9.1: Positive Psychology in Clinical Practice
- Page ID
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- Understand what positive health is and how it differs from traditional notions of health.
- Explore why positive psychology is crucial for managing chronic diseases today.
- Identify specific health benefits linked to positive emotions.
- Discuss how positive factors influence health outcomes.
Approach to Mental Health
Mental illness affects a significant portion of the population, with one in five adults experiencing some form of mental health condition. Among these, nearly one in twenty-five individuals live with a serious mental illness.
Traditional clinical approaches often follow a "fix-what's-wrong" framework that centers on deficits. This approach typically involves assessing symptoms and problems, followed by treatment aimed at reducing negative thoughts, emotions, behaviors, and relational difficulties. The ultimate objective is to promote wellness by alleviating symptoms and addressing underlying issues, thus guiding the pathway from identification through intervention to improved mental health outcomes.
In positive clinical psychology, the approach shifts towards emphasizing strengths rather than deficits. It begins with a thorough assessment that considers not just symptoms and problems, but also identifies strengths and personal values. Treatment focuses on enhancing positive thoughts, emotions, behaviors, and relationships. The goal is to achieve wellness by aligning behaviors with personal values, utilizing strengths effectively, and reducing symptoms. This approach aims to empower individuals by leveraging their inherent strengths to promote growth and well-being.
Positive psychology can complement traditional psychotherapy by offering strategies that differ in focus. While traditional therapy typically focuses on reducing distress and addressing existing problems, positive psychology emphasizes building strengths and promoting success. Balancing both prevention and enhancement approaches is crucial in this context.
Shifting more focus towards primary prevention in positive psychology can be particularly impactful. By preventing issues before they arise, this approach has the potential to reach a larger number of individuals and promote overall well-being more effectively.
Dr. Nancy Sin and Dr. Sonja Lyubomirsky's 2009¹ meta-analysis of 51 studies involving 4,266 individuals found that positive therapy interventions significantly enhance well-being (r = 0.29) and decrease depressive symptoms (r = 0.31). Factors such as initial depression status, self-selection into therapy, older age, individualized sessions, and longer treatment durations were linked to greater effectiveness. Positive therapy's impact on reducing depressive symptoms was comparable to standard psychotherapy for depression. These findings highlight its potential as a valuable approach in mental health treatment.
In 2005², Seligman, Steen, Park, and Peterson conducted a study involving 577 participants. They utilized an online intervention to measure changes in both happiness and depression levels among the participants.
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Participants in the Gratitude intervention wrote and delivered a letter expressing gratitude.
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Those in the Three good things intervention wrote about positive experiences and their causes nightly.
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The You at your best intervention involved reflecting on past positive experiences and personal strengths.
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Participants in the Using strengths intervention identified and applied a strength daily in a new way.
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In the Identifying strengths intervention, participants generally used identified strengths more often.
The Gratitude intervention appeared to have the greatest impact on happiness, while the Three good things intervention likely had the most impact on reducing depression. These findings highlight the effectiveness of positive psychology practices in improving well-being and managing depressive symptoms.
Positive Psychology Includes several Effective Therapeutic Approaches
Well-Being Therapy (Fava et al., 2004)³ is a structured method focusing on problem-solving and enhancing environment mastery, personal growth, purpose, autonomy, self-acceptance, and positive relationships.
Positive Psychotherapy (Rashid, 2008)⁴, based on Seligman’s happiness theory, involves 14 sessions that integrate strengths, gratitude, forgiveness, optimism, love/attachment, savoring positive experiences, and finding meaning in life.
Strengths-Centered Therapy (Wong, 2006)⁵ emphasizes validating strengths (expliticizing), setting goals aligned with them (envisioning), boosting motivation (empowering), and facilitating ongoing application of strengths beyond therapy (evolving). It aligns with Seligman's framework of the pleasant life, engaged life, and meaningful life.
To gain a clear understanding of positive psychotherapy, watch Dr. Russ Curtis, a professor of counseling, demonstrate a counseling role play session⁶.
Then, watch Dr. Russ Curtis demonstrate how to utilize strengths in Positive Psychotherapy in another counseling role play session⁷.
Positive Psychotherapy: Session-By-Session Example:
Suicidality and Hope
Suicidality and hope are examined in the research by Beck et al. (1990)⁸ involving 1,958 outpatients. They found that scores on the Beck Hopelessness Scale accurately predicted 94.2% of suicides, with patients scoring over 9 being 11 times more likely to die by suicide.
This is where hope comes into play. Clinical approaches, as discussed by Lopez, Floyd, Ulven, and Snyder (2000)⁹, focus on fostering hope through various strategies:
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Hope finding: Helping individuals develop narratives that highlight instances of hope in their past or present.
