Seeking out any type of therapy can be daunting.
We often realize that we could benefit from external support slowly, and for many, taking the next step can be clouded by internal fears:
What will a therapist have to say about me and my behavior?
What shortcomings will they uncover and assign to me?
How will this change how I think and feel about myself?
All therapy should have a focus on cultivating positive aspects of a person and how they engage with the world and others around them, so that they may start to uncover areas of growth and begin to move towards their full authentic potential.
Positive Psychotherapy is one such therapeutic model that has aimed to reorient the therapeutic approach to be more focused on supporting clients to use their inner resources to overcome challenges, understand and recognize areas of growth, and focus instead on working towards resilience and a greater sense of wellbeing.
This article contains:
- What is Positive Psychotherapy (PPT)
- Nossrat Peseschkian’s Work and A Brief History of Positive Psychotherapy
- Five Benefits of Positive Psychotherapy
- How Does Positive Psychotherapy Relate to Positive Psychology?
- 3 Positive Psychotherapy Interventions
- The Positive Psychotherapy Model (inc. Table with Brief Session Descriptions)
- 20 Positive Psychotherapy Resources
- A Take-Home Message
What is Positive Psychotherapy (PPT) (Incl. Definitions)
Positive Psychotherapy (PPT) is a relatively new therapeutic approach, influenced by both the humanistic and psychodynamic approaches towards diagnosis and treatment. Its core focus is on moving away from what’s ‘wrong’ or the negative aspects of an individual, and instead move towards what’s good and positive.
Seligman, Rashid, and Parks (2006) offer the following definition for PPT concerning depression:
Positive psychotherapy (PPT) contrasts with standard interventions for depression by increasing positive emotion, engagement, and meaning rather than directly targeting depressive symptoms.
PPT often uses a range of interdisciplinary approaches of psychotherapy, including the use of multicultural stories, ideas, and metaphors to help individuals create a new view of their mental health in positive ways. Therapists using PPT often invite the individual to place themselves in the stories used, so they become active in their healing process in an empowered way, and in so doing, become the ‘therapist’ of their own recovery.
While the emphasis is on positivity and positive outcomes, the overall theory of PPT also asserts that three core principles need to be addressed to allow this to happen:
- The Principle of Hope: This principle encourages the individual to focus on the overall positivity of humanity, and negative experiences are to be seen as having a higher purpose with a positive reframing. Any disruptions to a sense of well-being are encouraged to be explored and reframed as signals that there is an imbalance that requires addressing.
- The Principle of Balance: This principle examines how we experience discontent and the coping methods we might use to address this. According to PPT, negative symptoms arise when these coping methods aren’t working, and our areas of life are out of balance, with discontent impacting how we think and feel.
Peseschkian (1979) ascertained there are four key areas where we will experience imbalance: body/sense, achievement/activities, contact/environment, and fantasy/future. These are the areas PPT focuses on when exploring and addressing the principle of balance.
- The Principle of Consultation: This principle sets out the five stages of therapy that must be worked through to address any issues that arise in the above two principles, to achieve a positive outcome:
- Observation – where the individual provides an account of the issues, challenges, or situations that are upsetting them and those that are making them happy.
- Inventory – where the therapist and individual work together to explore and highlight the correlation between negative feelings/symptoms and the individual’s true capabilities.
- Situational Support – where the individual is asked to focus on their positive traits and those of the people around them who significantly offer them support.
- Verbalization – where the individual is encouraged to verbally discuss and talk openly about any negative feelings, challenges, or symptoms.
- Development of Goals – where the individual is invited to turn their focus to the future, setting positive goals, and envisioning the positive feelings they want to cultivate, as well as connecting these with their unique strengths.
- Observation – where the individual provides an account of the issues, challenges, or situations that are upsetting them and those that are making them happy.
Another core component of PPT is the emphasis it places on core capabilities. According to PPT theory, everyone – regardless of gender, age, class, ethnicity, or preconceived ideas of their mental health – has two core capabilities:
- The Capability of Perception: Our ability to draw connections between the different areas of life with more significant reasons behind the meaning of not only our own existence but the existence of everything around us.
- The Capability of Love: Our ability to develop emotionally and develop interpersonal relationships.
