Dear Holly,

There are references on the issue:

Schrank, B., Riches, S., Coggins, T., Rashid, T., Tylee, A., & Slade, M. (2014). Wellfocus PPT – modified positive psychotherapy to improve well-being in psychosis: study protocol for a pilot randomised controlled trial. Trials, 15, 203. doi: 10.1186/1745-6215-15-203

Bolier, L., Haverman, M., Westerhof, G.J., Riper, H., Smit, F., & Bohlmeijer, E. (2013). Positive psychology interventions: A meta-analysis of randomized controlled studies. BMC Public Health, 13, 119.

Lu, W., Wang, Z. & Liu, Y. (2013). A pilot study on changes of cardiac vagal tone in individuals with low trait positive affect: The effect of positive psychotherapy. International Journal of Psychophysiology, 88, 213-217.

Meyer, P. S., Johnson, D. P., Parks, A. C., Iwanski, C. & Penn, D. L. (2012). Positive living: A pilot study of group positive psychotherapy for people with schizophrenia. Journal of Positive Psychology, 7, 239-248.

Mongrain, M. and Anselmo- Matthews, T. (2012). Do positive psychology exercises work? A replication ofSeligman et al. (2005). Journal of Clinical Psychology, 68, 382-389.

Guney, S. (2011). The Positive Psychotherapy Inventory (PPTI): Reliability and Validity Study in Turkish Population. Social and Behavioral Sciences, 29, 81-86.

Akhtar, M. & Boniwe, I. (2010). Applying positive psychology to alcohol-misusing: A group intervention. Groupwork, 20, 7-23.

Seligman, M.E.P., & Wyatt, R. C. (2008). Positive psychology and psychotherapy [DVD]. Available from http://www.psychotherapy.net

Thayer, J.F., & Lane, R.D. (2007). The role of vagal function in the risk for cardiovascular disease and mortality. Biological Psychology, 74, 224–242.

Thanks Beatrice for your reply. Because I am focusing mainly on depression in the elderly in nursing homes, I had not come across positive psychotherapy in other pathologies (here, schizophrenia and psychosis). It's good to know research is curently being conducted on positive psychotherapy.

I would really like to know if any inroads have been made in positive psychotherapy in nursing homes. I really haven't seen much done in the US in this area. I suspect that this is because nursing homes in the US don't usually have psychologists on staff.

I am doing research in France where nursing homes now almost all have psychologists. I am currently doing a study to ascertain if positive psychology interventions can lower depression levels and increase affect in depressed nursing home residents. I am at the early stages, but I suspect that the benefits from these interventions will be incremental at best. I see these interventions more as a supplement to supportive therapy that can be offered by the psychologist. If anyone has any input to give, I'm all ears!

It's particularly interesting doing research on positive psychology in France, as there is a real backlash against the field. For example a recent cultural magazine had on its cover a smiling Ken doll with the title "Shut up an be happy." The articles mainly criticize positive psychology while clumping it together with anything along the lines of untested personal development. Other intellectuals here have made the accusation that positive psychology is a US export with a latent capitalist agenda to convince people to ignore economic inegalities and just "be happy". The field of positive psychology would appear to be, after the CBT wave, yet another potential threat to psychoanalysis, which is the main approach adhered to teeth and nails in this country...

Holly,

You may get some valuable information from  this email address:

Linda Bolier [email protected]

Positive psychology interventions: a meta-analysis of randomized controlled studies Linda Bolier et al. BMC Public Health 2013, 13:119  

CONCLUSIONS:

The results of this meta-analysis show that positive psychology interventions can be effective in the enhancement of subjective well-being and psychological well-being, as well as in helping to reduce depressive symptoms.

Positive psychology interventions for depressive symptoms

By James Coyne PhD

Posted: October 28, 2014

Thank you sincerely for these references !

best

Holly Rougier

Hi Holly.

You might find Compassion Focused Therapy of interest for you purpose.  It has a little different view on how to strengthen resilience and well-being, compared to positive psychology. 

A question to maybe ponder owed is who you should target with your intervention: 

Patients, caregivers, relatives ? Or all of them, in a sequence?

As we mirror and "infect" each other with our behavior and feelings, it could be smart to broaden the inclusion of Compassion training receivers ;-)

You could find some interesting info here:

http://www.compassionatemind.co.uk

http://ccare.stanford.edu/research/

Empathy and compassion.

