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Psychotherapy & positive psychology: why psychotherapists should pay attention

Early next month I'm scheduled to run a workshop on "Psychotherapy & positive psychology".  Most of the participants will be 3rd year counselling psychology students, with a few practising psychotherapists in the mix as well.  I haven't run a workshop on this subject before.  It's a fascinating area that I know a good deal about and that's totally relevant to the work that I do.  What better way to learn more than to teach a workshop about it!?  The workshop publicity, that I wrote several months ago, reads: "Positive psychology focuses on what helps humans flourish. Recent meta-analyses have shown that positive psychology interventions - cultivating positive feelings, positive cognitions, and positive behaviours - significantly enhance wellbeing, decrease depressive symptoms (Sin & Lyubomirsky, 2009), and reduce mortality (Chida & Steptoe, 2008).  Increased happiness and wellbeing are valuable in themselves. Fascinatingly such improvements also reduce relapse rates, bolster resilience and boost effective functioning.  This one day workshop highlights the relevance of recent positive psychology research for psychotherapists and looks a bit more deeply at several specific areas including Seligman & Peterson's paths to happiness, Fredrickson's broaden-and-build theory of positive emotions, Deci & Ryan's self-determination theory, and Gilbert's compassionate mind training. We'll also explore assessment methods in positive psychology, and the field's relevance both for our clients and for ourselves."

The abstract for the Sin & Lyubomirsky study I quoted - "Enhancing well-being and alleviating depressive symptoms with positive psychology interventions: a practice-friendly meta-analysis" - reads "Do positive psychology interventions - that is, treatment methods or intentional activities aimed at cultivating positive feelings, positive behaviors, or positive cognitions - enhance well-being and ameliorate depressive symptoms? A meta-analysis of 51 such interventions with 4,266 individuals was conducted to address this question and to provide practical guidance to clinicians. The results revealed that positive psychology interventions do indeed significantly enhance well-being (mean r=.29) and decrease depressive symptoms (mean r=.31). In addition, several factors were found to impact the effectiveness of positive psychology interventions, including the depression status, self-selection, and age of participants, as well as the format and duration of the interventions. Accordingly, clinicians should be encouraged to incorporate positive psychology techniques into their clinical work, particularly for treating clients who are depressed, relatively older, or highly motivated to improve. Our findings also suggest that clinicians would do well to deliver positive psychology interventions as individual (versus group) therapy and for relatively longer periods of time."  While the Chida & Steptoe study - "Positive psychological well-being and mortality: a quantitative review of prospective observational studies" - states "Objective: To review systematically prospective, observational, cohort studies of the association between positive well-being and mortality using meta-analytic methods. Recent years have witnessed increased interest in the relationship between positive psychological well-being and physical health. Methods: We searched general bibliographic databases: Medline, PsycINFO, Web of Science, and PubMed up to January 2008. Two reviewers independently extracted data on study characteristics, quality, and estimates of associations. Results: There were 35 studies (26 articles) investigating mortality in initially healthy populations and 35 studies (28 articles) of disease populations. The meta-analyses showed that positive psychological well-being was associated with reduced mortality in both the healthy population (combined hazard ratio (HR) = 0.82; 95% Confidence Interval (CI) = 0.76-0.89; p < .001) and the disease population (combined HR = 0.98; CI = 0.95-1.00; p = .030) studies. There were indications of publication bias in this literature, although the fail-safe numbers were 2444 and 1397 for healthy and disease population studies, respectively. Intriguingly, meta-analysis of studies that controlled for negative affect showed that the protective effects of positive psychological well-being were independent of negative affect. Both positive affect (e.g., emotional well-being, positive mood, joy, happiness, vigor, energy) and positive trait-like dispositions (e.g., life satisfaction, hopefulness, optimism, sense of humor) were associated with reduced mortality in healthy population studies. Positive psychological well-being was significantly associated with reduced cardiovascular mortality in healthy population studies, and with reduced death rates in patients with renal failure and with human immunodeficiency virus-infection. Conclusions: The current review suggests that positive psychological well-being has a favorable effect on survival in both healthy and diseased populations".

Both these meta-analyses are two or three years old, and since their publication there has been a continuing stream of further relevant research underlining the importance of the positive psychology & psychotherapy link.  The blog post "The spectrum of mental health: part 2 - moderate & full wellbeing" highlights both that over 80% of the population are not in "flourishing" mental health and that this has important implications for increased vulnerability to subsequent psychiatric illness, poorer levels of functioning, and less happy & fulfilling lives. 

For more on this subject, see next week's post "Psychotherapy & positive psychology: the assessment dashboard".


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