Pesechkian (1979) concluded that these two core capabilities are what lay behind our further abilities. PPT seeks to explore an individual’s two core capabilities to understand better and, where appropriate, address imbalances to create additional positive outcomes.
Due to its openness around utilizing multicultural stories and ideas, one criticism of PPT is that it does not work as well in westernized society. This is because there is often a focus on individualism and independence, and by not allowing enough exploration of negative or traumatic experiences can be seen to lead to trivializing these experiences.
Overall, PPT has been received very positively in the positive psychology community, with some wonderful outcomes and results.
Nossrat Peseschkian’s Work and A Brief History of Positive Psychotherapy
Although Seligman is often attributed as being one of the co-founders of PPT, similar therapies focusing on happiness or quality of life over emphasis on negatively experienced symptoms pre-date Seligman’s work.
Most notably is Nossrat Peseschkian, an Iranian-born psychotherapist, psychiatrist, and neurologist, who set up practice in Germany in the 1960s.
Influenced by humanist psychology, meetings with multiple influential psychologists, and spiritual practitioners, as well as his own experiences working with clients across more than twenty cultures, Peseschkian wanted to create an integrative therapy model that focused on positive experiences alongside being culturally sensitive.
In the 1970s, Peseschkian began to deliver lectures around his therapy model and published four books based on PPT during this time. In the early 1970s, Peseschkian referred to his model as ‘Differentiation Analysis.’
In 1977 he published his first book, ‘Positive Psychotherapy,’ and in so doing renamed his approach. During this time, PPT gained further acknowledgment with structured training and the founding of the Psychotherapeutic Group of Wiesbaden, The German Association for Positive Psychotherapy, and the Journal of Positive Psychotherapy in 1979.
Through the 1980s and 1990s, PPT grew in its structure, uses, and acknowledgment as a prevalent theory outside of Germany, with Peseschkian traveling to more than 60 countries to deliver talks and lectures, and opening more than 30 centers. He also continued to publish books, and the ‘Wiesbaden Inventory for Positive Psychotherapy and Family Therapy’ was also published in 1988.
In 1994 the International Center for Positive Psychotherapy opened its doors, later becoming the Word Association for Positive Psychotherapy in 2008. The first effectiveness study of PPT was conducted between 1995 and 1997, concluding that PPT demonstrated a strong therapeutic influence for a range of mental health diagnoses.
Peseschkian wasn’t the only one to recognize the benefits of focusing on the positive in therapy. During this time, several other psychologists also explored similar concepts.
Fordyce (1977) developed a ‘Happiness’ intervention and worked with students to help them utilize a series of 14 tactics aimed at assisting them in developing a better sense of well-being and happiness.
These tactics came with detailed instructions and included things such as socializing, engaging in meaningful work, deepening close relationships with loved ones, and managing expectations. Fordyce found that those students who used the tactics and instructions reported being happier and showed fewer depressive symptoms over a control group.
Fava (1999) and Fava and Ruini (2003) developed their Well-Being Therapy (WBT), which places a focus on building personal mastery across different areas of life, including environmental, personal growth, life purpose, self-acceptance and positive relationships with others.
Alongside Peseschkian’s approach, Seligman has been responsible for developing the PPT model alongside more contemporary notions of positive psychology. Where Peseschkian’s model is more integrative, cross-disciplinary, and focuses on multi-cultural concepts, more modern PPT practice is primarily based on Seligman’s notion of happiness and well-being overall (Seligman, 2002).
It’s important to acknowledge that while similar, there are some slight differences between the two approaches.
Five Benefits of Positive Psychotherapy
The primary goal of PPT is to help individuals better understand the skills and capabilities they have, and ones they might need to develop, to achieve a greater sense of inner balance. This is achieved by exploring innate resources – physical, emotional, spiritual, and cognitive – the individual already has and may need help tapping into in positive ways.
There are many benefits of positive psychotherapy and in approaching our mental health in this way. Below I’ve explored the top five in more detail:
1. Empowers the Individual
As PPT places a strong emphasis on helping the individual to examine their strengths, skills, and capabilities in a positively reframed manner, it increases their sense of empowerment and control over the different areas of their life, as well as their capacity to handle challenges and negative experiences (Rashid, 2014).