Singer T, Klimecki OM.

Curr Biol. 2014 Sep 22;24(18):R875-8. doi: 10.1016/j.cub.2014.06.054.

Best, Walter

Dear Holly,

Consistent with Walter's last remark, the approach we are taking is to educate  the staff, raising  their awareness of the  humanity of those they look after  so that they may provide higher quality  person-centered care.  If interested in learning more about this, let me know. Best wishes,....Alex 

You will find many recent studies showing the effectiveness of positive psychology variables in psychotherapy. For example, search for Forgiveness interventions and Hope focused therapy.

To answer Walter's question, the interventions are targeting depressed residents in nursing homes. I practice insight meditation and am aware of compassion focused therapy which of course I find very interesting. However, undertaking research along these lines in France would be tricky. As I said, it is sort of a mine field when it comes to unconventional approaches.

For Alex, if I understand correctly, you're saying that you are using compassion therapy training as well with the staff in a nursing home ? (Maybe I misunderstood this.) If that is the case, I am most definitely interested in learning more.

For Geoffrey, yes I know about forgiveness interventions and Hope focused therapy. However, I am looking more along the lines of testing short interventions to see if they'll have an impact. The reason is that the psychologists working in nursing homes have very little time (usually part-time posts).

Thanks very much to you all for your feedback...

best

holly

Dear Holly,

Interesting that Compassion Focused Therapy can be problematic to implement in France (and that it might be easier to use a "Positive Psychology" approach). We find a very great interest from both clinicians in pediatric oncology, stress management, cardiology etc but also from people in business and education when we present the concept here in Sweden, but also in the USA & UK, as you certainly are aware of. I notice more resistance towards positive psychology, which is popularly described as "wishful thinking", although I know that there is some overlap between the two approaches. Regarding the time for performing the intervention, we plan to study the effect of 5 sessions. As was concluded in a systematic review, it is of importance that the participants really understands what compassion/self-compassion is about. http://www.ncbi.nlm.nih.gov/pubmed/25215860

Have you seen Matthieu Ricards book http://www.matthieuricard.org/books/plaidoyer-pour-l-altruisme ? He could maybe provide support, as he is deeply involved in cutting edge compassion research.

Positive psychology has got some critic also in the USA, e.g Barbara Ehrenreichs book http://www.amazon.co.uk/Smile-Die-Positive-Thinking-America/dp/1847081738 which seem to be in line with what you described regarding France.

What is your main concern regarding introducing Compassion Mind Training/Compassion Focused Therapy?

Sorry for the nagging.. Best Walter

Oh Walter, I don't consider you're nagging at all! To the contrary, it's great to be able to exchange on this.

Yes, Matthieu Ricard is very well known here. His books are on the Buddhism/personal development shelves. As far as links to psychology are concerned, MBSR et mindfulness have finally made their way into some therapeutic approaches. The idea of Buddhist psychology would seem, I suspect, too unorthodox to be really accepted in the academic field here. This is why I think compassion focused therapy would be difficult to introduce into practice by any "serious" psychologist. But who knows, things can change...

Doing research on positive psychology is most definitely problematic. For example, I recently listened to a French podcast whose goal was basically to discredit the field. It was led by a very well-known psychoanalyst and a sociologist who'd written a book titled "To put an end to happiness." So this research I'm doing for my master's degree is definitely risky. Although the director of my thesis is open to the approach because it's based on scientific method, there is the risk that the other 2 professors who will be grading it could follow more of a psychoanalytic approach, and thus might be automatically turned off by the theme. It's a risk I'm willing to take because I am interested in exploring methods that could be realistically useful for the psychologist working in a nursing home.

Holly

Hm. I do not see compassion related interventions (e.g CompassionFocused Therapy CFT, Compassion Mind Training CMT, or Compassion Cultivating Training) as exclusively Buddhistic. On the contrary, as I have understood it both Paul Gilbert and other researcher and clinicians emphasize the non-religious background in such interventions. Here my favorite background publication on Compassion:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2864937/

In Sweden psychoanalysis and even psychodynamic theories and practices have lost a lot of "territory" to the CBT and lately ACT proponents, and it seems as if CFT/CMT is more easily accepted here. I do just speculate, but the impression of french academia is that it is very elitist, and that already children are thought to be harsh to themselves in order to perform excellent, in a competitive and sometime hostile environment (which is known to not unequivocally further trust, creativity or even performance). That might in grown up academics have instilled a fear of compassion (towards others, from others and towards themselves, as Paul Gilbert has described). A quite complicated and cognitively demanding therapy such as psychoanalysis could therefor also reign more easily (although there has been a huge criticism re the scientific foundation of it).

