Today is Thanksgiving here in the US, and it’s the first of many holidays in the coming weeks. For some clients, the press of this time of year can make it difficult to stick to regular sessions.
So how might you extend the benefits of therapy in-between sessions?
According to research, one effective practice is gratitude.
In a 2015 study in the Journal of Psychotherapy Research, researchers wanted to see how gratitude might enhance psychotherapeutic treatment.
So Joel Wong, PhD and his team gathered 293 participants and randomly assigned them to one of three groups:
- The control group received psychotherapy as usual.
- One test group received psychotherapy plus expressive writing (wherein they wrote about their thoughts and feelings related to the most stressful events in their lives).
- The other test group received psychotherapy plus gratitude writing (in which they wrote a letter to someone they wanted to thank – they focused on what the person did for them, the impact it had on them, and their feelings about the experience).
Using the General Mental Health (GMH) Index of the Behavioral Health Measure-20 (a clinical outcome measure of three groupings: wellbeing, psychological symptoms, and life functioning), researchers measured participants four separate times: before intake, at both 3 and 4 weeks after intake, and then one final time at 12 weeks after their last writing assignment.
Here’s what they found. . .
Three weeks after intake, participants in each group scored similarly. But after 4 weeks and again after 12 weeks, participants in the gratitude group demonstrated increased mental health compared to both the expressive writing group and the control group.
On top of that, the mental health benefits of gratitude writing appeared to increase over time.
This matters because previously, the benefits of a gratitude practice had not been shown to increase over time. The researchers hypothesize that the added benefits of adjunctive psychotherapy and gratitude writing are responsible for the extended benefits.
Now of course, more research is needed. But for now, I’d like to hear from you. How have you integrated gratitude into your clinical practice?
And if you celebrate the holiday, happy Thanksgiving.
A little while back you mentioned in one of your circulars about the triggering marrass (indifference of people in our society) around survivors of child abuse, and how that is now becoming a recognised phenomenon. This is an oppressive aspect of their environment that speaks to the social assumptions about family being a good thing, for example. Yet, Christmas being a remarkably high season for suicide could possibly be an aspect of family not being a good thing. It’s triggering, as are the people (often family members or close friends) who do not know how to respond to child abuse survivors upon their first disclosure. Social estrangement hurts.
I should be much obliged if you could please direct me to any academic studies of this phenomenon, as it has taken a hell of a long time for this matter to be given the gravity and seriousness that it deserves in academia.
I would be very grateful for any comments.
Fantastic reminder, thank you. Individuals in 12-step recovery programs (a lifelong activity) start each morning off by looking at the “Gratitude List” that they write into and carry around. Looking at the “Benefits of Smoke-Free” lists similarly help ex-smokers.
I appreciate the added information about improvement over time, thank you.
Those in the recovery groups mostly notice that when they slacken and start skipping the gratitude their well-being takes a downturn.
i suggest gratitude to most of my clients. i do it myself at the end of the day as i prepare for sleep. it’s a really helpful practice to balance out hurt, fear, anger, etc.
I also offer a gratitude practice to my clients, where at least one of these is gratitude for themself… also writing these down is the most therapeutic… perhaps paying attention to what is felt in the body and where with each gratitude that is written on the paper…
My homework to clients on a regular basis is to write, not just think or feel, but write what you are grateful for. Start with one thought in the morning and one at night. They are not limited to on two thoughts a day.
I do a similar practice. As a school Social worker in a middle school, I have the opportunity to gather a class of students and their teacher once every two to three weeks to conduct a circle following a restorative practice model. It’s not therapy but more a group sharing model that follows normative guidelines of speaking and listening from the heart. At the end of each circle we do a round where everyone thinks of someone in the circle who shared a comment they can appreciate or who did something in the recent or distant past which they appreciate or feel grateful. As a group we then collectively slap our thighs, clap our hands, snap our fingers, then point to the person whom we appreciate. We then go around the circle and tell that person, speaking their name and in the second person (using the word “you”) what they did and how it made us feel. The power of this is palpable and evident in everyone’s face. Teachers say it’s the best thing they’ve done to help all of us recover our humanity after the forced isolation of the pandemic.
I think there’s a risk of imposing a moral conditionality of worth when gratitude is demanded or prescribed. I’d want to be very careful to avoid that.
Absolutely, graditude is an important process of integrating your total experiences, both breezy ones and brutal ones, in my opinion. I have gone through many traumas in my own life and have realized that there is beauty in the pain after you can navigate through to the other side. So much is learned and an attitude of graditude for what occurred is important in moving on. A question to ask yourself after a devastating experience would be “And now what does this make possible?” It is a reframe of the negative experience and a way of looking at it such that good can come out of it. For example, in a group I belong to the couple had just purchased their dream home on a lake with lovely trees all throughout the back facing the lake. A terrible storm came through one harrowing evening uprooting the entire lot of trees with damages totaling over $30,000. They were so distraught and the cleanup went on for months. After grieving for some time, the question ‘What will this make possible?’ was reframed and they saw the positives that came out of the destruction. They now had a clear view of the beautiful lake and night sky. The gentleman is an artist that works from home and now had a wonderful view from his new studio to paint etc. And each passing week a new perspective was made apparent.