The therapist’s role in the client-therapist relationship is to encourage the individual to uncover things on their own terms. It places the good with the bad, helping individuals find the balance they need to accept all parts of themselves.
This integration of skills, weaknesses, virtues, vulnerabilities, and strengths helps to build a more balanced perspective rather than reducing individuals to merely their symptoms or what challenges them.
2. Positive Reframing of Negative Symptoms and a Focus on Balance
A great benefit of PPT is how it brings the negative in line with the positive. Although it might sound like the model only focuses on positive and dismisses the negative, it focuses more on bringing the two into alignment and balance.
This approach helps individuals to better understand their strengths and skills, where they might have gaps and how these can perpetuate negative feelings or imbalances if not addressed appropriately.
3. Acknowledges and Supports Cultural Transitions and Differences
Because PPT encourages empowerment on the individual, it can help them to feel more in control across different areas of their life, even when it might feel that external circumstances are taking over. This has proven especially beneficial for individuals experiencing conflict in multi-cultural environments or relationships.
Bontcheva and Huysse-Gaytandjieva (2013) explored migration and the challenges faced by those who had moved to new countries and cultures. They found that those who applied positive psychotherapy techniques were better able to overcome these challenges, with two-thirds of participants reporting depressive symptoms were entirely resolved.
4. Better Management of Expectations and Therapy Outcomes
Another important benefit of PPT is how it acknowledges the importance of the client-therapist relationship, and how the self-directed techniques used are instrumental in helping individuals get the most out of the therapy (Rashid and Seligman, 2018).
With a greater sense of awareness for personal capabilities, strengths, and skills, the individual can understand their mental health journey better, and how they can act to improve this. As a result, therapy expectations are better managed, and individuals see the outcome of PPT as being about more than merely eliminating negative symptoms or feelings.
5. Proven to Help a Range of Mental Health Conditions
With its focus on strengths and cultivation of the positive elements of life, PPT has shown to be highly beneficial across a range of mental health conditions including psychosis (Schrank et al., 2016), suicidal ideation (Johnson et al., 2010), depression (Seligman, Rashid, and Parks, 2006, Carver, Scheier and Segerstrom, 2010) and borderline personality disorder (Uliaszek, 2016).
How Does Positive Psychotherapy Relate to Positive Psychology?
While the two approaches sound very similar, there are some cross-overs in how each tackles individual experiences within therapy. Positive psychology is popularly attributed as being the brain-child of Martin Seligman, developed in 1998, where positive psychotherapy is more commonly attributed to Nossrat Pesechkian, first developed in 1968.
Both approaches draw influences from humanistic and psychodynamic models of psychology.
What are the similarities and differences between the two?
Both approaches place emphasis on personal development and the importance of tapping into innate resources and strengths to overcome challenges and negatively experience emotions. Both also work on the assumption that we are all inherently good, and need to work hard to uncover when external influences prevent us from becoming the best versions of ourselves.
There are also some slightly nuanced, but very essential differences:
|Positive Psychotherapy||Positive Psychology|
|Believes all negative experiences can be challenged and reframed in a positive way, as they are essentially opportunities for further growth.||Acknowledges negative experiences and emotions but doesn’t necessarily incorporate them in the same way.|
|Focuses more on multi-cultural experiences and the challenges that individuals can face across different cultures – both similar and different.||Has a more Westernised approach to therapy and an individual’s experiences.|
|Influenced equally by humanistic and psychodynamic approaches and seeks to integrate the best of both.||Less focused on humanistic models and therapies and less integrative of other psychological approaches.|
Seligman has spoken extensively about both approaches, and how the two are related in specific ways, identifying that positive psychotherapy helps individuals to move past the process of suffering to uncover deeper insights about their wellbeing (Seligman and Wyatt, 2008).
While acknowledging negative or traumatic experiences is a core component of many therapeutic approaches, Seligman has acknowledged that positive psychotherapy does place a more positive focus when going through this process.
3 Positive Psychotherapy Interventions
As touched on briefly, positive psychotherapy has proven beneficial in a range of clinical settings addressing various mental health concerns.
The interventions utilized in PPT are varied, and will often rely on what the individual expresses in the therapy sessions for the therapist to select the ones most appropriate.
