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The effectiveness of positive psychotherapy on

happiness and gratitude of female students

Sahar Amini, Kourosh Namdari, Hossinali Mehrabi Kooshki

Department of Psychology, Faculty of Educational Science and Psychology, University of Isfahan, Isfahan, Iran

Introducion

It is for more than one century that the patients have referred to psychotherapists for their own issues, problems, defects, and deficiencies believing that discussing and investigating these issues can be healing. Psychotherapy has taken great steps with emphasis on deficits and deficiencies. Careful and meticulous studies have indicated that psychotherapy can be certainly more effective than other placeboes.[1] In spite of the fact that the main flow

of psychotherapy with emphasis on psychopathology

has greatly helped treating the clinical symptoms and disorders, but it has significantly neglected the happiness as one of the treatment aims despite the demand of patients for being happy.[2] Historically, psychology mainly

emphasizes psychopathology and deficits of mental health, and therefore, it has caused that the positive traits of human beings which make their lives more valuable be greatly overlooked.[3] Psychotherapists usually attend

weaknesses, social and psychological problems, and ABSTRACT

Aim: The aim of the present study is to determine the effectiveness of positive psychotherapy on

the happiness and gratitude among female students of the University of Isfahan in the academic year

2013–2014. Methodology: The design of the present study is quasi‑experimental with the control

group and pretest‑posttest and follow‑up test. For sampling among 100 female girls who registered for this study, a number of 30 individuals who were lacking in any symptom of severe psychological disorders or character disorders in the irst and second axes of diagnostic and statistical manual of mental disorders‑IV‑Text review were selected. Then, this number were randomly divided into two control and experimental group each with 15 participants. The instruments used for collecting data included the positive psychotherapy questionnaire and the gratitude questionnaire‑six item form. In the experimental group, positive psychotherapy sessions were held in group in 10 sessions. However, the control group received no intervention. To analyze the data of the present study, ANCOVA and SPSS‑17 software were used. Results: The results indicated that the positive psychotherapy is effective on the increase of overall happiness and the components of pleasant, engaged, and meaningful life in the stages of posttest and follow‑up (P < 0.05), although this effectiveness is conirmed on the component of meaningful life in the posttest. In addition, in the domain of gratitude, the members of the experimental group indicated a signiicant increase in their scores in the stages of posttest and follow‑up as compared to the control group (P < 0.05). Conclusion: From the indings obtained from this study, it can be concluded that, in general, positive psychotherapy is effective on the increase of overall happiness and its components and gratitude of female students in the University of Isfahan. Therefore, the positive psychotherapy is an appropriate alternative for increasing happiness and gratitude of students.

Key words: Gratitude, happiness, positive psychotherapy

Address for Correspondence:

Dr. Kourosh Namdari, Department of Psychology, Faculty of Educational Science and Psychology, University of Isfahan, Isfahan, Iran. E‑mail: k.namdari@edu.ui.ac

Original Article

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DOI:

10.4103/2395-2296.179069

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environmental problems of patients and consequently, mostly overlook their environmental resources. One of the reasons for neglecting patients’ abilities and environmental resources is the exclusive reference of therapists to diagnostic and statistical manual of mental disorders (DSM)[4] because this type of evaluation system

lacks a comprehensive design and regarding its medical root, it has not paid attention to the status and culture of individual;[5] therefore, the specialists are motivated

to exclusively emphasize the psychopathological aspects. However, the therapists are required to have more comprehensive and profound understanding of their own patients. Accordingly, it is necessary that in addition to paying attention to the problems and deficits of patients, pay attention to their personal and environmental capabilities and traits and apply these positive resources in line with increasing their happiness and mental health. Therefore, according to Magyar‑Moe,[4] among

the reasons of using positive psychology, one can refer to comprehensive conceptualization of the status of patients, definition of the successful treatment results and the process of psychological evaluation. Therefore, the positive psychology is a branch of psychology which believes that it is necessary that something more than describing the improvement and health in the sense of reduction in anxiety and distress is conducted and it be identified that what an individual can do to obtain his psychological health and live hopefully and happily. Consequently, a movement for the positive conceptualization of mental health is conducted.[1] Another factor which is considered

important in the realm of positive psychology is gratitude. Gratitude refers to the sense of appreciation and happiness in response to receiving a gift from another person or happiness and satisfaction of the moment which are received from the beauty of nature. This positive trait is one of the character strengths of human beings.[5] The

experience of gratitude is one of the powerful ways of increasing the satisfaction with life and positive feelings in relation to past and present.[4] Different researches

indicate that the increase in gratitude is along with the increase in the traits such as hope, optimism, resilience,[6]

physical and psychological well‑being,[7] and depression

symptom relief.[8]

