POSITIVE INTERVENTIONS Running Head: Positive ...

[Pages:38]POSITIVE INTERVENTIONS Running Head: Positive Interventions

Positive Interventions: Past, Present, and Future

To appear in "Bridging Acceptance and Commitment Therapy and Positive Psychology: A Practitioners's Guide to a Unifying Framework" Editors: Todd Kashdan and Joseph Ciarrochi

Acacia C. Parks Hiram College

& Robert Biswas-Diener Portland State University

Positive Acorn

Contact Author: Acacia Parks, Department of Psychology, Hiram College, P.O. Box 67, Hiram, OH 44234. Email: parksac@hiram.edu, Phone: (330) 569-5229, Fax: (330) 5695448

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Positive Interventions: Past, Present and Future As positive intervention researchers, we are often approached by proponents of ACT, and the ensuing conversation is freuqently the same. The questioner says, "I have always wondered what the difference is between a positive intervention and ACT." Obscured within this polite statement are the questions they really want to ask: is there anything new about positive interventions, or are we "selling old wine in a new bottle"? What do positive interventions bring to the table that other interventions do not? These are, we think, reasonable questions, and ones that researchers in our field too rarely take the time to answer. Equally pressing is a concern that we hear more rarely, but are fairly certain lurks in the back of our questioners' minds with some regularity: Isn't it irresponsible to ignore a person's problems? Isn't there a risk that such an approach can do harm to clients? One central goal of this chapter is to explore the ways in which positive intervention research has and has not been thoughtful about exactly these issues. First, we address the question of what, exactly, a positive intervention is. We follow with a review of the different areas of positive intervention, including descriptions of prototypical activities, evidence of their effectiveness, and important considerations for their application. Lastly, we discuss several future directions for positive intervention research; most notable of these is investigation of the possibility that positive interventions, in certain contexts, may be ineffective, or even cause harm. Each of these sections constitutes a step towards our final goal of discussing what distinguishes positive interventions from other approaches in general, and from acceptance-based approaches in particular.

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What is a positive intervention? One legitimate criticism of positive intervention research is that it is difficult to

determine what actually counts as a "positive intervention". Indeed, there is no definitive definition of a "positive intervention," and no clear set of guidelines for classifying interventions as "positive." However, this is a problem that researchers have attempted to tackle. Our efforts at synthesis led us to three broad conceptualizations of positive interventions: 1) interventions that focus on positive topics, 2) interventions that operate by a positive mechanism or that target a positive outcome variable, and 3) interventions that are designed to promote wellness rather than to fix weakness.

First, "positive" interventions can be defined as those that focus on topics that are positive; in other words, they contain little or no mention of problems, instead emphasizing the positive aspects of peoples' lives. The "positive content" approach is consistent with the Positive Psychotherapy (PPT) interventions proposed by Seligman, Rashid, and Parks (2006): "The goal [of PPT] is to keep the positive aspects of the clients' lives in the forefront of their minds... and to strengthen already existing positive aspects." (p. 780). We think that this definition is much too broad; it encompasses any intervention in which an individual does not attend to their problems, or does something pleasant. By this definition, procrastinating by playing video games until 4am constitutes a positive intervention; so does drinking oneself into oblivion to mask anxiety. In other words, while a content-level definition does describe all positive interventions, it also describes a variety of other behaviors that are not positive interventions, and so it is not sufficient.

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An intervention can also be defined as "positive" if the mechanism or target outcome is a positive variable such as positive emotion, meaning, and so on (see below for an extensive overview of such variables). The definition used by Sin & Lyubomirsky (2009) in their meta-analysis is a good example of this approach; they define a positive intervention as one that is "aimed at cultivating positive feelings, positive behaviors, or positive cognitions." (p. 1). This definition is better than the last in that it is less inclusive, requiring some level of theoretical development (there must be some positive variable being targeted, so avoidance doesn't fit). However, the definition does not include any requirement that the intervention defines its target variable, nor that the target variable has an empirical basis, nor that the intervention actually changes that target variable; "positivity," for example, would be sufficient, even though we have no idea what "positivity" means, nor do we know how to measure or change it. Thus, the variable-level definition encompasses anything with the tag line "be positive" or "think positive" ? including, we shudder to say, The Secret, and other myriad crackpot self-help approaches.1

Lastly, an intervention can be "positive" if the goal of the intervention is to improve rather than to remediate; in other words, the target population is non-distressed, and so the intervention is self-help rather than therapy. The goal of the intervention, then, is to bring individuals from acceptable levels of functioning to "good" or "great." This definition is consistent with the rhetoric that came from Seligman and colleagues during the first few years after positive psychology's inception. For example, when speaking

1 We don't have space or license here to do justice to all of the things that are wrong with The Secret, nor to sufficiently express how icky it makes us feel when people think The Secret is part of positive psychology.

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about the general goals of the positive psychology movement, Seligman, Parks and Steen (2004) stated: "We know very little about how to improve the lives of the people whose days are largely free of overt mental dysfunction." (p. 1379). A positive intervention, by this definition, is one designed for the subset of the population not suffering from a mental disorder. While this definition is more selective than the previous two, it excludes one prominent positive intervention ? Positive Psychotherapy (PPT) ? which has been applied in major depression (Seligman, Rashid & Parks, 2006), schizophrenia (Meyer et al., in press) and nicotine dependence (Kahler et al., 2011).