A very distinct component of the interventions used in PPT is how it incorporates imagination and intuition as part of the therapeutic process. Storytelling is another key way PPT encourages individuals to engage with their therapy journey, and this idea of building the self into the stories helps individuals to better articulate their journeys, experiences, challenges, and desires.
Through this process, PPT therapists can begin to introduce adjustments or dive deeper into sensitive topics without seeming to ‘attack’ the individual.
Therapists can also help those they work with to reframe their experiences and symptoms in positive ways, and then proactively work on rebuilding them positively within their lives (creating better balance). Once individuals can accept all aspects of themselves and begin to see negative experiences in a positive light, they generally no longer repeat those negative experiences.
The specific interventions used in this process have a focus on empowering the individual and providing them with the tools and resources to face up to negative or traumatic experiences, cultivate resilience, and develop better emotional functioning.
1. Practicing Gratitude
Gratitude is a strong cognitive state, generally associated with the idea that you have achieved a personal benefit that wasn’t initially or intentionally sought after (Emmons and McCullough, 2003). Feeling gratitude can have a strong re-energizing impact on our emotional well-being and has been shown to lead to greater feelings of happiness and healing.
In therapy, practicing gratitude can begin with making the time to acknowledge all the small everyday things that occur and for which we can feel grateful. Gratitude journals, worksheets, and resources are widely available, and it’s a popular intervention in PPT to help show individuals everything they have in their lives to feel grateful for – something many of us often forgets to acknowledge.
2. Practicing Forgiveness
Many therapists agree that forgiveness – for the self, others, and general experiences – is a vital part of healing and promoting a greater sense of well-being. Worthington (2003) proposed two core types of forgiveness within clinical/therapy settings:
- Decisional Forgiveness: Where the individual states a behavioral intent to forgive.
- Emotional Forgiveness: Where the individual has true emotional acceptance of the situation, experience, or personal feelings that requires forgiveness.
We can utilize decisional forgiveness but still feel emotionally upset, which can lead to further unforgiveness and negative symptoms related to our mental health (Worthington and Scherer, 2007). PPT utilizes the practice of forgiveness as a key intervention, particularly focusing on emotional forgiveness so that individuals feel a complete sense of healing when moving past negative symptoms.
3. Practicing Empathy
The PPT approach teaches that all humans are inherently good, and innately want to live meaningful lives and have enriching relationships. Empathy is a core component of this, but it has been shown to routinely fail as an innate ability in several challenging or conflicting scenarios (Zaki & Cikara, 2015).
Most empathy-related interventions build on the notion that we are all capable of empathy, and these interventions support individuals to focus instead on developing their ability to tap into empathy and target it in specific ways.
One approach utilized by PPT is using the storytelling method to ask individuals to put themselves in another’s shoes and describe how they might feel, react or respond to challenging situations, as well as how they might react to positive situations.
The Positive Psychotherapy Model (inc. Table with Brief Session Descriptions)
Similar to other therapy models, the PPT model focuses on a series of sessions aimed at uncovering ideas, desires, vulnerabilities and strengths, and working through them to reach positive reframing and overall balance between the positive and the negative.
The below outline of sessions is a brief overview of the PPT model. Some versions of this relate more to the approach developed by Pesechkian, and as with all therapy models, there can be slight nuances depending on the therapist and where they practice.
|Session and Topic||Description|
|Orientation to PPT; Current Positive Resources||Psychological distress is discussed as a lack of positive resources, such as positive emotions, relationships, meaning, and accomplishment.
To explore this, the therapist might use an exercise that encourages the individual to write a one-page, real-life story that called for the best in them and has a positive ending.
|Individual Character Strengths||In this session, individual character strengths are explored, and the concept of engagement and flow is introduced.
To begin exploring individual character strengths, the individual may be asked to identify what they believe are their signature strengths both in the session and through an online self-report.
They may also ask two other close persons to rate their signature strengths.
|Signature Strengths & Positive Emotions||Following on from the last session, signature strengths are discussed in more detail.