Among positive therapies, positive psychotherapy is a positive approach to psychotherapy which is experientially validated and specifically pays attention to positive strengths and emotions in patients, and the increase of meaning in their lives so that it can facilitate psychotherapy and educate happiness.[9] The theoretical confirmation of

positive psychotherapy originates from the works done by Seligman.[10] In a study conducted by Seligman etal.[11]

on 46 individuals in the University of Pennsylvania, who searched for counseling services and psychotherapy, the results indicated that personal positive psychotherapy by itself or with pharmacotherapy, can result in the depression symptom relief or complete removal of the symptoms in these patients and cause the increase in positive emotions, engagement, and meaning. In the same study, Seligman et al.,[11] conducted group positive psychotherapy on

the students with minor to moderate depression in the University of Pennsylvania. The results indicated that the depression symptoms in the experimental group decreased significantly, while in the control group, the severity of the symptoms remained in their initial levels (minor or moderate levels). The sense of satisfaction of life increased in both groups, but in the follow‑up in 1‑year later, the experimental group kept these results contrary to the control group. Rashid and Anjum,[12] reported the

increase in the health of secondary school children by applying the shorter type of positive group psychotherapy in them. In addition, Rashid et al.[13] investigated the effect

of personal positive psychotherapy on the increase of the positive emotions, the creation of abilities and strengths and meaning in children and adolescents by which they can increase happiness in them. The results of the research conducted by Recio[14] indicated this type of psychotherapy

is effective on the depression symptom relief in adolescence. In addition, Savage,[15] by applying some of the variables

of positive psychotherapy such as using character strengths and optimistic thinking indicated that this intervention can be effective on increasing the satisfaction with life in adolescents. In another study, Seligman etal.[8] conducted

on 577 participants, it was indicated that training the positive psychotherapy for 1‑month increases happiness and the depression symptom relief. Nikoozadeh,[16] conducted

the positive psychotherapy in compared with Adlerian therapy, on voluntary addicts in the addiction treatment centers in Tehran and studied its effects on the degree of the resilience of these individuals. He concluded that the positive psychotherapy, as Adlerian therapy, can be effective in enhancing the resilience of addicts. Vejdani etal.,[17] by applying the positive psychotherapy based on

the happiness approach of Seligman, indicated that this type of psychotherapy can be effective on reducing the depression and increasing the level of depressed women’s marital satisfaction in Tehran. In recent studies[18] done on

positive psychotherapy indicate that this intervention for increasing well‑being, positive emotions, hope, self‑worth, meaning, and symptom relief in some more severe disorders such as psychosis was used.

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scientific and economic future as well as the advancement of that country in different personal and social domains, and an important part of the scientific, social and economic welfare, and fate of the country depends on their capabilities and virtues; therefore, their well‑being, as well as physical and psychological health, should be considered in a particular way and they should be assisted to increase their sense of happiness, engagement and meaning in life, and gratitude to facilities and bounties which God bestowed them and enhanced their motivation for activities in diverse scientific and social domains of the country. Accordingly, enhancing Iranian students’ mental health and making them stronger are among the most important necessities of the present study. Therefore, the present study aimed at determining the effectiveness of positive psychotherapy on the degree of happiness and gratitude among female students of the University of Isfahan.

