Positive Psychotherapy: 5 Exercises and Tools for Therapists

Positive Psychotherapy
Positive Psychotherapy as a Powerful Tool. Image by Wikimedia.

Positive psychotherapy: the term almost seems self-contradictory.

The word “psychotherapy” often evokes images of nerve-wracked patients reclining on couches, a stern therapist with furrowed brows and a notepad, and a deep uneasiness linked to the identification and analysis of every childhood trauma you have suffered, whether you remembered it before the session or not.

Although this is an outdated and largely inaccurate idea of psychotherapy, it still may seem counterintuitive to combine positive psychology with psychotherapy. Psychotherapy is typically reserved for those with moderate to severe behavioral, emotional, or personality issues—not people who are often happy and healthy, and also struggle with occasional stress.

How can this type of therapy, which deals with such serious and difficult subject matter, possibly be considered “positive?”

Fortunately, many respected psychologists have been working to develop a useful and evidence-based positive approach to psychotherapy over the last two decades.

These pioneering researchers have married the research of positive psychology and the science and practice of psychotherapy into a life-affirming alternative to traditional psychotherapy—one that focuses on your strengths instead of your weaknesses, and works towards improving what is good in life instead of mitigating that which is not (Seligman, Rashid, & Parks, 2006).

It does not replace traditional psychotherapy, but can act as an extremely effective supplement to help a person move from “just getting by” to flourishing and thriving!

 

What is Positive Psychotherapy?

Positive psychotherapy is a psychological treatment that reduces symptoms of negative functioning in addition to developing a person’s engagement and positive emotions.

It’s unlike standard interventions for depression because positive emotions and engagement are the key focus, instead of depressive symptoms themselves (Seligman, Rashid, & Parks, 2006).

Positive psychotherapy is rooted in Chris Peterson’s work on character strengths, as it integrates clinical symptoms with character strengths, resources with risky behaviors, hopes and regret, and values with rash behavior. This type of therapy sees the individual as more balanced than the more usual “deficit-oriented approach to psychotherapy.”

 

How Does Positive Psychotherapy Relate to Positive Psychology?

Martin Seligman, the father of modern positive psychology, has described some key connections between positive psychotherapy and positive psychology in interviews and instructional DVDs (Seligman & Wyatt, 2008).

He says that positive psychotherapy involves a person discovering insight, and going beyond the pain and suffering of the process. Other therapy (especially when talking about incidents of childhood trauma) can be especially painful, and testifying can initially be as painful as “rip[ping] off nature’s scabs” (Seligman & Wyatt, 2008).

Acknowledging pain is still a part of the therapy—it is not necessary to deny the suffering a person might be experiencing. However, positive psychotherapy does involve more positive emotions, gratitude, and meaning – a much more positive focus.

Although forms of positive psychotherapy have developed since the 1970s, figures like Martin Seligman have been influential in the therapy’s development and testing. Below you’ll find an interview during which he introduces this field.

 

Positive Effects

Seligman has published earlier work showing the effects of positive psychotherapy. By delivering individual and group therapy to students, Seligman and his colleagues showed significant, long-lasting decreases in depression (Seligman et al., 2006).

More recent reviews have combined the data from many smaller studies to conclude that positive psychotherapy can have significant positive effects, even though the impact of these benefits has been questioned (Bolier et al., 2013). As part of a broad range of positive psychological interventions, psychological and subjective well-being can be enhanced.

Other emerging studies have shown various positive effects, even on the body. In one study, researchers investigated cardiac vagal tone – a good measure of how strong a part of the nervous system is, and a potential measure of stress (Lü, Wang, & Liu, 2013).

The tone influences heart rate level at the end of breathing cycles and is a good way to measure the body’s functional flexibility. Past studies have shown how cardiac vagal tone is related to a person’s positive affect, so Wei Lü and colleagues ran a positive psychotherapy intervention for participants with low positive affect.

70 participants from a Chinese college were scored as having either high or low trait positivity, and then half of the 34 that scored low attended group psychotherapy for 16 weeks. Physiological data were obtained with electrodes and software. Although the low-scoring group had lower tone levels, these levels improved significantly after psychotherapy.

Increasing positive affect and vagal tone can then have broader health effects for individuals and is even associated with a lower risk of illness in the longer term (eg. Thayer & Lane, 2007).