As an exercise, the therapist may ask the individual to compile a signature strengths profile, which could include setting SMART (specific, measurable, achievable, realistic, and timely) goals.
|Good vs. Bad Experiences, Symptoms or Memories||The concept of how negative experiences and symptoms can be perpetuated is discussed in alignment with positive experiences.
The therapist might use an exercise that asks the individual to explore a memory or experience that elicited feelings of anger, bitterness, or resentment and how these feelings further perpetuated the negative experience.
|Forgiveness||Forgiveness is explored as a resource to reframe negative symptoms and feelings into more positive emotions.
The therapist might use a letter-writing exercise that asks the participant to remember a negative experience and to write out a letter of forgiveness towards the perceived transgressor/s of the scenario – themselves included.
|Gratitude||Alongside forgiveness, gratitude is explored as a resource for generating better balance, and to view individual circumstances more positively.
The role of positive and negative memories, feelings, and symptoms are discussed with an emphasis on gratitude for all the lessons both of these states have allowed for.
The therapist might use gratitude journaling as an exercise to help build more focus and awareness of all the things for which the individual is grateful.
|Mid-Therapy Check||At this point, the therapist may follow up on any at-home tasks related to the forgiveness and gratitude sessions, and to revisit any of the previous sessions that may feel unresolved.
This is also the opportunity for the individual to discuss their perceived gains or hurdles they might be experiencing so far as an outcome of the sessions.
As an exercise, the therapist may seek to explore different ways the individual can overcome any of the hurdles, utilizing their signature strengths uncovered previously.
|Satisficing vs. Maximizing||The therapist may now introduce the two concepts of satisficing (mainly, being ‘good enough’) and maximizing.
The individual may be asked to explore the different ways in life they have not felt ‘good enough’ and to tell the story of one experience where they did feel good enough, and one where they did not.
Again, these can be explored regarding the individual’s signature strengths.
|Hope and Optimism||The additional concepts of optimism and hope are explored.
As an exercise, the therapist may ask the individual to think about a time when they may have felt they lost out on something, only to discover it opened up new opportunities.
|Positive Communication||Various interventions that involve developing positive communication, such as Active-constructive, are explored and referenced in association to the individual’s signature strengths.|
|Signature Strengths of Others||The importance of recognizing, acknowledging, and associating with the signature strengths of the key people the individual has close relationships with is explored.
As an exercise, the therapist may ask the individual to draw up a ‘Family Strengths Tree’ where the individual asks their significant relationships to complete an online self-report strengths test and identify their signature strengths.
These can then be discussed in the session.
|Savoring||The concept of savoring is explored, as well as some of the techniques and strategies that can be used to prevent adaptation, along with techniques and strategies to safeguard against adaptation.|
|Gift of Time and Positive Legacy||The benefits of kindness, sharing, and helping others are explored and discussed in alignment with therapeutic outcomes.
As an exercise, the therapist might ask the individual to make plans for how they might give the gift of their time utilizing their signature strengths.
|The Full Life||In the final session, ‘The Full Life’ is discussed in terms of what the individual feels they have that leads to this.
Therapeutic gains are discussed, focusing on positive emotions, engagement, and meaning.
How to keep this momentum going is also discussed, and ways of doing this are devised with the individual taking the lead and considering their signature strengths to achieve this.
As mentioned, the above is a brief overview of the sessions that can be included in the PPT model. If you’d like to find out more about the model and detailed descriptions of the sessions, as well as interventions and positive psychotherapy exercises that can be used within them, you can find more information through the Positive Psychology Toolkit.
20 Positive Psychotherapy Resources
As a psychological approach, PPT has grown considerably in popularity over the past decade or so. There is now a wide range of resources, tools, books, and other media to help you either as a therapist or an individual better understand this model and utilize it in productive ways.
Below I’ve listed some of the resources I’ve found during my research on the topic that you might also find beneficial:
5 Books on Positive Psychotherapy
1. Positive Psychotherapy: Clinician Manual – Tayyab Rashid and Martin Seligman
It includes a detailed and accessible write up of the theories and research that underpin PPT, alongside ‘best practice’ and inspiring case studies.
Available on Amazon.
2. In Search of Meaning: Positive Psychotherapy Step by Step – Nossrat Pesechkian
Available on Amazon.