If my speculations are any valid, this might also explain why positive psychology gets such a negative reception :) Said once again: My experience is that compassion is not that easily attacked, however, I might be active in a different habitat. Best, Walter

Yes, your perceptions seem to me to be pretty accurate. I remember reading a comparative international research study on young students and their percieved abilities after taking a rather general test based on their school level. The study showed that although French students did approximately as well as other European counterparts in terms of concrete results, their perception of how they did (before hearing the results) based them on the bottom of the list of nations (along with Indonesia). Not surprisingly the Americans overestimated how well they did in comparison to actual results !

Yes, I realize that compassion therapy isn't exclusive to Buddhism. It's just that I think it would be seen as very unorthodox here. But maybe it will just take a little more time for them to open up to it. (To give you an idea, there are approximately only 4 or 5 universities in the country who will even offer any courses covering therapeutic approaches outside of the psychoanalytique approach.)

best

holly

Probably because positive psychology is relatively new compared with the more traditional approaches and therefore less credible in the minds of some scholars (not me). Same thing happened to Maslow. (See great paper by Koltko-Rivera in the Review of General Psychology, 10(4) 2006: 302-317). Best wishes

Thanks for the reference Christine...

best

Holly

One of the challenges in the field is the diverse terminology - positive psycholoday, happiness, well-being, flourishing etc.  On a practical note, the Mental Health Foundation in New Zealand has a very clear user guide for well-being specifically for elders

http://boomers.org.nz/

http://www.mentalhealth.org.nz/home/ways-to-wellbeing/

Hello Theresa,

You are the second person to refer to research on positive psychology in New Zealand. I most definitely will check out the references.

To return to Christine's message where she mentioned that more research hasn't been done on positive psychotherapy because it's a new field, in fact Seligman's study took place in 2006. Given the enormous amount of research taking place in this field now, it still remains a bit of a mystery to me why replications of his study or even similar studies on positive psychotherapy with depressed patients haven''t been undertaken. I guess I'll just keep searching...

best

Holly

Yes it's interesting.  The fields (of positive psychology and of depression interventions) are treated as if they are very different, when in fact the overlap is very large and differences are relatively small.  Clinically, many people that I have worked with would be more interested in a positive focused intervention.  Actually I will put up an article we did which gets at this in a small way soon (it should come out on early view in a couple of weeks).

Will look forward to reading it ....

Holly

Oh now you have hit my sweet spot.  Dr. Seligman started a coaching certification for psychologists and therapists,  I was fortunate enough to take that certification.  Then he sort of dropped out of it for a while and when he came up for air, he had started his Positive Psychology program at Penn State.  If I had not already done a Ph.D. I would have started all over, I loved it so much.  But I was able to take some courses and read some recent books by him.  I am disappointed if what you say is true, that his program is no more because it was highly acclaimed at the time.  Think I'll see if I can connect and find out more.  I will keep you informed if I find out anything new

Dear Holly,

Thanks for the feed back re different mind sets in our different cultures, although we are quite close geographically. BTW This discussion led me to researchers in my neighborhood that I wasn't aware of - a Positive outcome, both psychological and practical, to me ;-)

Best, Walter

Hello everyone, Like Christine I am also in Nottingham U.K.

Tenured within the University of Nottingham, Professor Joseph has written a great deal about positive psychology, and post-traumatic growth. you will find a very healthy smattering of references to Martin Seligman's work throughout I am sure. 

He has written a number of books on person-centred psychotherapy, positive psychology and integrating positive psychology into therapeutic practice.

http://www.profstephenjoseph.com/books/ 

hello Matthew,

I checked out the website and there appear to be some interesting books for integrating P. psychology into clinical practice. However, I am really looking for scientific studies which measure the efficacy of positive psychotherapy with depressive elders.

I may look into buying pr. Joseph's books just for personal interest. thanks for this website.