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Hope bonding: Cultivating hope within the therapeutic relationship to enhance trust and collaboration.
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Hope enhancing: Facilitating improvements in goal-setting and behavioral strategies to achieve those goals.
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Hope reminding: Encouraging clients to recognize and embrace their own capacity for hope autonomously.
According to Snyder (2002)¹⁰, hope is characterized by the ability to envision multiple pathways to achieve a goal (pathways thinking) and the motivation to utilize those pathways (agency). These approaches highlight the importance of instilling, developing, and reinforcing hope as a crucial component in therapeutic interventions aimed at reducing suicidality and promoting well-being. As we discussed in the previous, along with hope, it is also important to consider the role of culture.
Cultural Considerations
Joshanloo (2014)¹¹ outlines differences between Western and Eastern philosophies of well-being. Western views emphasize self-enhancement, hedonism, mastery, satisfaction, and avoiding suffering, while Eastern perspectives prioritize self-transcendence, eudaimonism, harmony, contentment, and spiritual values. Take a moment to reflect on how these cultural characteristics play a role in positive psychology- it might be a good idea to review the previous chapter on culture.
Definitions
- Explicitizing
- validating and highlighting strengths
- Envisioning
- identifying strengths and goal utility
- Empowering
- boost motivation and empowerment, using strengths
- Evolving
- termination and facilitating continued strengths use outside
- Hope Finding
- helping individuals develop narratives that highlight instances of hope in their past or present
- Hope Bonding
- cultivating hope within the therapeutic relationship to enhance trust and collaboration
- Hope Enhancing
- facilitating improvements in goal-setting and behavioral strategies to achieve those goals
- Hope Reminding
- encouraging clients to recognize and embrace their own capacity for hope autonomously
Attribution
¹Sin, N. L., & Lyubomirsky, S. (2009). Enhancing well‐being and alleviating depressive symptoms with positive psychology interventions: A practice‐friendly meta‐analysis. Journal of clinical psychology, 65(5), 467-487. https://doi.org/10.1002/jclp.20593
²Seligman, M. E., Steen, T. A., Park, N., & Peterson, C. (2005). Positive psychology progress: empirical validation of interventions. American psychologist, 60(5), 410. https://doi.org/10.1037/0003-066X.60.5.410
³Fava, G. A., Ruini, C., Rafanelli, C., Finos, L., Salmaso, L., Mangelli, L., & Sirigatti, S. (2004). Well-being therapy of generalized anxiety disorder. Psychotherapy and psychosomatics, 74(1), 26-30. https://doi.org/10.1159/000082023
⁴Rashid, T. (2014). Positive Psychotherapy. In: Michalos, A.C. (Ed.) Encyclopedia of Quality of Life and Well-Being Research. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-0753-5_3378
⁵Wong, Y. J. (2006). The future of positive therapy. Psychotherapy: Theory, Research, Practice, Training, 43(2), 151–153. https://doi.org/10.1037/0033-3204.43.2.151
⁶Russ Curtis, Ph.D., Professor of Counseling. (2011, Oct. 21). How to Apply Positive Psychology: Counseling Role Play Session [Video]. YouTube. https://youtu.be/efOZL9STwEA?si=YlAx6BbKjIrOg4uP
7Russ Curtis, Ph.D., Professor of Counseling. (2015, July 15). Positive Psychotherapy: Strengths Survey Interpretation role-play [Video]. YouTube. https://youtu.be/2H-czhyGamE?si=H5mHwJ-dpc5nRfow
⁸Beck, A. T., Steer, R. A., Epstein, N., & Brown, G. (1990). Beck self-concept test. Psychological Assessment: A Journal of Consulting and Clinical Psychology, 2(2), 191. https://doi.org/10.1037/1040-3590.2.2.191
⁹Lopez, S. J., Floyd, R. K., Ulven, J. C., & Snyder, C. R. (2000). Hope therapy: Helping clients build a house of hope. In C.R. Snyder (Ed.), Handbook of hope; Theory, measures, and applications (pp. 123-150). Academic Press. https://doi.org/10.1016/B978-0-12-654050-5.X5000-3
¹⁰Snyder, C. R. (2002). Hope theory: Rainbows in the mind. Psychological inquiry, 13(4), 249-275. https://doi.org/10.1207/S15327965PLI1304_01
¹¹Joshanloo, M. (2014). Eastern conceptualizations of happiness: Fundamental differences with western views. Journal of happiness studies, 15, 475-493. https://doi.org/10.1007/s10902-013-9431-1