3. Positive Psychotherapy of Everyday Life: A Self-Help Guide for Individuals, Couples and Families with 250 Case Stories – Nossrat Pesechkian
In this book, Pesechkian offers a more in-depth look at how PPT can be applied in ‘real-life’ relationships and scenarios, supporting individuals, couples, and families to utilize the techniques effectively.
It also includes a wide range of case studies that many may find useful.
Available on Amazon.
4. Positive Psychotherapy Workbook – Tayyab Rashid and Martin Seligman
Available on Amazon.
5. Savoring: A New Model of Positive Experience – Fred Bryant and Joseph Veroff
Available on Amazon.
5 Podcasts on Positive Psychology and Positive Psychotherapy
Below is a selection of podcasts that further explore PPT, positive psychology, or some of the core concepts that PPT encapsulates:
- The Positive Psychology Podcast: Bringing the Science of Happiness to Your Earbuds with Kristen Truempy – Access here.
- PositivePsychology.Com Podcast: How Dangerous Positive Psychology can be with Dr. Hugo Alberts and Seph Fontane Pennock – Access here.
- Live Happy Podcast: How to Banish Negative Thoughts with Ora Nadrich – Access here.
- Greater Good Centre: Why Gratitude Works with Christine Carter and Rona Renner – Access here.
- Being Well Podcast: Forgiveness with Dr. Rick Hanson – Access here.
5 Videos on Positive Psychotherapy
These videos are fantastic resources for further developing an understanding of some of the core ideals and concepts that formulate PPT approaches:
1. TEDx – The New Era of Positive Psychology – Martin Seligman
2. The Art of Charm on YouTube – Positive Psychology & the Science of Well-Being with Rob Mack
3. TEDx – Why Forgiveness is Worth It – Sarah Montana
4. TEDx – The Hidden Power in a Breath of Gratitude – Roy Ledbetter
5. TEDMED – The Positive Effects of Positive Emotions – Jennifer Stellar
5 Downloadable Positive Psychotherapy Resources
Below is a selection of downloadable resources, worksheets, and toolkits offering guidance on a range of PPT practices and approaches:
1. Develop Good Habits – 90 Day Gratitude Journal
This comprehensive little journal includes 90 tips, anecdotes, guidance, and exercises to help you incorporate more gratitude into your everyday. It’s perfect for those who want to practice more gratitude, but are unsure how or where to start.
2. ‘Three Good Things’ Gratitude Journal Worksheet
Another gratitude focused worksheet, ‘Three Good Things’ is a very common exercise utilized within PPT. This free downloadable worksheet offer prompts to meditate on the specific things – small or otherwise – that have happened during your day, week, or month for which you are grateful.
3. The Path of Forgiveness – Forgiveness Workbook
This extremely comprehensive workbook is a fantastic source of information, guidance, and exercises to help you better understand how forgiveness plays an active role in your perceptions and relationships – for good or bad. It’s detailed and thoughtful and can help you develop a better and healthier practice of forgiveness.
4. Short Exercises for Understanding Empathy Worksheet
This quick and easy to use worksheet describes a few different exercises that can be used to open up a dialogue around empathy and help individuals further develop their empathy. It’s easily tailored to different groups, and perfect for anyone working with others in individual or group settings, wanting to explore empathy.
5. Increasing Empathy: Empathy Training Manual
This is a more in-depth and comprehensive workbook exploring empathy. It includes details of what empathy is, how it has been explored in different contexts, and short exercises to use individually or as a coach to further develop empathy.
A Take-Home Message
I hope this article has helped to give you a more in-depth and balanced perspective of what PPT is, what it can do for individuals, and how the model can be beneficial in a range of mental health settings.
As someone who travels extensively and interacts with a range of cultures, I’ve found exploring the topic extremely beneficial for me personally, and it’s one I’ll be coming back to during my work and studies as an approach that embraces multicultural approaches and how different cultures can approach challenges we might all experience.
If there’s one thing I’d like you to take away from reading this article, it’s how PPT offers a balance across the positive and negative we all experience in our daily lives.
Positive psychology overall is all about bringing better understanding and balance across the many different spheres we exist in. If you’re sensing an imbalance, PPT could be a great approach to explore and help you better understand the where, what, why, and how to address that imbalance.
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