Holly

your'e welcome Holly, and please do let me know any high quality scientific studies you unearth relating to your area of research , I would be very interested in a general sense. Kind regards, Matt.

Hi Holly,

There is not much research on well-controlled positive interventions as they are still in their infancy. We are just finishing a 6-month follow-up of a RCT comparing group CBT and group POsitive Psychology inteventions in clinically severe depression. The results, so far, is that both treatments are equally effective. We are preparing a manuscript for submission.

I do agree that we need much more clinical interventions (replicating and also going beyond initial trials like those of Seligman).

Hello Carmelo,

If you are doing a RCT with severely depressed subjects your sample size must be pretty big ? I would really be interested in hearing which positive interventions you're using. I have always wondered about the feasability of doing positive psychology interventions with the severely depressed, as it would seem difficult given their state for them to be motivated enough to do them. I'm not saying impossible, just that I imagine it would be harder to find subjects willing to participate fully. 

This brings to mind a methodological point : in Seligman's milestone study (2005) testing the long-term benefits of PPIs in a sample of 441 subjects, a key point that wasn't emphasized is that the participants chose to do this study of their own accord. An initial motivation to reap the benefits of the exercises was already present.

However, when the researcher has to ask the depressed subject to participate, I imagine that the final results will not be as positive as in the Seligman case. In any event, in my study doing PPIs with older depressed nursing home residents, I am having a hard time getting them to accept to be involved in the study... which doesn't completely surprise me. You never really read about these aspects in scientific articles...

Once again, I would love to hear a little more detail about your study !

Thanks in advance

Holly Rougier

Hi Holly,

Engagement of patients is a good point. This is a natural obstacle in interventions with depressed people. In our case, we were fortunate because we have conducted a rather large study (N=96) of patients who were actively looking for treatment in a Community Municipal Center that was offering different workshops (including several on depression).

The drop-out rate was rather low. All pArticipants had a MDD (SCID, DSM-IV-TR) with an average BDI of 35. The good news is that positive interventions were as effective as standard CBT (around 75% of participants did not fulfill diagnostic criteria after the interventions) and were very well accepted by participants.

We're right now finishing some papers for submission to top-rank journals (crossed fingers).

Thanks so much for replying Carmelo. I really look forward to reading your article. Could you let me know which interventions you used ?

Thanks again,

Holly

The question of effectiveness of positive psychology is likely to receive much more attention going forward.  In blogs, Coyne has been critical of meta-reviews.  In science McNally criticized the Seligman army training.  I think the lists of strengths has issues with it, i.e., spirituality isn't a strength.  

I am wondering if Mr. Seligman's project in applying positive psychology methods in army training is one of the reasons why he is not being cited as much by other important researchers in this area...

Hi Steven, there are researchers at the Jubilee Centre for Character and Virtues at the University of Birmingham, UK, who are integrating moral psychology and with moral philosophy and moral education.

In this context, spirituality can be regarded as an intellectual virtue, as opposed to a moral or performance-driven virtue. See http://www.jubileecentre.ac.uk/434/projects/flagship-research/

Kind regards,

Christine

Unfortunately the psychology of religion is a weak field.  The ideas are half thought out and nothing original and important in many years.  The science of religion is much stronger field.  If spirituality were a trait of personality, strength or not, it would be poorly correlated to other traits, ie, it would be about an isolated, narrow part of life. It can't be a trait of any kind.  Spirituality is a way of life.  Positive psychology got this wrong. To have mass appeal, religion must bless the optimists and the pessimists and everybody in between.  I hope to shake up this field real soon. 

There is a group after Seligman for cooperating with the military.  Seligman has responded that he is proud of that work.  The group has no following in psychology.  The field is behind Seligman on this.  His critics have left APA. I think the absence of data is the real issue. 

Reading Steven Reiss comment makes me gasp for air

Seligman's response was published in the American Psychologist, I think October 2013, but maybe it was 2011.   

I believe it is still soon to talk about a "Positive psychotherapy". Yet, there is a number of interventions (based on some of Seligman's 2006 contribution as well as on the work of many others) that seem to be effective to enhance participants' well-being whether in clinical and subclinical populations.

A recent narrative review can be seen in:

Rashid, T. (2014). Positive psychotherapy: A strength-based approach. The Journal of Positive Psychology, 10(1), 25–40. doi:10.1080/17439760.2014.920411