Most of the time CBT therapists are dealing with the difficulties and challenges of everyday life: depression, anxiety, loneliness, anger, shyness, fears and many, many other problems and issues that clients are struggling to overcome. Something is felt to be wrong, or missing, or misfiring – so the focus is on helping the client overcome their fears and assumptions about the world and how they can act on it. It feels like the beginning of a journey of repair.
Positive psychology, by contrast, usually has a focus on strengthening happiness and fulfilment – typically from a stable base where the client is already functioning well. So are not these two perspectives of CBT and Positive Psyhchology really different animals, dealing with different types of clients with diffferent issues? Isn’t CBT really about therapy, while Positive Psychology is really about coaching?
Not necessarily. Here are five ways positive psychology can be incorporated into mainstream Cognitive Behavioural Therapy. We promote these approaches all the time at Practical CBT and can require considerable reflection, skill and patience, but here are the headlines.
- Use resilience techniques to support client discharge and relapse prevention. When a client has gone through CBT for, say, anxiety or depression and they are ready to move on, it’s important that we help them to ‘become their own therapists’ as we say. But how do we do that? If you asked 100 therapists what qualities are needed to be a successful therapist in the longer term, I am sure ‘resilience’ would be high up the list. Helping clients develop core resilience skills by building on their existing strengths is easier than it sounds – but if you have a solid model, such as SB-CBT, it is more straightforward than you might think.
- Remember that the light at the end of tunnel should also shine on the darkness at the entrance. At the beginning of psychotherapy the focus is often on stablisation, rapport and psychoeducation. All three of these can be served by introducing the client to the prospect of developing strengths and positive qualities which will promote a happier life – and not just a repaired one – when the therapy itself has come to an end. Introduce this light from the beginning even if we are still some way from the exit.
- Boost activity scheduling with a strength-based focus. In many psychological conditions, especially for example depression, client inactivity can be a major symptom and maintenance factor. So strong is the immobilising effect of low mood that the client gets into a vicious circle of demoralisation and passivity. Activity scheduling, where a client is encouraged and supported to target a day and time to take action (even if it is just something as simple as walking the dog initially) can be a powerful way of breaking that maintainance cycle, However, by introducing a positive psychology dynamic into CBT activity scheduling we can help the client not only be active, but meaningfully active. So it becomes not simply walking the dog but going to the park where I used to be happy and will be happy again. This is a powerful but complex therapeutic skill which needs careful exploration with the client and a supportive briefing.
- Identify everyday client positive strengths as well as positive experiences. Often to get a more balanced overview of their everyday life we ask client to take a log of their everyday encounters. This way a more balanced picture of their life situation can be captured and crucially the role of negative automatic thoughts can be monitored and challenged. Introducing client vigiliance for everyday strengths can be an effective way of building on initial logs such as the traditional Padesky 7-column thought diaries.
- Put wisdom on the agenda. For a modality that begins and ends with a comprehensive focus on thoughts, beliefs, learning and self-knowledge, CBT has been extraordinarlity silent on the role of wisdom in psychological recovery. In this sense ‘wisdom’ is not the solemn musings of a grey-haired sage, but rather the practical application of learning under uncertainty which everyone is able to develop and apply.
These are just some of the ways introducing positive psychology perspectives into mainstream CBT practice can be therapeutically powerful. In the end therapy can be not just a journey of repair, but also of renewal.
As powerful as the combination of positive psychology and CBT can be, it is not always straightforward. Few training programmes incorporate these ideas and techniques even though they are known to be effective if used carefully in collaboration with the client. That is one of the reasons we have launched a series of workshops at Practical CBT looking at Positive Psychology from a clinical perspective. Find out more by joining our next webinar: Click Here
Professor Patrick McGhee, FRSA, BABCP, C Psychol.
Practical Therapy 