 

5 Positive Psychotherapy Exercises and Tools

Here is an overview of some of the most effective exercises and tools in a positive psychotherapist’s toolbox.

1. Gratitude Journal

One of the simplest yet most effective exercises in positive psychology is a gratitude journal. Evidence has shown that developing gratitude for the things in your life that you may otherwise take for granted can have a big impact on your outlook and satisfaction with your life (Davis et al., 2016; Sheldon & Lyubomirsky, 2006).

The practice of keeping a gratitude journal is quite simple and easy to explain to a client who might need a boost in positive emotions.

As a therapist or other mental health professional, instruct your client to do the following:

  1. Get a notebook or journal that you can dedicate to this practice every day.
  2. Every night before bed, write down three things that you were grateful for that day.
  3. Alternatively, you can write down five things that you were grateful for on a weekly basis.
  4. Encourage them to think of particular details from the day or week, rather than something broad or non-specific (i.e., “the warm sunshine coming through the window this afternoon” rather than “the weather”).

 

Positive Psychotherapy Exercises and Tools gratitude journal
Gratitude Journal and Designing Dream Days. Image Provided by Pixaby.

If your client is having trouble thinking of things they are grateful for, tell them to try thinking about what their life would be like without certain aspects. This will help them to identify the things in their life they are most grateful (Marsh, 2011).

2. Design a Beautiful Day

The appeal of this exercise is immediately evident. Who doesn’t want to design a beautiful day for themselves? This exercise is not only fun for most clients, it also carries a double impact: the planning of the near-perfect day, and the actual experience of the near-perfect day.

As a counselor or therapist, encourage your client to think about what a beautiful day means to them.

What do they love to do? What do they enjoy that they haven’t had a chance to do recently? What have they always wanted to do but have never tried?

These questions can help guide your client to discover what constitutes a beautiful day to them. Direct your client to pick a day in the near future and design their day with the following tips from in mind:

  1. Some alone time is fine, but try to involve others for at least part of the day.
  2. Include the small details that you are looking forward to in your plan, but don’t plan out your entire day. Leave some room for spontaneity!
  3. Break your usual routine and do something different, whether it’s big or small.
  4. Be aware that your beautiful day will almost certainly not go exactly as planned, but it can still be beautiful!
  5. Use mindfulness on your beautiful day to soak in the simple pleasures you will experience throughout the day (link to these tips).

3. Self-Esteem Journal

The self-esteem journal is another straightforward but effective exercise for clients suffering from feelings of low self-worth.

This worksheet provides a template for each day of the week and three prompts per day for your client to respond to, including prompts like:

  1. Something I did well today…
  2. Today I had fun when…
  3. I felt proud when…
  4. Today I accomplished…
  5. I had a positive experience with…
  6. Something I did for someone…

The simple act of noticing and identifying positive things from their day can help clients gradually build their self-esteem and enhance their well-being. Sometimes all we need is a little nudge to remember the positive things we do!

4. Mindfulness Meditation

Mindfulness meditation can be an excellent tool to fight anxiety, depression, and other negative emotions, making it a perfect tool for therapists and counselors to use with their clients.

To introduce your client to mindfulness meditation, you can try the “mini-mindfulness exercise,” a quick and easy lesson that only takes a few minutes to implement.

Follow these steps to guide your client through the process:

  • Have your client sit in a comfortable position with a dignified but relaxed posture and their eyes closed. Encourage them to turn off “autopilot” and turn on their deeper awareness of where they are, what they are doing, and what they are thinking.

 

  • Guide them through the process of becoming aware of their breath. Instruct them to take several breaths without trying to manipulate or change their breathing; instead encourage them to be aware of how it feels as they inhale air through the nostrils or mouth and into the lungs, as they hold the air for a brief moment, and as they exhale the air again. Direct their attention to how their chest feels as it rises and falls, how their belly feels as it expands and contracts, and how the rest of their body feels as they simply breathe.

 

  • Direct your client to let their awareness expand. Now, they can extend their focus beyond their breath to the whole body. Have them pay attention to how their body feels, including any tightness or soreness that may be settled into their muscles. Let them be present with this awareness for a minute or two, and tell them to open their eyes and continue with the session or with their day when they are ready.

 

Once your client is introduced to mindfulness meditation, encourage them to try it out on their own. They may find, as so many others have, that mindfulness can be a great way to not only address difficult or negative emotions but maintain positive ones throughout the day as well.