While each of these definitions seems reasonable at first glance, each is uniquely problematic when used as a stand-alone method for classifying interventions as "positive" or not. We believe this is because the goal of creating a single definition may be impractical. Research on positive interventions was well underway before anyone attempted to infuse it with theory, and so the research follows no common theoretical thread. Any definition we create, then, is going to be a post-hoc rationalization of the research that has been done so far, rather than a theory-driven attempt to classify. It will not be simple because it is an attempt to bring together a broad body of work that was not a cohesive effort. Thus, rather than creating a single definition, we propose a set of criteria derived by integrating and refining the above definitions:

- The primary goal of the intervention is to build some "positive" variable or variables (e.g. subjective well-being, positive emotion, meaning). This criterion eliminates self-indulgent or avoidant behaviors with no real function towards self-improvement.

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- Empirical evidence exists that the intervention successfully manipulates the above target variable(s). This criterion eliminates the myriad existing selfhelp approaches that have no research basis.

- Empirical evidence exists that improving the target variable will lead to positive outcomes for the population in which it is administered. This criterion requires that the target variable has an empirical basis2. It allows for special cases in which positive interventions are responsibly applied in a clinical population (for example, Kahler et al. (2011) use a positive intervention in smoking cessation because positive affect is a predictor of treatment success). It also excludes interventions that target positive variables in clients for whom this approach would be inappropriate; we would assert, for example, that a gratitude intervention for recent trauma victims would be unlikely to produce positive outcomes, and thus would not be a positive intervention.

We believe that this set of criteria is the right balance of inclusive and exclusive ? it encompasses all existing positive interventions, but excludes none that we know of. What do we know about the benefits of positive interventions?

Modern positive intervention research began as the study of individual techniques that target specific happiness-related constructs (see below for a comprehensive review). In these seminal studies, many of which are discussed in greater detail below, participants

2 We acknowledge that requiring an "empirical basis" is a slippery slope without any formal criteria for what constitutes an empirical basis. We also acknowledge that previous efforts to do this in other arenas have proven fruitful (e.g. the guidelines for what constitutes an "Empirically Supported Therapy" set forth by the APA Task Force on Promotion and Dissemination of Psychological Procedures in 1995). While creating such criteria is beyond the scope of this chapter, we are enthusiastic about doing so in other venues.

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are randomly assigned to practice one of several potential activities ? some designed to serve as "controls," and others designed to increase some aspect of well-being. They complete a battery of pre-intervention questionnaires, practice the activity for some predefined time period ranging from one to six weeks, and then complete post-intervention questionnaires. In some cases, participants may complete one or more long-term followup questionnaires as well.

Other chapters (including at least one written by the first author) have attempted to organize existing positive interventions according to one theoretical framework or another. However, just as there is no common definition of a "positive intervention," neither does there exist any single, empirically-based theoretical framework that unifies positive interventions. Unlike many areas of psychology, where theory drives the research, in positive interventions, the opposite is true; data showing that an activity is effective came first, with questions of "how" and "why" tabled for a later date. Thus, the series of summaries below ? while, to our knowledge, comprehensive ? comes in no particular order. For each area of intervention we discuss, we endeavor not only to describe the most common techniques and the evidence for their effectiveness, but also to take a critical approach, highlighting caveats and special considerations as appropriate.

Strengths ?Different conceptualizations of strengths exist, with some focusing more on character (VIA-IS; Peterson & Seligman, 2004) and others focusing more on talent (Clifton StrengthsFinder; The Gallup Organization, 1999). Broadly speaking, however, strengths are positive personality traits, and strengths interventions are activities that involve the identification, use, and/or development of one's strengths. The general

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paradigm for all strengths interventions is the same: an individual takes a strengths test3, receives feedback on his strengths, and then changes his behavior in order to use his strengths more often.

Although Gallup has been using a strengths-based model in practice for many years (Hodges & Clifton, 2004), the first empirical study to use this model was Seligman, Steen, Park & Peterson (2005), who found that the process of identifying and using one's strengths resulted in increases in happiness and decreases in depressive symptoms after a month; these gains lasted through six-month follow-up among those individuals who continued to practice it. The actual use of one's strengths, above and beyond learning what one's strengths are, is an essential ingredient of this activity; participants in an "assessment-only" condition (where they learned their strengths but were not asked to use that information in any way) were indistinguishable from those who practiced a placebo activity (Seligman, Steen, Park & Peterson, 2005). Although untested empirically, Parks & Seligman (2007) proposed an extension of this activity entitled "positive service," wherein an individual devises a way to use his/her strengths in the service of something larger than him/herself. Other variations have also been proposed in applied settings (e.g. Seligman's "Authentic Happiness Coaching" course), including a "Strengths Family Tree," wherein one examines one's own strengths in relation to the strengths of one's family members, and the "Strengths Date," in which two or more people coordinate an outing, event, or project that allows each member of the group to use his/her strengths.

3 Whereas Gallup's survey is pay-only, the VIA strengths inventory is available for free online. This difference, in part, explains why the VIA model is so strongly represented in the literature, and in practice; both researchers and members of the general public can freely access the assessment.

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