical health, and
cognition. Loneliness can also be caused by a lack of feelings about social
life with someone. However, according to some researchers, the feeling of lack
is caused by a mismatch between reality and expectation (Arumdina, 2013). An estimated 35% of adults over the age of
45 and over 40% of those over the age of 60 report feeling lonely, with more
than one in five describing their loneliness as severe (Reiland et al., 2021). Physiological changes in
motor skills that occur not infrequently make the elderly feel useless, then
experience demotivation and withdrawal from the environment so that the need
for attention becomes excessive, leading to loneliness in the elderly (Putra et al., 2012). When examining loneliness in the elderly,
it is essential to consider it a subjective experience distinct from social
isolation and social support. Loneliness is related to psychological problems
and dissatisfaction with family and social relationships (Amalia, 2013).
Not all older people can enjoy their twilight years in the warmth of the
family, and there are main psychological problems experienced by the elderly (Munandar et al., 2017).
The first is the problem caused by life changes and
physical decline experienced by the elderly. Second, the elderly often experiences
loneliness caused by breaking up with the closest and dearest people. Third,
the post-power syndrome is often experienced by the elderly who have just
retired and lost strength, income, and happiness. Based on the psychological
problems experienced by the elderly, the elderly need family support which is
expected to prosper their lives of the elderly. The separation problem
experienced by the elderly can trigger feelings of loneliness experienced by
the elderly. The feelings of loneliness will be increasingly felt when their
partners have lived with the elderly. Loneliness in the elderly refers more to
loneliness in the context of "empty nest syndrome," where loneliness
is caused by the departure of a life partner to return to God (Munandar et al., 2017). Losing a partner in the
elderly gradually, this situation can cause feelings of emptiness in the
elderly. It will increase the feelings of loneliness they experience. The
feeling of loneliness experienced by the elderly gradually tends to negatively
influence their health condition (Hariandja et al., 2014). Loneliness experienced
by the elderly has an impact that tends to cause various problems such as
depression, suicidal ideation, decreased immune system, and sleep disorders.
Cognitive Behavior Therapy (CBT) is a technique for
modifying behavior and changing maladaptive beliefs. Therapists help
individuals replace irrational interpretations of events with more realistic
interpretations. Alternatively, it helps control disturbed emotional reactions,
such as anxiety and depression, by teaching them more effective ways to
interpret their experiences (Mujib & Mudzakkir, 2001).
Cognitive Behavior
Therapy (CBT) is a very effective form of psychotherapy pay attention to
aspects of the role in thinking, feeling, and acting. There are several
approaches to CBT psychotherapy including approach to Rational Emotive Behavior
Therapy, Rational Behavioral Therapy, Rational Living Therapy, Cognitive
Therapy, and Dialectical Behavior Therapy. However, CBT has the following
characteristics which makes CBT more distinctive than other approaches.
Cognitive Behavior Therapy
(CBT) is considered capable of applied repeatedly by the client without help
from the therapist, so it is effective to change distorted thinking about him.
There has been no
previous research that has examined this, therefore researchers are interested
in researching. This phenomenon is quite interesting to study closely in depth
and comprehensively through scientific research to reveal the effect of CBT (Cognitive
Behavior Therapy) therapy techniques in reducing moderate loneliness disorders
in the elderly.
METHOD
The research
method used is an experimental study, namely a single experimental design in a home setting, where the
subject is treated with CBT (Cognitive
Behaviour Therapy) therapy to overcome loneliness. The stages of therapy used are:
1) Approach to the client
2) Identify client problems
3) Disclosure of problems faced by clients
4) Disclosure of the client's desire for his child
5) Explain positive thoughts through positive
statements
6) The transition from negative thoughts to positive
thoughts
7) Evaluation
8) Giving positive reinforcement
Data collection
in this study used the methods of observation, interviews, and psychological
tests (SAT and UCLA - Loneliness Scale).
Data analysis in this study uses insight evaluation on the subject and
evaluation of increased interaction with neighbours.
