Effectiveness of a positive psychology intervention combined with cognitive behavioral therapy in university students

  1. Rosario Josefa Marrero Quevedo 1
  2. Mónica Carballeira Abella 1
  3. Sabrina Martín 1
  4. Miriam Mejías 1
  5. Juan Andrés Hernández Cabrera 1
  1. 1 Universidad de La Laguna
    info

    Universidad de La Laguna

    San Cristobal de La Laguna, España

    GRID grid.10041.34

Journal:
Anales de psicología

ISSN: 0212-9728

Year of publication: 2016

Volume: 32

Issue: 3

Pages: 728-740

Type: Article

Export: RIS
DOI: 10.6018/analesps.32.3.261661 DIALNET GOOGLE SCHOLAR lock_openOpen access editor

Abstract

The aim of this study was to design and implement a positive intervention combined with cognitive-behavioral therapy to enhance subjective and psychological well-being and other positive functioning constructs in a convenience sample. Participants analysed were 48 university students (mean age 22.25), 25 assigned nonrandomized to intervention condition and 23 to no-treatment waiting-list control condition. All participants were assessed pre- and post-intervention to test the treatment program effectiveness. Repeated-measures ANCOVAs, controlling baseline differences between the two groups, indicated that the intervention group reported greater social support after the intervention period than the waiting-list control group. Within-group differences were found for happiness, selfacceptance, positive relations with others, optimism, and self-esteem in the intervention group; these differences did not appear in the waiting-list control group. These findings suggest the limited capacity of this intervention program for improving well-being through positive activities combined with cognitive-behavioral therapy. Future research should analyse what kind of activities could be more effective in promoting well-being depending on the characteristics of participants.

