Text Size A A A

The Practice Corner 

Notes on Sin & Lyubomirksy's Positive Psychology Inverventions

(August 4,  2009)

By Ryan M. Niemiec, Psy.D.
Education Director, VIA Institute on Character
Follow Ryan on Twitter

Study: Sin, 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: In Session, 65(5), 467-487.

Nancy Sin and Sonja Lyubomirsky begin their meta-analysis – as any good “study of studies” does – with a question: do interventions aimed at improving positive thoughts, emotions, and behaviors work, that is, enhance well-being and decrease depression?

Key points in literature review: Ed Diener’s research has established that most people believe they are happy. However, as research by Corey Keyes notes, a minority are flourishing (fewer than 20%). Barbara Fredrickson has noted that a high number of people are languishing (going through the motions or stuck) although not suffering at a level of mental disorder.

A variety of positive interventions have been shown to be beneficial in non-clinical populations. In terms of helping a clinical population – those who are depressed – Positive Psychotherapy and other approaches have shown that positive interventions can address positive affect (decreasing the physiology of negative emotion), engagement (broadening coping), and meaning (decreasing relapses) that are often lacking in those depressed. Nevertheless, positive interventions do not have universally positive results which leads to confusion – all the more reason such a meta-analysis is needed.

In their literature review for the meta-analysis, Sin & Lyubomirksy included studies that incorporated the following criteria:

1.) Empirical testing of an intervention or therapy aimed to increase positive emotions, thoughts, or behaviors, rather than those that sought to decrease psychopathology.

2.) Pre and post measures of well-being or depression.

3.) A comparison group (control, placebo, treatment as usual).

4.) Effect size data to compare the two groups.

Of the studies they looked at (the authors note they did not examine every positive psychology intervention study ever done), 51 met each of these criteria.


Interventions studied (quantity in parentheses)
Focus is on increasing well-being:
Mindfulness (2)

Positive writing (5)

Hope therapy

Positive reminiscence

Life review therapy

Gratitude (10)

Well-being therapy (3)

Fordyce’s happiness program (6)

Forgiveness (2)

Cultivating sacred moments

Goals (5)

Self-management

Discussing beliefs

Rehearsal of positive statements

Kindness (3)

Positive psychotherapy (4)

Focus is on decreasing depression:
Mindfulness (5)

Fordyce happiness program (3)

Forgiveness (3)

Rehearsal of positive statements

Positive psychotherapy (4)

Gratitude (4)

Well-being therapy (3)

Life review therapy

Hope therapy

 
Results: Positive psychology interventions (PPIs) were significantly more helpful  for both increasing happiness and decreasing depression in groups utilizing PPIs vs. control groups receiving treatment as usual, no treatment or placebo.  Effect sizes for each are medium, indicating that PPIs work well. People receiving PPIs compared to no-treatment control group had the greatest boost in well-being, second were those compared to treatment as usual, followed by those compared to neutral control groups or placebo. This suggests that PPIs may be more beneficial for depression than standard treatments. Those who self-selected interventions have stronger outcomes than those who do not, perhaps reflecting the important role of motivation. The benefits of PPIs increased with age. The highest benefit was seen in individual therapy, followed by group therapy, which was followed by interventions that were self-administered.
 
Sin and Lyubomirsky offer three suggestions for clinical practice:
1) Encourage clients to regularly practice PPIs and keep a record as they turn the intervention into a habit. They reflect that high effort and ongoing practice after the intervention’s conclusion lead to greater well-being.

2) Consider assigning multiple, different PPIs at once. This “shotgun approach” may be more effective than engaging in one at a time

3) Remember the client’s culture and unique inclinations in assigning PPIs. Lyubomirsky has found that individualist cultures benefit more than collectivist cultures in PPIs. The latter might benefit more from other-focused PPIs (e.g., kindness, gratitude) whereas the former might benefit from more individual-focused PPIs (e.g., focusing on personal strengths).

Niemiec’s comments for practitioners: This is the first meta-analysis on positive psychology interventions, thus is a very important article that I suspect will be referenced a multitude of times, certainly in both conversations and in research on positive interventions. Of underlying importance in the article is character strengths. It makes me wonder, is it possible to have a positive psychology intervention that does not involve building strengths? Since it is one’s strengths that would be mobilized to complete and engage in the intervention, I think not. In reflecting on the suggestions for clinical practice, it seems that the clinician should practice strengths of open-mindedness and perspective when applying PPIs and should considering training and building persistence in their clients (per suggestion  #1 above).

Another emerging theme is the importance of individual (one-on-one) work with PPIs with a client – whether this be by a psychologist, counselor, or coach – rather  than the client self-administering an intervention they have read about in a book or on a website.

This is part of a series on Positive Psychology research reports that Dr. Niemiec thinks are of particular help to practitioners. For more, click the News tab at the top of each page on our site.