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Strength-based assessment can enhance clinical clarity, improve the range of information, and provide a more complete picture of clients and their circumstances. Deficit-oriented assessment has improved the assessment and treatment of a number of disorders but, at the same time, has created a negative bias, considered strengths as clinical peripheries or by-products, tended to reduce clients to diagnostic categories, and created a power differential, which could be counterproductive to clinical efficacy. Strength-based assessment explores weaknesses as well as strengths to effectively deal with problems. We present a number of strength-based strategies for use in clinical practice. These strategies, we hope, will help clinicians to operationalize how strengths and weaknesses reverberate and contribute to a client's psychological status, which is comprehensive and guards against negative bias.

Positive psychotherapy (PPT) is an established psychological intervention initially validated with people experiencing symptoms of depression. PPT is a positive psychology intervention, an academic discipline which has developed somewhat separately from psychotherapy and focuses on amplifying wellbeing rather than ameliorating deficit. The processes targeted in PPT (e.g. strengths, forgiveness, gratitude, savouring) are not emphasised in traditional psychotherapy approaches to psychosis. The goal in modifying PPT is to develop a new clinical approach to helping people experiencing psychosis. An evidence-based theoretical framework was therefore used to modify 14-session standard PPT into a manualised intervention, called WELLFOCUS PPT, which aims to improve wellbeing for people with psychosis. Informed by a systematic review and qualitative research, modification was undertaken in four stages: qualitative study, expert consultation, manualisation and stake-holder review. The resulting WELLFOCUS PPT is a theory-based 11-session manualised group therapy.

The promotion of well-being is an important goal of recovery oriented mental health services. No structured, evidence-based intervention exists that aims to increase the well-being in people with severe mental illness such as psychosis. Positive psychotherapy (PPT) is a promising intervention for this goal. Standard PPT was adapted for use with people with psychosis in the UK following the Medical Research Council framework for developing and testing complex interventions, resulting in the WELLFOCUS Model describing the intended impact of WELLFOCUS PPT. This study aims to test the WELLFOCUS Model, by piloting the intervention, trial processes, and evaluation strategy. This study is a non-blinded pragmatic pilot RCT comparing WELLFOCUS PPT provided as an 11-session group therapy in addition to treatment as usual to treatment as usual alone. Inclusion criteria are adults (aged 18–65 years) with a main diagnosis of psychosis who use mental health services. A target sample of 80 service users with psychosis are recruited from mental health services across the South London and Maudsley NHS Foundation Trust. Participants are randomised in blocks to the intervention and control group. WELLFOCUS PPT is provided to groups by specifically trained and supervised local therapists and members of the research team. Assessments are conducted before randomisation and after the group intervention. The primary outcome measure is well-being assessed by the Warwick-Edinburgh Mental Well-being Scale. Secondary outcomes include good feelings, symptom relief, connectedness, hope, self-worth, empowerment, and meaning. Process evaluation using data collected during the group intervention, post-intervention individual interviews and focus groups with participants, and interviews with trial therapists will complement quantitative outcome data. This study will provide data on the feasibility of the intervention and identify necessary adaptations. It will allow optimisation of trial processes and inform the evaluation strategy, including sample size calculation, for a future definitive RCT. Current Controlled Trials ISRCTN04199273 – WELLFOCUS study: an intervention to improve well-being in people with psychosis, Date registered: 27 March 2013, first participant randomised on 26 April 2013.

Background The field of positive psychology has grown exponentially within the last decade. To date, however, there have been few empirical initiatives to clarify the constructs within positive psychology as they relate to rehabilitation medicine. Character strengths, and in particular resilience, following neurological trauma are clinically observable within rehabilitation settings, and greater knowledge of the way in which these factors relate to treatment variables may allow for enhanced treatment conceptualization and planning. Objective The goal of this study was to explore the relationships between positive psychology constructs (character strengths, resilience, and positive mood) and rehabilitation-related variables (perceptions of functional ability post-injury and beliefs about treatment) within a baseline data set, a six-month follow-up data set, and longitudinally across time points. Methods Pearson correlations and supplementary multiple regression analyses were conducted within and across these time points from a starting sample of thirty-nine individuals with acquired brain injury (ABI) in an outpatient rehabilitation program. Results Positive psychology constructs were related to rehabilitation-related variables within the baseline data set, within the follow-up data set, and longitudinally between baseline positive psychology variables and follow-up rehabilitation-related data. Conclusions These preliminary findings support relationships between character strengths, resilience, and positive mood states with perceptions of functional ability and expectations of treatment, respectively, which are primary factors in treatment success and quality of life outcomes in rehabilitation medicine settings. The results suggest the need for more research in this area, with an ultimate goal of incorporating positive psychology constructs into rehabilitation conceptualization and treatment planning.