Bibliographic References

  • Beck, A. T. (1993). Cognitive therapy: past, present, and future. Journal of Consulting and Clinical Psychology, 61, 194-198. http://dx.doi.org/10.1037/0022-006X.61.2.194
  • Beck, J. G., & Coffey, S. F. (2005). Group cognitive behavioral treatment for PTSD: Treatment of motor vehicle accident survivors. Cognitive and Behavioral Practice, 12, 267-277. http://dx.doi.org/10.1016/S1077-7229(05)80049-5
  • 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, 13-119. http://dx.doi.org/10.1186/1471-2458-13-119.
  • Burton, C. M., & King, L. A. (2004). The health benefits of writing about intensely positive experiences. Journal of Research in Personality, 38, 150-163. http://dx.doi.org/10.1016/S0092-6566(03)00058-8.
  • Butkovic, A., Brkovic, I., & Bratko, D. (2012).Predicting well-being from personality in adolescents and older adults. Journal of Happiness Studies, 13, 455-467. http://dx.doi.org/10.1007/s10902-011-9273-7
  • Catalino, L. I., Algoe, S. B., & Fredrickson, B. L. (2014). Prioritizing positivity: An effective approach to pursuing happiness? Emotion, 14, 1155-1161. http://dx.doi.org/10.1037/a0038029
  • Chaves, C., López-Gómez, I., Hervás, G., & Vázquez, C. (2016). A comparative study on the efficacy of a positive psychology intervention and a cognitive behavioral therapy for clinical depression. Cognitive Therapy and Research, 1-17. http://dx.doi.org/10.1007/s10608-016-9778-9
  • Cohen, J. (1988). Statistical power analysis for the behavioral sciences. Hillsdale, New Jersey: Lawrence Erlbaum Associates.
  • Cohn, M. A., & Fredrickson, B. L. (2010). In search of durable positive psychology interventions: Predictors and consequences of long-term positive behavior change. The Journal of Positive Psychology, 5, 355-366. http://dx.doi.org/10.1080/17439760.2010.508883
  • Deci, E. L., & Ryan, R. M. (2008). Facilitating optimal motivation and psychological well-being across life's domains. Canadian Psychology/PsychologieCanadienne, 49, 14-23. http:/dx.doi.org/10.1037/0708-5591.49.1.14
  • Deci, E. L., & Ryan, R. M. (2013). The importance of autonomy for development and well-being. In B. W. Sokol., F. M. E. Grouzet., & U. Müller (Eds.), Self- Regulationand Autonomy (pp. 19-46). Cambridge: Cambridge University Press.
  • DelleFave, A., & Fava, G. A. (2011).Positive psychotherapy and social change. In R-Biswas-Diener (Ed.), In Positive psychology as social change (pp. 267-291). Milan: Springer Netherlands.
  • Diener, E., & Diener, M. (2009).Cross-cultural correlates of life satisfaction and self-esteem. Culture and Well-Being, 38, 71-91. http://dx.doi.org/10.1007/978-90-481-2352-0_4
  • Diener, E., Emmons, R.A., Larsen, R.J., & Griffin, S. (1985). The Satisfaction with Life Scale.Journal of Personality Assessment, 49, 71-75. http://dx.doi.org/10.1207/s15327752jpa4901_13
  • Diener, E., Suh, E. M., Lucas, R. E., & Smith, H. L. (1999). Subjective well-being: Three decades of progress. Psychological Bulletin, 125, 276-302. http://dx.doi.org/10.1037/0033-2909.125.2.276
  • D'Zurilla, T. J., & Goldfried, M. R. (1971).Problem solving and behavior modification.Journal of Abnormal Psychology, 78, 107-126. http://dx.doi.org/10.1037/h0031360
  • D’Zurilla, T. J., & Nezu, A. M. (2010). Problem-solving therapy.In K. S. Dobson (Ed.),  Handbook of Cognitive-Behavioral Therapies (pp. 197-225). New York: The Guilford Press.
  • Emmons, R. A., & McCullough, M. E. (2003).Counting blessings versus burdens: an experimental investigation of gratitude and subjective well-being in daily life.Journal of Personality and Social Psychology, 84, 377-389. http://dx.doi.org/10.1037/0022-3514.84.2.377
  • Fava, G. A., Ruini, C., Rafanelli, C., Finos, L., Conti, S., & Grandi, S. (2004). Six-year outcome of cognitive behavior therapy for prevention of recurrent depression. American Journal of Psychiatry, 161, 1872-1876. Retrieved from http://ajp.psychiatryonline.org/doi/full/10.1176/ajp.161.10.1872