RESULTS AND DISCUSSION
In general, the
client's appearance was clean and well-maintained. The client is a middle-aged
woman with a height of about 150 cm and a weight of about 40 kg. The client
looks pretty neat in a plain long dress and a plain black hood. The client has
a physical appearance with tan skin colour. The teeth are almost gone, the face
is oval, and the eyes are black. Clients still speak very clearly. The client
walks alone without the aid of a cane. The client's body posture is ideal, tall
and fat.
The client lives in a village, which is quite
densely populated. Along the highway to the client's home address passing
through urban areas with many shops and places of business. The distance of the
client's house from the highway to the alley is quite far but can be passed by
car to the front of the client's house.
The client's
residence is inhabited by three family members, including the client and the
client's two children. The house has a tiled roof, brick walls, and a tiled
floor. The client's house does not have a yard, and there is only a tiny
terrace that the client made to dry clothes and some ornamental plants.
Upon entering
the door, on the left side, there is a guest chair equipped with green and
patterned guest table described as a living room. Behind the living room is a
family room with a TV attached to the wall and a mattress in front of it. On
the right side of the living room, there are three rooms. Then there is a door
leading to the back of the house, a kitchen, a dining room, and a bathroom.
In the kitchen, there is a gas stove and other
cutlery. In the dining room, there is a round dining table, four chairs, and a
serving hood.
From the client
interviews, the client said he felt lonely at home because his two children
were busy with their respective jobs. The son sometimes does not come home
while the daughter comes home late at night and is never on time, so clients
often wait anxiously in the living room until the children come home. The
client feels miserable when the client requires help and is sick, but no one is
at home. The client takes care of himself as much as possible while waiting for
one of his children to come home from work and take care of him. The client
admitted that if the client felt very bored at home, the client chose to leave
the house and sit in front of the house while interacting and watching neighbours’
activities around the client's house.
The client wants to immediately pet
grandchildren and has a son-in-law so that the client's life is not lonely, but
the client's daughter has no desire to get married. In addition, the client
also wants his daughter to get married soon because her daughter's age is very
mature for a woman. This makes the client feel very anxious and worried.
According to a neighbour,
when sitting with a client, the client often complains about his daughter. The
latter has no desire to get married even though, according to the client, she
is of the age to get married. The client was worried and asked close neighbours
how to get their children to want to get married. In addition, according to neighbours,
the client often feels lonely because his two children are busy working, and
the client does everything alone. Sometimes neighbours finally step in to help
the client out of pity to see the client's condition, which worsens daily.
From the
results of psychological tests, it was found that the client needs to protect
his family, especially his children. Besides that, the client also wants to be
protected, looked after, and cared for by his two children. The client also
wants to establish a close and intimate relationship with his family. A happy
and loyal family to each other is the client's desire.
A quiet and comfortable life that clients want
in their lives. Clients have feelings of suffering, loneliness, and
helplessness due to a lack of support, help, enthusiasm, protection, and love
from family and people around them. As a result, the client tends to cry
because the desire for support and love does not materialize and makes the
client feel helpless.
The client
experiences a moderate degree of loneliness. She desires to be cared for by her
child, especially with the client's condition, who was abandoned by her husband
a few years ago. However, it seems useless because her children are busy. The
client is often alone at home because his two children are busy with their
respective jobs. His son sometimes works but does not come home, while his
daughter often does not come home on time and late at night. Clients often wait
for their children in the living room until they come home. When the client is
sick or needs help, he does everything himself. The following are the results
of the intervention:
Table 1
Intervention Results
|
Before the Intervention
|
After the Intervention
|
|
The client feels lonely when at home alone because his children are
busy with their respective jobs
|
The client no longer feels lonely because the client already has
activities to get rid of loneliness and is more likely to do activities with
close neighbours
|
|
The client feels that their children do not care and do not care about
the clients
|
Clients feel that clients care. They have to work and earn money to
support clients.
|
CONCLUSION
Based on the
discussion above, it can be concluded that the intervention of CBT (Cognitive Behaviour Therapy) therapy
technique reduces moderate loneliness disorder in the elderly. After therapy,
client no longer feels lonely because the client already has activities to get
rid of loneliness and is more likely to do activities with close neighbours,
clients feel that clients care (Their children have to work and earn money to
support clients).
