Positive Clinical Interventions

Overview

Traditional psychotherapy has come a long way in terms of treating disorders, but it is lacking in helping people achieve complete mental health. That is where positive clinical interventions can help. Positive psychotherapy is not equivalent to a self-help recipe; it is a systematic approach that focuses on the client's strengths and assets in order to build a happy and fulfilling life. Positive psychotherapy is unique from more traditional methods in the sense that is is concerned with both strengths and weaknesses and the techniques discussed can be applied in order to improve the lives of people not suffering from a mental disorder ^[1] That being said, it should be noted that positive psychotherapy is not meant to replace traditional therapy, but merely to supplement it.

Approaches and Theories

There are several positive psychology theories and techniques that have been found to be effective in defining and implementing the good life.

One of the most prominent theorists in the field is Martin E.P. Seligman. His major techniques for promoting the good life include:

The Gratitude Visit

In this method participants are asked to write and deliver a letter to someone they are grateful for, but have never formally thanked.

The 3 Blessings Method/Gratitude Journal

Participants are asked to write down three positive things that happened to them each day for a week along with why they believe they occurred.

Using Your Strengths

This approach asks participants to take the Value in Action Inventory of Strengths survey whose results will present them with their signature strengths and their lesser strengths. They are then asked to use these strengths more often or in a different way in their daily lives.

Acts of Kindness

In this method, participants are asked to perform 5 acts of kindness either throughout the course of a day or throughout the course of a week,

Savoring

Try to take time during your day to enjoy the simple things without rushing. Examples include eating, exercising, and showering. Then reflect on these experiences and write them down.

Theoretical Background

Seligman claims that happiness can be broken down into three parts. The first part is the pleasant life which is defined as having positive emotions relating to the past, present, and future. The gratitude and forgiveness based interventions are used to enhance positive interventions in the past, optimism and hope based interventions are used to enhance positive emotions in the future, and savoring and the three good things interventions are used to promote positive emotions in the present. The second part is the engaged life which is defined as the involvement and complete absorption in activities. Discovering and using one's signature strengths are though to enhance the engaged life. And finally, the third component to Seligman's theory is the meaningful life which involves using one's strengths and talents to contribute to something bigger than themselves. Using signature strengths also helps achieve this aspect of life.^[2]

There is also another approach to achieving the good life called well-being therapy. This is a short-term therapy that looks to enhance several things: environmental mastery (which gives the individual a sense of control and the ability to take advantage of opportunities), personal growth, purpose in life, autonomy, self-acceptance, and positive relations with others ^[3]

Major Empirical Findings

Seligman and Colleagues

One of the largest studies comparing multiple positive psychotherapy methods to a control method was performed by Seligman and colleagues. They had participants in each group take surveys before therapy and then 1 week after, 2 weeks after, 1 month after, 3 months after, and 6 months after therapy. It was found that all groups, including the control, were happier immediately after intervention. After 1 week, the control group went back to their baseline level of happiness and participants who used the Gratitude Method went back to their baseline after 1 month. However, it was found that participants using the Character Strengths and the 3 Blessings Method were significantly happier than their baselines for the 1, 3, and 6 month checkups. In general it was found that if participants voluntarily continued with their method, they were more likely to stay above their baseline. ^[4]

Lyubomirsky

Lyumbomirsky also conducted a set of experiments whose findings support some of these positive interventions. He conducted a study where participants were told to count their blessings (similar to the 3 Blessings Method) either once a week or three times a week for 6 weeks. He found that those who counted their blessings once a week were significantly happier.

He also conducted a study that asked participants to perform 5 acts of kindness either all in one day or throughout the course of a week. He found that those who performed all 5 acts in a day were happier compared to those who performed them throughout a whole week. In both of the studies referenced, Lyubomirsky quantified happiness using his four-item Subjective Happiness Scale. ^[4]

Well-Being Therapy

Since Well-Being Therapy is one of the newer positive clinical interventions, there are only a few smaller studies supporting its efficacy. One study looked at how well-being therapy helped in the residual phase of affective disorders which include but are not limited to major depression, generalized anxiety disorder, and Obsessive Compulsive Disorder. Participants meeting the criteria were randomly assigned to either well-being therapy or traditional cognitive behavioral therapy. Both groups fared better than those with no treatment, but there was a slightly better outcome with well-being therapy. However, it should be noted that this experiment had such a small sample size that replication is required to solidify the findings. ^[3]

Another experiment looked at the efficacy of well-being therapy in preventing recurrent depression. Participants were assigned to receive either a cognitive behavioral package that included cognitive behavioral therapy and well-being therapy or simple clinical management. Patients receiving the cognitive behavioral package experienced less residual symptoms after being taken off their medication and lower relapse rates overall. However, it should be noted that well-being therapy was paired with cognitive behavioral therapy so we cannot claim for certain which therapy accounted for this difference among groups. ^[3]

Applications

All of the different methods discussed have clinical applications, but some methods could work better for certain types of people or people suffering from particular mental disorders. For example, the preliminary research has found that well-being therapy is most effective with helping treat eating disorders and agoraphobia along with the residual phases of affective disorders. It can also serve as a preventative measure for depression. ^[3]

While research regarding well-being therapy offers applications for specific disorders, the majority of literature regarding positive clinical interventions makes note that a lot of the research has explored the effects of these interventions on non-clinical patients. Therefore, the majority of these methods right now can be seen as mere preventative measures or ways to enhance happiness as opposed to treating specific disorders. ^[4]

Controversies

There are several different controversies associated with positive clinical interventions. For starters, the field of humanistic psychology claims that positive psychologists are too concerned with the empirical evidence backing their methods and not focused enough on the theories behind them and actually implementing them. Secondly, critics of the field say that while the field of positive psychology claims to be all-encompassing, they pay too much attention to Western culture and the problems associated with it Critics also claim that positive psychologists pay too much attention to the individual and internal mechanisms and not enough on the societal context they live in which also contributes to well-being. And finally, the majority of the interventions discussed have not been empirically tested on clinically diagnosed individuals so their reliability in helping everyone gets called into question. ^[5]

Conclusion

Since this is still a relatively new field, there is always room for new positive interventions to be discovered and empirically tested. Additionally, the existing methods could use some more validation since many of the studies use small sample sizes and are currently lacking replication. Finally, it is important to note that the majority of the studies presented examine the effects of positive interventions on non-clinical individuals. Therefore a huge area in future research might want to examine how or if these methods would work when paired with traditional treatments for clinically diagnosed individuals.

Positive psychotherapy is a new, up and coming field that does not wish to replace traditional methods of therapy, but instead build on it so that everyone can lead happier, more fulfilling lives.

References