  • Fordyce, M. W. (1983). A program to increase happiness: Further studies. Journal of Counseling Psychology, 30, 483-498.http://dx.doi.org/10.1037/0022-0167.30.4.483
  • Fordyce, M.W. (1977). Development of a program to increase happiness.Journal of Counseling Psychology, 24, 511-521. http://dx.doi.org/10.1037/0022-0167.24.6.511
  • Fredrickson, B. L., & Joiner, T. (2002). Positive emotions trigger upward spirals toward emotional well-being. Psychological Science, 13, 172-175. http://dx.doi.org/10.1111/1467-9280.00431
  • Fredrickson, B. L., Grewen, K. M., Coffey, K. A., Algoe, S. B., Firestine, A. M., Arevalo, J. M. & Cole, S. W. (2013). A functional genomic perspective on human well-being. Proceedings of the National Academy of Sciences, 110, 13684-13689.http://dx.doi.org/10.1073/pnas.1305419110
  • Fujita, F., &Diener, E. (2005). Life satisfaction set point: stability and change. Journal of Personality and Social Psychology, 88, 158-164. http://dx.doi.org/10.1037/0022-3514.88.1.158
  • Gable, S. L., Reis, H. T., Impett, E. A., & Asher, E. R. (2004). What do you do when things go right? The intrapersonal and interpersonal benefits of sharing positive events. Journal of Personality and Social Psychology, 87, 228-245.http://dx.doi.org/10.1037/0022-3514.87.2.228
  • Gander, F., Proyer, R. T., Ruch, W., & Wyss, T. (2013). Strength-based positive interventions: further evidence for their potential in enhancing well-being and alleviating depression. Journal of Happiness Studies, 14, 1241-1259. http://dx.doi.org/10.1007/s10902-012-9380-0
  • Gillet, N., Lafrenière, M. A. K., Vallerand, R. J., Huart, I., & Fouquereau, E. (2014). The effects of autonomous and controlled regulation of performance‐approach goals on well‐being: A process model. British Journal of Social Psychology, 53, 154-174. http://dx.doi.org/10.1111/bjso.12018
  • Hernández, J.A. &Betancort, M. (2016). ULLRToolbox.https://sites.google.com/site/ullrtoolbox/
  • Herzog, T. R., & Strevey, S. J. (2008). Contact with nature, sense of humor, and psychological well-being. Environment and Behavior, 40, 747-776. http://dx.doi.org/10.1177/0013916507308524
  • Hochberg, Y. (1988). A sharper Bonferroni procedure for multiple tests of significance. Biometrika, 75, 800-803.http://dx.doi.org/10.1093/biomet/75.4.800
  • Izard, C. E. (1992). Basic emotions, relations among emotions, and emotion-cognition relations.Psychological Review, 99, 561-565. http://dx.doi.org/10.1037/0033-295X.99.3.561
  • Keltner, D., & Gross, J. J. (1999). Functional accounts of emotions. Cognition & Emotion, 13, 467-480. http://dx.doi.org/10.1080/026999399379140
  • Keyes, C. L., Shmotkin, D., & Ryff, C. D. (2002). Optimizing well-being: the empirical encounter of two traditions. Journal of Personality and Social Psychology, 82, 1007-1022. http://dx.doi.org/10.1037/0022-3514.82.6.1007
  • Layous, K., Nelson, S. K., & Lyubomirsky, S. (2013). What is the optimal way to deliver a positive activity intervention? The case of writing about one’s best possible selves. Journal of Happiness Studies, 14, 635-654. http://dx.doi.org/10.1007/s10902-012-9346-2
  • Lykken, D., &T ellegen, A. (1996). Happiness is a stochastic phenomenon. Psychological Science, 7, 186-189. http://dx.doi.org/10.1111/j.1467-9280.1996.tb00355
  • Lyubomirsky, S., &Layous, K. (2013). How do simple positive activities increase well-being? Current Directions in Psychological Science, 22, 57-62. http://dx.doi.org/10.1177/0963721412469809
  • Lyubomirsky, S., & Lepper, H.S. (1999). A measure of subjective happiness: Preliminary reliability and construct validation. Social Indicators Research, 46, 137-155. http://dx.doi.org/10.1023/A:1006824100041
  • Lyubomirsky, S., Sheldon, K. M., &Schkade, D. (2005).Pursuing happiness: the architecture of sustainable change.Review of General Psychology, 9, 111-131. http://dx.doi.org/10.1037/1089-2680.9.2.111