Resilience includes attributes such as bouncing back, adapting and making sense of trauma or setbacks, and also decreasing vulnerability to environmental risks. To understand and enhance resilience, research has largely focused on risk and protective factors. Among these protective factors, one missing element is character strengths. This chapter presents an overview of resilience research and introduces a holistic model of resilience called Strength-based Resilience (SBR) which integrates risks and resources, namely, character strengths to buffer against vulnerabilities. We also present results of two pilot studies conducted with diverse samples of children and adults, demonstrating promising results. We conclude the chapter by discussing implications of incorporating a focus on character strengths in fostering resilience.

Positive psychology urges psychologists to ask a deeper and loftier question, what is right with children and adolescents, in addition to exploring their weaknesses. This chapter discusses a strength-based assessment approach in detail, arguing that that such an approach yields useful information above and beyond the information produced by traditional measures of psychopathology. Some salient measures of strengths are listed, and in particular the VIA Youth Survey, which is used to determine an individual’s signature strengths, is discussed in detail. Previous findings have suggested that the frequent use of signature strengths is associated with greater well-being. This assertion has not been tested widely with children and adolescents. The chapter presents results of three intervention studies including one that has demonstrated that a multi-informant approach (i.e., strengths identified by teacher, parent, and a peer) of assessing signature strengths that boosts well-being and social skills. The chapter concludes with practical strategies for professionals to incorporate various ways to assess and develop strengths of children and adolescents.

Well-being has become a prominent term in the political arena in recent years. However, in research the concept and use of well-being has been unclear, especially in the context of severe mental illness such as psychosis. This systematic review aims to characterise the evidence base relating to well-being in people with psychosis, by reviewing how well-being is measured, developing a new conceptual framework, and summarising empirical evaluations of psychosocial interventions to improve well-being. We conducted a systematic review and narrative synthesis of controlled trials of interventions investigating well-being in people with psychosis. The 28 studies meeting the inclusion criteria used 20 different measures of well-being. Five dimensions of well-being emerged: non-observable, observable, proximal, distal, and self-defined. Interventions to improve well-being vary widely. The investigated interventions have been targeted at non-observable, observable and proximal levels, while evaluation measures span all five dimensions. This review offers an evidence based conceptual framework of well-being which can provide an empirical basis for organising future well-being research in psychosis. The review also shows that the evidence base for interventions is small and methodologically weak. Recommendations are made for choosing well-being measures for future research.

Positive psychotherapy (PPT) contrasts with standard interventions for depression by increasing positive emotion, engagement, and meaning rather than directly targeting depressive symptoms. The authors have tested the effects of these interventions in a variety of settings. In informal student and clinical settings, people not uncommonly reported them to be "life-changing." Delivered on the Web, positive psychology exercises relieved depressive symptoms for at least 6 months compared with placebo interventions, the effects of which lasted less than a week. In severe depression, the effects of these Web exercises were particularly striking. This address reports two preliminary studies: In the first, PPT delivered to groups significantly decreased levels of mild-to-moderate depression through 1-year follow-up. In the second, PPT delivered to individuals produced higher remission rates than did treatment as usual and treatment as usual plus medication among outpatients with major depressive disorder. Together, these studies suggest that treatments for depression may usefully be supplemented by exercises that explicitly increase positive emotion, engagement, and meaning. ((c) 2006 APA, all rights reserved).

Male and female university students from the United States, Canada, Germany, the Netherlands, Ecuador, Pakistan, the Philippines, Taiwan, and Turkey read a standardized scenario in which a male professor was accused of sexually harassing a female graduate student. Respondents from individualist countries judged the professor to be guilty of sexual harassment more often than did those from collectivist countries. Women rendered significantly more guilty judgments and assigned more severe punishments to the accused professor than did men. Implications for the individualist–collectivist classification system and cross-cultural research are discussed.

High-point coding refers to the popular practice of classifying Minnesota Multiphasic Personality Inventory (Hathaway & McKinley, 1983) profiles based on which clinical scales are the most elevated. A previous review of high-point code studies (McGrath & Ingersoll, 1999a) noted marked discrepancies across studies in the rules used to define high-point codes. This study was conducted to evaluate the costs and benefits of different strategies for high-point coding. The impact of 4 rules for high-point coding on effect sizes and group sizes was evaluated. The 4 rules included requiring a minimum elevation, excluding potentially invalid protocols, restricting coding to well-defined codes, and replacing the lower scale in infrequently occurring codes with the next most elevated scale. The evidence supported the clinical utility of requiring a minimum elevation for code scales. The results were more equivocal concerning the value of well-defined coding and for not replacing the lower scale in infrequent codes. Results were surprisingly negative concerning the utility of excluding potentially invalid protocols, suggesting that guidelines developed in situations in which there is a clear motivation to distort results may not generalize to other settings.