Methodology

The present study used a quasi‑experimental design in the form of pretest‑posttest and follow‑up with control and experimental groups. The population of the present study included female students of the University of Isfahan in the academic year 2013–2014. The procedure of the present study was that first, by installing calls in different faculties of the university, the volunteers were invited to register and participate in this research project. Then, among 100 female students having registered in this project, a number of 30 students who lacked any diagnostic symptoms of severe psychological disorder or character disorder in the first and second axes of DSM‑IV‑Text Review were selected according to structured clinical interviews conducted by the clinical psychologist working in the Counseling Center of the University of Isfahan. Furthermore, the study had other inclusion criteria such as the lack of serious physical problems, and preferably residing in the city of Isfahan for the participants. In the next stage, these participants were randomly selected into two control and experimental groups (n1 = n2 = 15). After that, the pretest was administered on all participants. Then, the intervention for the experimental group was conducted for 10 sessions (each session took 90 min), weekly in the counseling center for the students of the university and by a Master of Science in Clinical Psychology, who had been trained and also the executive of this course in centers for counseling and psychological services. In all treatment sessions, at the end of them, the therapist received feedbacks from the participants and presented them their homework related to each session. The general content of these sessions was developed based on Rashid’s ideas.[9] The process and themes trained in

this courses in 10 sessions are presented in Table 1.

In the time interval when positive psychotherapy was conducted on the experimental group, the control group did receive no intervention. One week after, the last session of positive psychotherapy conducted on the experimental group, posttest was administered on both groups. The follow‑up stage was conducted 2 months after the end of conducting the intervention. In addition, for preventing the violation of ethics in the research, researcher kept confidential the questionnaires completed by the participants using the coding method. After the end of the research, the positive psychotherapy courses were held for the control group for some sessions.

Instruments for collecting data

• Positive psychotherapy inventory: According to Rashid,[9] the positive psychotherapy inventory was

designed to measure the happiness and the three routes to happiness, including pleasant, engaged, and meaningful life. This measure includes 21 items and three subscales of pleasant, engaged, and meaningful life which each subscale has seven items. The method of scoring the options of the inventory was based on a four‑point Likert scale. In each of the subscales, participants’ scores are located in the range from 0 to 21 and the total score, in the total scale, ranges from 0 to 63, with higher scores indicating the higher levels of overall happiness.[9] The positive psychotherapy

inventory has been shown to have good internal consistency reliability, with an overall alpha of 0.90 and subscale alphas of 0.78–0.80. Convergent validity has been found between the positive psychotherapy inventory and the measures of well‑being such as the satisfaction with life scale (r = 0.23), the Fordyce emotion questionnaire (r = 0.56), and the positive affectivity scale from the positive and negative affect schedule (r = 0.23). Discriminant validity has been

Table 1: Processes and themes trained in positive psychotherapy sessions

Sessions Educational processes and themes

1 Pretest, positive introduction, and familiarity, training the three paths for attaining happiness

2 Introducing positive psychotherapy, introducing the concept of character strengths, identifying character strengths

3 Training the value of positive emotions, operationalizing character strengths

4 Forgiveness 5 Gratitude 6 Optimism

7 Finding meaning in life by making positive relations 8 Finding meaning by paying attention to character

strengths of oneself and others

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established between the positive psychotherapy inventory and the measures of depression, including the Beck depression inventory (r = 0.62) and the Zung depression rating scale (r = −0.57). Since this questionnaire is sensitive to change, it can be used for measuring the results of the treatment.[9]

In the present study, exterior and content validity of the questionnaire were confirmed. In addition, the internal consistency reliability of the positive psychotherapy inventory was investigated by Cronbach’s alpha in such a way that the alpha coefficients for the subscale of pleasant life were 0.85, engaged life was 0.77, and meaningful life was 0.72. For the total scale, the alpha coefficient was 0.87.

• Gratitude questionnaire‑six item (GQ‑6) form: This questionnaire was designed by McCulloug et al.,[19]

and include six items which evaluate the gratitude. The scoring method of this questionnaire ranges from 1 (totally disagree) to 7 (totally agree) and the total scores of this scale ranges from 6 to 42, the higher score reflects higher level of gratitude.[6] The reliability of the

GQ is satisfactory and is equal to alpha coefficients of 0.75 and 0.83. The internal consistency reliability of the Persian version of the questionnaire has been established in student and nonstudent cases, with an alpha of 0.81 and its validity has been obtained from its correlation with some measures such as the spirituality scale and the satisfaction with life scale as 0.43 and 0.44, respectively.[20]

To investigate the effect of positive psychotherapy in the experimental group, ANCOVA was used. Statistical analyses were conducted employing SPSS‑17 (SPSS Inc. Released 2008. SPSS Statistics for Windows, Chicago).