  • MacLeod, A. K., Coates, E., & Hetherton, J. (2008).Increasing well-being through teaching goal-setting and planning skills: results of a brief intervention.Journal of Happiness Studies, 9, 185-196. http://dx.doi.org/10.1007/s10902-007-9057-2
  • Maltby, J., Day, L., & Barber, L. (2005).Forgiveness and happiness.The differing contexts of forgiveness using the distinction between hedonic and eudaimonic happiness.Journal of Happiness Studies, 6, 1-13. http://dx.doi.org/10.1007/s10902-004-0924-9
  • Manassis, K., Mendlowitz, S. L., Scapillato, D., Avery, D., Fiksenbaum, L., Freire, M., Monga, S., & Owens, M. (2002). Group and individual cognitive-behavioral therapy for childhood anxiety disorders: a randomized trial. Journal of the American Academy of Child and Adolescent Psychiatry, 41, 1423-1430. http://dx.doi.org/10.1097/00004583-200212000-00013
  • Marrero, R.J., & Carballeira, M. (2010). El papel del optimismo y del apoyo social en el bienestar subjetivo. Salud Mental, 33, 39-46. Retrieved from http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S0185-33252010000100005
  • Marrero, R. J., & Carballeira, M. (2011). Well-being and personality: Facet-level analyses. Personality and Individual Differences, 50, 206-211. http://dx.doi.org/10.1016/j.paid.2010.09.030
  • Marrero, R. J., & Carballeira, M. (2012). The contribution of Personality to PWB: an exploratory study. In B.S. Nguyem (Ed.), Psychology of Satisfaction (pp. 41-65). New York: NOVA.
  • Marrero, R. J., Carballeira, M., & Rodríguez, J. P. (2007). El papel del optimismo en la salud. Memoria de investigación no publicada. Universidad de La Laguna: La Laguna.
  • Martínez-Martí, M. L., Avia, M. D., & Hernández-Lloreda, M. J. (2010). The effects of counting blessings on subjective well-being: A gratitude intervention in a Spanish sample. The Spanish Journal of Psychology, 13, 886-896. http://dx.doi.org/10.1017/S1138741600002535
  • Mazzucchelli, T. G., Kane, R. T., & Rees, C. S. (2010). Behavioral activation interventions for well-being: A meta-analysis. The Journal of Positive Psychology, 5, 105-121. http://dx.doi.org/10.1080/17439760903569154
  • McCullough, M. E., Emmons, R. A., & Tsang, J. A. (2002). The grateful disposition: a conceptual and empirical topography. Journal of Personality and Social Psychology, 82, 112-127. http://dx.doi.org/10.1037/0022-3514.82.1.112
  • Neff, K. D. (2011). Self‐compassion, self‐esteem, and well‐being. Social and Personality Psychology Compass, 5, 1-12. http://dx.doi.org/10.1111/j.1751-9004.2010.00330.x
  • Orth, U., Robins, R. W., & Widaman, K. F. (2012). Life-span development of self-esteem and its effects on important life outcomes. Journal of Personality and Social Psychology, 102, 1271-1288. http://dx.doi.org/10.1037/a0025558
  • Park, N., Peterson, C., & Seligman, M. E. (2004).Strengths of character and well-being. Journal of Social and Clinical Psychology, 23, 603-619. http://dx.doi.org/10.1521/jscp.23.5.603.50748
  • Parks, A. C., College, H., & Biswas-Diener, R. (2013). Positive interventions: Past, present and future. In T. Kashdam& J. Ciarrochi (Eds.), Bridging acceptance and commitment therapy and positive psychology: A practitioner’s guide to a unifying framework (pp. 140-165).Oakland, CA: New Harbinger.
  • Pearson, D. G., Deeprose, C., Wallace-Hadrill, S. M., Heyes, S. B., & Holmes, E. A. (2013). Assessing mental imagery in clinical psychology: A review of imagery measures and a guiding framework. Clinical Psychology Review, 33, 1-23.http://dx.doi.org/10.1016/j.cpr.2012.09.001
  • Pennebaker, J. W. (1997). Writing about emotional experiences as a therapeutic process. Psychological Science, 8, 162-166. http://dx.doi.org/10.1111/j.1467-9280.1997.tb00403.x
  • Peterson, C., & Seligman, M. E. (2004). Character strengths and virtues: A handbook and classification. New York: Oxford University Press.
