Introduction
Aging is a natural process and a stage of growth with physical, psychological, social, and spiritual dimensions. According to their physiological conditions, the elderly are prone to various physical and mental diseases that can affect their life satisfaction and lead them to mental exhaustion and unhappiness. Life review therapy can be an effective intervention in increasing positive feelings and happiness in the elderly [1, 2]. Considering the importance of the phenomenon of population aging and the psychological problems of the elderly, and since old age is a sensitive period of human life, it is a social necessity to pay attention to the issues and needs of elderly people. Therefore, the present study aims to determine the effect of a life review therapy program on the Self-actualization and happiness of the elderly in Iran. 

Methods
This is a quasi-experimental study with a pre-test/post-test/follow-up design with a control group. The study population includes all elderly men and women over 60 years of age referred to the daycare centers in Tehran, Iran in 2022. Of these centers, one center was randomly selected, and the elderly who met the inclusion criteria were purposefully selected and randomly divided into two intervention (n=11) and control (n=11) groups. The data were collected using the PERMA-Profiler and the Oxford happiness questionnaire. 
The life review therapy was provided to the intervention group based on Haight and Webster’s protocol in 6 group therapy sessions of 60-90 minutes. The first session focuses on childhood, the second session on adolescence, the third session on youth, the fourth session on middle age, the fifth session on old age, and the sixth session includes summarizing and evaluating the individuals [3]. During this period, the control group did not receive any intervention. Immediately after and one month after the intervention, the questionnaires were completed again to measure the happiness and Perma Flourishing Scale of the elderly in both groups. SPSS version, 26 software was used for data analysis. 

Results
The mean age of participants was 74.09 years in the intervention group and 68.45 years in the control group. Based on the results of the chi-square test, there was no statistically significant difference between the intervention and control groups based on Gender (P=0.231), level of education (P=0.563), marital status (P=0.303), and employment status (P=0.112). The mean score of the happiness variable in the intervention group was 50. 27 in the pre-test phase, 58. 27 in the post-test phase, and 57. 09 in the follow-up phase. In the control group, it was 48. 63 in the pre-test phase, 48. 18 in the post-test phase, and 49. 54 in the follow-up phase. The results of Greenhouse-Geyser test showed a significant difference in the mean happiness scores among the three phases of evaluation. After the intervention, the mean score of happiness in the intervention group increased significantly compared to the pre-test score. Therefore, life review therapy was effective in increasing the happiness of the elderly. The effect was maintained in the follow-up phase. There was no significant difference in the mean score of happiness in the control group in the post-test phase. 
The mean Perma Flourishing Scale in the intervention group was 98.63 in the pre-test phase, 111.63 in the post-test phase, and 104.81 in the follow-up phase. In the control group, it was 95.18 in the pre-test phase, 94.81 in the post-test phase, and 92.36 in the follow-up phase. The results of the repeated measurement test showed a significant difference in the mean scores of Flourishingamong the three phases of evaluation. After the intervention, the mean score in the intervention group increased significantly compared to the pre-test score. Therefore, life review therapy was effective in increasing the Flourishing of the elderly. There was no significant difference in the mean score of Flourishing in the control group in the post-test phase. In the follow-up phase, the mean scores of Flourishing in the intervention group decreased. 

Conclusion
The use of life review therapy can improve the self-actualization and happiness of the elderly. This study revealed important information about the elderly’s need for social participation, resolution of past experiences, and finding meaning in current situations. The results can be used in further studies

Ethical Considerations
Compliance with ethical guidelines
This study was approved by the ethics committee of University of Social Health and Rehabilitation Sciences (Code: IR.USWR.REC.1400.255).

Funding
This study was extracted from the master’s thesis of Naseh Mohammadi Safa registered by the Department of Counseling, University of Social Health and Rehabilitation Sciences. This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Authors' contributions
The authors contributed equally to preparing this paper.

Conflicts of interest
The authors declared no conflict of interest.

Acknowledgment
The authors would like to thank the seniors and the staff of elderly day care centers in Tehran for their cooperation in this study.

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