Findings

The mean age of the experimental group was 23.41‑year‑old, and that of the control group was 22.50‑year‑old. In addition, in terms of their educational statuses, both in the control group and experimental group, 66% of the participants studied in BA/BSc, and 34% of them studied in MA/BSc. The socioeconomic statuses of members of

the experimental and control groups were evaluated by researchers in the form of a five‑point scale ranging from very weak to very good so that both in the experimental and control groups, 83% participants reported their socioeconomic statuses at the moderate level and 7% of them reported it at the good level.

After conducting positive psychotherapy, for example, values of the mean scores in the experimental and control groups in the level of happiness in the posttest stage were 44.25 and 38, and in the follow‑up stage they were 44.4 and 35.5 (P < 0.05) [Table 2].

The results of ANCOVA with the deletion of the effect of the pretest indicated that the difference between the mean scores of the two groups in happiness and its components in the posttest and follow‑up test is significant (P < 0.05) [Table 3].

To identify the effect of positive psychotherapy on the degree of happiness and its components, ANCOVA was used. The degrees of the effect of positive psychotherapy on overall happiness in the posttest and follow‑up were 37% and 34%, on pleasant life were 30% and 40%, on engaged life were 26% and 29%, and on meaningful life were 24% and 13% (P < 0.05). Therefore, the positive psychotherapy has been effective on the degree and level of happiness and its components in the posttest and follow‑up stages.

The results of ANCOVA with the deletion of the effect of the pretest indicated that the difference between the mean scores of the two groups in happiness and its components in the posttest and follow‑up test are significant (P < 0.05) [Table 4].

To identify the effect of positive psychotherapy on the degree of gratitude, ANCOVA was used. The degrees of the effect of positive psychotherapy on gratitude in the posttest and follow‑up were 31% and 18% (P < 0.05). Therefore, the positive psychotherapy has been effective on the degree and level of gratitude in the posttest and follow‑up stages.

Table 2: Comparing scores of happiness and its components as well as those of gratitude in investigated groups in diferent evaluation stages

Variable groups Experimental group Control group

Pretest Posttest Follow-up Pretest Posttest Follow-up

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Discussion

The results of the present study indicated that group positive psychotherapy results in increasing the total happiness, in general, and increasing some of its components, including pleasant and engaged in posttest and follow‑up stages. While this effectiveness was observed on meaningful life, only in the posttest stage; in follow‑up stage, no effect was found on this component. The findings obtained from the mentioned components are consistent with the general results of researches done by Seligman etal.,[8,11] Recio,[14] Vejdani etal.,[17] and Schrank etal.;[18]

which in explaining this consistency, one can refer to the existence of similarity in the treatment contents, enhancing individuals’ understanding regarding their character strengths and training them for creating a perfect and happy life. In explaining the significance of the effectiveness of positive psychotherapy on the increase of pleasant life, one can refer to the results of researches done by Savage,[15] and Lyubomirsky, et al.[21] Therefore,

this intervention with training life skills in the present time, participating in pleasant activities and exploring and applying virtues and character strengths such as forgiveness, humanity, justice, praising beauty, morality, and etc. In everyday life, help the people to increase their

positive emotions in the present, past, and future time, and experience having a pleasant life.

In addition, in explaining the significance of the effectiveness of this educational and treatment pattern on the increase of engaged life, consistent with the theories of Seligman[10]

and Rashid,[9] one can refer to this issue that the positive

psychotherapy capable individual to be drown in activities when doing them and increase their own flow experiences by identifying and using consistently individuals’ character strengths. Furthermore, and in this line, the results of the study of Rashid et al.[13] in explaining the effectiveness of

positive psychotherapy on meaningful life, can be presented that training happiness via growing the best and most appropriate character strengths and helping individuals to use these strengths for belonging to or providing services for something other than oneself, increases meaning in individuals’ life and make them authorities who exert their efforts to realize personal aims, and try for better and superior objectives such as servicing to the society and other people.[4]

On the other hand, the lack of the effectiveness of positive psychotherapy on meaningful life in the follow‑up stage is not consistent with the mentioned studies. In explaining this inconsistency, one can refer to the shorter period of this intervention in the present study and assigning fewer sessions to the issue of meaningful life than in other studies.