  • Proyer, R. T., Ruch, W., & Buschor, C. (2013). Testing strengths-based interventions: A preliminary study on the effectiveness of a program targeting curiosity, gratitude, hope, humor, and zest for enhancing life satisfaction. Journalof Happiness Studies, 14, 275-292. http://dx.doi.org/10.1007/s10902-012-9331-9
  • Rius-Ottenheim, N., van der Mast, R. C., Zitman, F. G., & Giltay, E. J. (2013).The role of dispositional optimism in physical and mental well-Being.In A. Efklides& D. Moraitou (Eds.), A Positive Psychology Perspective on Quality of Life, (pp.149-173).Netherlands: Springer.
  • Rosenberg, M. (1965).Society and the adolescent self-image. Princeton, NJ, USA: Princeton University Press.
  • Ruini, C., Masoni, L., Ottolini, F., & Ferrari, S. (2014). Positive Narrative Group Psychotherapy: the use of traditional fairy tales to enhance psychological well-being and growth. Psychology of Well-Being, 4, 1-9. http://dx.doi.org/10.1186/s13612-013-0013-0
  • Ryff, C. & Keyes, C. (1995). “The structure of psychological well-being revisited”. Journal of Personality and Social Psychology, 69, 719-727. http://dx.doi.org/10.1037/0022-3514.69.4.719
  • Ryff, C. D. (1995). Psychological well-being in adult life.Current directions in Psychological Science, 4, 99-104.
  • Ryff, C. D. (2014). Psychological well-being revisited: Advances in the science and practice of eudaimonia. Psychotherapy and Psychosomatics, 83, 10-28. http://dx.doi.org/10.1159/000353263)
  • Sandin, B., Chorot, P., Lostao, L., Joiner, T.E., Santed, M.A. & Valiente, R.M. (1999).Escalas panas de afecto positivo y negativo: validación factorial y convergencia transcultural. Psicothema, 11, 37-51.
  • Sarason, I. G., Sarason, B. R., Shearin, E. N. & Pierce, G. R. (1987). A brief measure of social support: Practical and theoretical implications. Journal of Social and Personal Relationships, 4, 497-510. http://dx.doi.org/10.1177/0265407587044007
  • Scheier, M.F., Carver, C.S., & Bridges, M.W. (1994).Distinguishing optimism from neuroticism (and trait anxiety, self-mastery and self-steem): a reevaluation of Life Orientation Test. Journal of Personality and Social Psychology, 67, 1063-1078. http://dx.doi.org/10.1037/0022-3514.67.6.1063
  • Schimmack, U., & Diener, E. (2003).Predictive validity of explicit and implicit self-esteem for subjective well-being.Journal of Research in Personality, 37, 100-106. http://dx.doi.org/10.1016/S0092-6566(02)00532-9
  • Seligman, M. E. (2011). Learned optimism: How to change your mind and your life. New York: Vintage Books.
  • Seligman, M. E., Rashid, T., & Parks, A. C. (2006).Positive psychotherapy.AmericanPsychologist, 61, 774-788. http://dx.doi.org/10.1037/0003-066X.61.8.774
  • Seligman, M. E., Steen, T. A., Park, N., & Peterson, C. (2005). Positive psychology progress: empirical validation of interventions. American Psychologist, 60, 410-421. http://dx.doi.org/10.1037/0003-066X.60.5.410
  • Shanafelt, T. D., West, C., Zhao, X., Novotny, P., Kolars, J., Habermann, T., & Sloan, J. (2005).Relationship between increased personal well‐being and enhanced empathy among internal medicine residents.Journal of General Internal Medicine, 20, 559-564. http://dx.doi.org/10.1111/j.1525-1497.2005.0108.x
  • Shapira, L. B., & Mongrain, M. (2010).The benefits of self-compassion and optimism exercises for individuals vulnerable to depression.The Journal of Positive Psychology, 5, 377-389. http://dx.doi.org/10.1080/17439760.2010.516763
  • Sheldon, K. M., & Kasser, T. (1995). Coherence and congruence: two aspects of personality integration. Journal of personality and social psychology, 68, 531-543.http://dx.doi.org/10.1037/0022-3514.68.3.531
  • Sheldon, K. M., & Krieger, L. S. (2014).Walking the talk: Value importance, value enactment, and well-being. Motivation and Emotion, 38, 609-619.http://dx.doi.org/10.1007/s11031-014-9424-3
