Changing the focus of psychotherapy to what is good in your life

For one hundred years psychotherapy has been where you go to talk about your troubles. Looking over hundreds of controlled outcome studies, it is a moderately effective process. But does the troubles part matter?

We have recently been looking at a process—called Positive Psychotherapy—in which talking about what is good in your life is the central focus: strengths, virtues, flow, meaning, positive emotion, gratitude, hope and the like. We do not neglect troubles (depressed patients are socialized into the belief that troubles must be discussed and rapport would be undermined otherwise), but they are not the central focus and often form a segue into talking about strengths and meaning. Similarly trouble-focused psychotherapy does not wholly neglect the positive side of life, but damage and its repair are the central focus. Trouble-focused therapy, unlike strength-focus therapy, is not much fun (worse, sometimes patients unravel and cannot be ravelled up again), is stigmatizing, and has a considerable drop-out rate.

So let us finally test experimentally if it is troubles and repairing damage or building strength, meaning, and positive emotion that is the (more) active ingredient in psychotherapy: 200 depressed patients, randomly assigned to therapists, trained to deliver either trouble-focused or strength-focused psychotherapy. It could even be within subjects in an ABAB design. And how would these compare to medication or medication plus strength or trouble-focus?

About the author

Dr Martin Seligman is Leadership Professor of Psychology at the University of Pennsylvania. He has written over twenty books and two hundred articles on motivation and personality.