In general, the
intervention process for the client can take place smoothly and be targeted
because the client is well cooperative. The client's desire to change for the
better makes it easier for practitioners to provide counselling and solutions
so that clients can commit well. The client's neighbours can also be invited to
cooperate reasonably when the practitioner asks permission to interview about
the client's life.
However, here the practitioner cannot meet the
client's children because his two children are at work when the practitioner
visits the client. The client's two children come home from work late at night
even. Sometimes the son does not come home. Thus the practitioner does not have
data in the form of observations or interviews with the two children.
REFERENCES
Alwisol. (2014). Psikologi Kepribadian (Edisi Revisi).
UMM Press. Google
Scholar
Amalia,
A. D. (2013). Kesepian dan isolasi sosial yang dialami lanjut usia: Tinjauan
dari perspektif sosiologis. Sosio Informa: Kajian Permasalahan Sosial Dan
Usaha Kesejahteraan Sosial, 18(3). Google
Scholar
Arumdina,
A. F. (2013). Pengaruh kesepian terhadap pemilihan pasangan hidup pada
dewasa awal yang masih lajang. Universitas Airlangga. Google
Scholar
Dayakisni,
T., & Hudaniah. (2009). Psikologi Sosial. Malang. Google
Scholar
Hariandja,
J. R. O., Nainggolan, M., & Damayanti, K. A. (2014). Pengembangan teori
desain partisipatif untuk lansia Indonesia sebagai upaya peningkatan kualitas
hidup di usia lanjut melalui desain ruang hidup dan sistem pendukung komunikasi
sosial. Google
Scholar
Mujib,
A., & Mudzakkir, J. (2001). Nuansa-nuansa Psikologi Islam. In Cet ke-1,
h (Vol. 136). PT Raja Grafindo Persada. Google
Scholar
Munandar,
I., Hadi, S., & Ardiyani, V. M. (2017). Hubungan Dukungan Keluarga Dengan
Tingkat Kesepian pada Lansia yang Ditinggal Pasangan di Desa Mensere. Nursing
News: Jurnal Ilmiah Keperawatan, 2(2). Google
Scholar
Nurhayati,
U. N. (2018). Loneliness pada Lansia. UIN Sunan Ampel Surabaya. Google
Scholar
Nurlayli,
R. K., & Hidayati, D. S. (2014). Kesepian pemilik hewan peliharaan yang
tinggal terpisah dari keluarga. Jurnal Ilmiah Psikologi Terapan, 2(1),
21–35. Google
Scholar
Putra,
A. A., Nashori, H. F., & Sulistyarini, I. (2012). Decreasing Loneliness and
Blood Pressure of Old People Suffering Hypertension With Group Therapy. Jurnal
Intervensi Psikologi, 4(1), 1–15. Google
Scholar
Reiland,
H., Banerjee, A., Claesges, S. A., Giuca, A.-M., Hillard, C. J., Reynolds III,
C. F., & Goveas, J. S. (2021). The influence of depression on the
relationship between loneliness and grief trajectories in bereaved older
adults. Psychiatry Research Communications, 1(1), 100006. Scopus
Santrock,
J. W., Sumiharti, Y., Sinaga, H., Damanik, J., & Chusairi, A. (2002). Life-Span
Development (Perkembangan Masa Hidup Jilid 1. Google
Scholar
Widya,
W. (2016). Perbedaan Kualitas Hidup antara Lansia yang Tinggal di Keluarga
dengan Lansia di Panti Sosial Tresna Werdha. Universitas Islam Negeri
Alauddin Makassar. Google
Scholar
Zulfina,
U. (2014). Meningkatkan kebahagiaan lansia di panti wreda melalui psikoterapi
positif dalam kelompok. Psychological Journal: Science and Practice, 2(3),
256–267. Google
Scholar