  • Sheldon, K. M., Jose, P. E., Kashdan, T. B., & Jarden, A. (2015). Personality, effective goal-striving, and enhanced well-being: comparing 10 candidate personality strengths. Personality and Social Psychology Bulletin, 41, 575-585. http://dx.doi.org/10.1177/0146167215573211
  • Sheldon, K. M., Kasser, T., Smith, K., & Share, T. (2002). Personal goals and psychological growth: Testing an intervention to enhance goal attainment and personality integration. Journal of Personality, 70, 5-31. http://dx.doi.org/10.1111/1467-6494.00176
  • 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, 65, 467-487. http://dx.doi.org/10.1002/jclp.20593
  • Steel, P., Schmidt, J., & Shultz, J. (2008).Refining the relationship between personality and subjective well-being.Psychological Bulletin, 134, 138-161. http://dx.doi.org/10.1037/0033-2909.134.1.138
  • Storm, C., & Storm, T. (1987).A taxonomic study of the vocabulary of emotions. Journal of Personality and Social Psychology, 53, 805-816. http://dx.doi.org/10.1037/0022-3514.53.4.805
  • Tetley, A., Jinks, M., Huband, N., & Howells, K. (2011). A systematic review of measures of therapeutic engagement in psychosocial and psychological treatment. Journal of Clinical Psychology, 67, 927-941. http://dx.doi.org/10.1002/jclp.20811
  • Tkach, C., & Lyubomirsky, S. (2006). How do people pursue happiness?: Relating personality, happiness-increasing strategies, and well-being. Journal of Happiness Studies, 7, 183-225. http://dx.doi.org/10.1007/s109002-005-4754-1
  • Toepfer, S. M., Cichy, K., & Peters, P. (2012). Letters of gratitude: Further evidence for author benefits. Journal of Happiness Studies, 13, 187-201. http://dx.doi.org/10.1007/s10902-011-9257-7
  • Toussaint, L., & Friedman, P. (2009). Forgiveness, gratitude, and well-being: The mediating role of affect and beliefs. Journal of Happiness Studies, 10, 635-654. http://dx.doi.org/10.1007/s10902-008-9111-8
  • Vázquez, C., Duque, A., &Hervás, G. (2013).Satisfaction with Life Scale (SWLS) in a representative sample of Spanish adults: Validation and normative data. Spanish Journal of Psychology, 16, 82-97. http://dx.doi.org/10.1017/sjp.2013.82
  • Watson, D., Clark, L.A., & Tellegen, A. (1998). Development and validation of brief meauses of Positive and Negative Affect: The PANAS Scales. Journal of Personality and Social Psychology, 54, 1063-1070. http://dx.doi.org/10.1037/0022-3514.54.6.1063
  • Wergeland, G. J. H., Fjermestad, K. W., Marin, C. E., Haugland, B. S. M., Bjaastad, J. F., Oeding, K., Bjelland, I., Silverman, W. K., Öst, L. G., Havik, O. E., & Heiervang, E. R. (2014). An effectiveness study of individual vs. group cognitive behavioral therapy for anxiety disorders in youth. Behaviour Research and Therapy, 57, 1-12. http://dx.doi.org/10.1016/j.brat.2014.03.007
  • White, M. A., & Waters, L. E. (2015). A case study of ‘The Good School’: Examples of the use of Peterson’s strengths-based approach with students. The Journal of Positive Psychology 10, 69-76. http://dx.doi.org/10.1080/17439760.2014.920408
  • Woody, S. R., & Adessky, R. S. (2003).Therapeutic alliance, group cohesion, and homework compliance during cognitive-behavioral group treatment of social phobia. Behavior Therapy, 33, 5-27.http://dx.doi.org/10.1016/S0005-7894(02)80003-X
  • Worthington Jr, E. L., Witvliet, C. V. O., Pietrini, P., & Miller, A. J. (2007). Forgiveness, health, and well-being: A review of evidence for emotional versus decisional forgiveness, dispositional forgivingness, and reduced unforgiveness. Journal of Behavioral Medicine, 30, 291-302. http://dx.doi.org/10.1007/s10865-007-9105-8
  • Worthington, E. L. (1998). Dimensions of forgiveness: A research approach. Philadelphia & London: Templeton Foundation Press.
  • Worthington, E. L., & Scherer, M. (2004). Forgiveness is an emotion-focused coping strategy that can reduce health risks and promote health resilience: Theory, review, and hypotheses. Psychology & Health, 19, 385-405. http://dx.doi.org/10.1080/0887044042000196674