To read the full text of this exercise, follow this link.

5. Values in Action Inventory of Strengths (VIA-IS)

The VIA-IS is one of the most commonly used tools in positive psychology, and it has applications in positive psychotherapy as well. Completing this questionnaire will help your clients identify their dominant strengths— allowing them to focus their energy and attention on using their inherent strengths in their daily life, instead of getting distracted by the skills or traits they may feel they are lacking.

The VIA-IS is reliable, validated, and backed by tons of scientific research, and best of all – it’s free to use (Park, Nansook, & Seligman, 2004).

Direct your clients to this website to learn about the 24 character strengths and take the VIA-IS to discover their own top strengths.

These strengths are organized into six broad categories as follows:

Wisdom and Knowledge

  • Creativity;
  • Curiosity;
  • Judgment;
  • Love of learning;
  • Perspective.

 

Courage

Six Categories of Character Strengths.
Martin Seligman’s Chart of Six Character Strengths.

Humanity

  • Love;
  • Kindness;
  • Social intelligence.

 

Justice

  • Teamwork;
  • Fairness;
  • Leadership.


Temperance

 

Transcendence

  • Appreciation of beauty and excellence;
  • Gratitude;
  • Hope;
  • Humor;
  • Spirituality.

 

Once your client has taken the survey and identified their top 5 strengths, instruct them to bring in their results and have a discussion with them about how they can better apply these strengths to their work, relationships, recreation, and daily life.

 

A Take-Home Message

We hope that you found this quick overview of effective positive psychotherapy tools to be helpful. If you’re interested in practicing positive psychotherapy with your clients, please visit www.therapistaid.com, http://greatergood.berkeley.edu/, and www.goodtherapy.org to learn more about how to apply positive psychotherapy principles and practices to your work.

What has your experience been using these positive psychotherapy exercises? Leave a comment below. We would love to hear and learn from you.

Further Reading (PDF’s)

What is Positive Psychotherapy and how does it work? – By Tayyab Rashid (link)

Positive Psychology Exercises, Activities and Techniques

 

About the Authors

NathanStudying on the other side of the world opened Nathan Harrison‘s eyes to the world of positive psychology. He has since taken a look at the role of music’s positive effects for young people, inspired by his love for arts and drawing on years of performing experience as a musician.

 

Courtney Ackerman

Courtney Ackerman is a graduate of the positive organizational psychology and evaluation program at Claremont Graduate University. She is currently working as a researcher for the State of California and her professional interests include survey research, well-being in the workplace, and compassion. When she’s not gleefully crafting survey reminders, she loves spending time with her dogs, visiting wine country, and curling up in front of the fireplace with a good book or video game.

 

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.

Davis, D. E., Choe, E., Meyers, J., Wade, N., Varjas, K., Gifford, A., Quinn, A., …, & Worthington Jr., E. L. (2016). Thankful for the little things: A meta-analysis of gratitude interventions. Journal of Counseling Psychology, 63, 20-31. doi:10.1037/cou0000107

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.

Marsh, J. (2011, November 17). Tips for keeping a gratitude journal. Greater Good: The Science of a Meaningful Life. Retrieved from www.greatergood.berkeley.edu

Park, N., Peterson, C., & Seligman, M. P. (2004). Strengths of character and well-being. Journal of Social and Clinical Psychology, 23, 603-619.

Porges, S.W. (1995). Cardiac vagal tone: A physiological index of stress. Neuroscience & Biobehavioral Reviews, 19, 225-233.

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

Seligman, M.E.P., Rashid, T., & Parks, A.C. (2006). Positive psychotherapy. American Psychologist, 61, 774-788.

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

Sheldon, K. M., & Lyubomirsky, S. (2006). How to increase and sustain positive emotion: The effects of expressing gratitude and visualizing best possible selves. The Journal of Positive Psychology, 1, 73-82. doi:10.1080/17439760500510676

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.

www.goodtherapy.org

http://greatergood.berkeley.edu/

www.therapistaid.com

https://www.viacharacter.org/

About the Author

Studying on the other side of the world opened Nathan Harrison's eyes to the world of positive psychology. He has since taken a look at the role of music's positive effects for young people, inspired by his love for arts and drawing on years of performing experience as a musician. Get to know our whole team!

