Abstract

Researchers have increasingly called for the examination of both mental health symptoms and well-being when providing and evaluating psychotherapy, and although symptoms and well-being are typically inversely related, these appear to be distinct constructs that may require distinct intervention strategies. Positive psychology interventions, virtue-based treatments, and psychotherapies explicitly focused on promoting well-being have emerged in response to, or perhaps in concert with, the calls for attention to symptoms and well-being. Our review of the relevant and vast research pockets revealed that these treatments demonstrated relative efficacy in promoting well-being, whereas evidence for relative efficacy when reducing symptoms was largely inconclusive, particularly in psychotherapy contexts. We organized our review around the virtue-ethics notion that growth in virtuousness fosters flourishing, with flourishing consisting of more than the absence of symptoms, and specifically, that flourishing also involves increased well-being. The lack of evidence for relative efficacy among active alternative treatment conditions in promoting flourishing may suggest equal effectiveness, and yet, this also suggests that there are yet-to-be-identified moderators and mechanisms of change and/or insufficient use of research designs and/or statistical procedures that could more clearly test this major tenet of the virtue-ethics tradition. Nevertheless, we know that evidence-based problem-focused psychotherapies are effective at reducing symptoms, and our review showed that positive psychology interventions, virtue-based treatments, and psychotherapies explicitly focused on well-being promote well-being and/or virtue development. We encourage researchers and psychotherapists to continue to integrate symptom reduction and well-being promotion into psychotherapy approaches aimed at fostering client flourishing.

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Peter Jankowski, Ph.D.

Peter J. Jankowski, Ph.D. is a Visiting Researcher at the Danielsen Institute, Boston University; Associate Professor of Counseling, Bethel University, Mental Health Counselor, Bethel University Counseling and Health Services. He earned his doctorate in marriage and family therapy from Texas Tech University. He is a Licensed Marriage and Family Therapist, Clinical Fellow of the American Association for Marriage and Family Therapy (AAMFT), and AAMFT-Approved Supervisor.  He has published research in the areas of religiousness and adolescents’ and college students’ hazardous alcohol use, religion and interpersonal violence, positive psychology (forgivingness, gratitude, humility, hope, social justice, and intercultural competence), psychotherapy outcome research, differentiation-based spirituality, and clinical decision-making.