Comments

  1. Martin

    To the autors of this article: I am fairly certain that you are using the term “positive psychotherapy” not in a correct manner, because you haven’t taken into consideration the already existing positive psychotherapy, developed in 1968 by Nossrat Peseschkian. This original method has nothing to do with the principles of positive psychology, thus this article itself appears to be an embezzlement of intelectual property!

    Reply
  2. Bethel Smith

    I really loved your suggestion about using Gratitude Journals for counseling. This is a great way to help people realize all of the good things in their life. While this may seem like something simple, I am sure that it can make a great impact!

    Reply
  3. Dolline Busolo

    Paul good evening. The article is quite informative. I m in Kenya studying for masters in Counselling Psychology at the Tangaza university. I want to carry out a VIA for older people in a church environment as part of a bigger research am doing. The older people 60 and above do not have access to the internet. Is there a way l could get a questionnaire for them to fill out?
    Thanks
    Dolline Busolo

    Reply
  4. Mark Murphy

    I really like your tip to get a notebook and write down all of your thoughts. My wife and I have been thinking of getting our son some therapy. I will be sure to tell my wife that we should get our son a notebook first!

    Reply
  5. Marcus Coons

    I loved when you mentioned how a psychiatrist should ask their clients to write down every night a couple of things they were grateful for that day. It makes sense that doing this can help the patient start to look at the good side of life and start getting over their mental block. Personally, I would want to choose a professional mental doctor that has all the tools needed for the job and the training to advise me on what I need to do to positively change my problem and help me make it a normal thing.

    Reply
  6. Natalija Rascotina

    ‘Design a beautiful day’ i use an almost identical method with my clients, it really allows them to open up and does so much good.
    enjoyable read, ill be extracting bits and pieces from this and trialling them over the upcoming months. ill let you know how it goes

    Reply
  7. Titiek Rohani

    Thank you so much for this valuable sharing. I am taking this to practise on myself using the tools given.
    I have loved so much about positive psychology and inspired by all the facts of evidence based research.

    Reply
  8. Jessie van den Heuvel

    This article has been updated on the 13th of March 2017. Enjoy!

    Reply
  9. Nathan

    Hi Paul,
    Thanks so much for your kind words. You make excellent points – the benefits are very promising. I definitely agree that the care should focus on skills, an idea which is too often forgotten! The research is looking strong, and it will be interesting to see how this field continues to grow.
    Thanks for your comment.
    Nathan

    Reply
  10. Paul

    This was a great article, very well written.
    Positive psychotherapy sounds like it could hold serious promise with future research. It would seem that far too often that people ruminate on thoughts in a negative manner. While talking about such thoughts in therapy might be functional in reducing symptoms of depression, positive psychotherapy would be optimal for long lasting wellness. Fostering engagement and positive coping skills is not only effective, but innovative as well.
    Additionally, there is evidence to suggest that one of the major benefits of positive psychology is reducing stress. The happier someone is psychologically, not just appearing to be, the less stressed they tend to be. This might seem like a universal truism, but it has been groundbreaking in terms of contemporary research. Current research has demonstrated links between more stress and a decline in not only psychological health but also in physical health, too. For example, inflammation caused by stress can damage internal organs if not dealt with swiftly. So current treatment methods are targeting stressors, and focusing on preventative care. Like Martin Seligman said, in part, “Nothing against pain and suffering, but it’s just not enough.” Those are valid ways to deal with stress and problems in people’s lives; however that does not go deep enough, and needs a supplement to reduce stress long term. The supplement discussed would be targeting those thought processes and encouraging the positive behaviors and thought patterns to reduce stress.
    There seems to be a fixation on the medical model in contemporary psychology. Of course, that is not to say it does not have it’s merits, but other forms of therapy tend to get thrown aside for the quickest–most effective– form of therapy (i.e medication therapy.) This is not suggesting that medication should not be prescribed, as it does work wonders with some people, but rather methods of therapy target the problem and not just the symptoms associated with it. Furthermore, the methods of outpatient care should reflect skills needed to proactively pressure lifetime happiness.
    The research on positive psychotherapy that shows results cannot be ignored. The article above has shown promising results. With any luck, it is just a matter of time before positive psychotherapy has enough data to be added to other therapeutic approaches, or used as a stand alone therapy, to treat psychological problems.

    Reply

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