The results of the present study indicated that group positive psychotherapy results in increasing gratitude and appreciation in students in posttest and follow‑up stages. These findings are consistent with the general results of the study of Rashid[9] in terms of the similarity in the

application of positive psychotherapy and its components such as forgiveness, optimisms, hope., for increasing

Table 3: The results of ANCOVA related to the efect of positive psychotherapy on happiness and its components in diferent evaluation stages

Variable Evaluation stage Sources of variations Mean square F Eta squared Statistical power

Overall happiness Posttest Pretest 1127.48 47.09** 0.69 1

Group 298.14 12.45** 0.37 0.92

Follow-up Pretest 277.67 5.98* 0.22 0.64

Group 517.42 11.15** 0.34 0.88

Pleasant life Posttest Pretest 128.35 22.03** 0.51 0.99

Group 52.45 9** 0.30 0.81

Follow-up Pretest 43.66 6.7* 0.24 0.69

Group 93.21 14.31** 0.40 0.95

Engaged life Posttest Pretest 184.83 54.09** 0.72 1

Group 25.53 7.47* 0.26 0.74

Follow-up Pretest 27.69 4.15* 0.16 0.49

Group 57.24 8.59** 0.29 0.79

Meaningful life Posttest Pretest 192.14 76.81** 0.78 1

Group 17.06 6.82* 0.24 0.7

Follow-up Pretest 50.41 7.24** 0.25 0.72

Group 23.57 3.38 0.13 0.42

*P<0.05, **P<0.01, df=1. ANCOVA: Analysis of covariance

Table 4: The results of ANCOVA relate to the efect of positive psychotherapy on gratitude in diferent evaluation stages

Evaluation stage

Sources of variations

Mean square F

Eta squared

Statistical power

Posttest Pretest 138.6 53.10** 0.71 1 Group 24.49 9.42** 0.31 0.83 Follow-up Pretest 29.12 3.86* 0.15 0.46 Group 35.13 4.66* 0.18 0.54

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the level of character strengths including gratitude. In addition, the results of the present study is consistent with the general results of the study done by Namdari[1] in terms

of similarity in using some of the components available in positive psychotherapy such as interventions based on hope for increasing the level of character strengths and gratitude as one of the most important strengths or in other words, the mother of other character strengths.[5]

According to the findings of the present study, the positive psychotherapy is consistent with some other interventions conducted in different studies using different methods and trainings, can reinforce the sense of gratitude as one of the most important character strengths,[5] and one

of the ways of increasing positive emotions in relation with the past and present time[4] in individuals and

increase their satisfaction with life. For example, one of the methods of positive psychotherapy for increasing gratitude, consistent with the results of the study of Emmons and McCullough,[7] is to prepare the gratitude list daily or

weekly. In addition, positive psychotherapy, according to the results of Seligman etal.,[8] causes the increase in the

level of gratitude and consequently, the increase in positive emotions by training how to write the gratitude letters in such a way that participants think about the individuals who have significant effects on their lives but to whom they have never formally expressed their gratitude toward or properly thanked. As a result, they can learn the skill of appreciation and gratitude better. Therefore, the results of positive psychotherapy, as the results of the research done by Park and Peterson[22] shows, indicate that to train

character strengths such as gratitude, individuals should be encouraged, and motivated to regularly use these strengths in their daily lives. Consistent with the idea of Namdari et al.,[1] as individuals obtain more qualification by more

trainings in their strengths, they may be more interested in growing these strengths and be more confident in using these positive skills and resources for pursuing complete mental health. Therefore, positive psychotherapy can enhance these strengths in different groups of participants by gratitude training. Furthermore, reviewing the literature of positive psychological interventions indicates that usually gratitude‑based educational programs, as effective variables, are used for increasing other positive psychological variables such as happiness, resilience, hope, psychological well‑being, and etc., this is while contrary to the results of the present study, the effectiveness of other variables and positive educational programs such as positive psychology on gratitude, as a dependent variable, has received less attention.

One of the limitations of the present study is that the effectiveness of this intervention was studies only on

female students of the University of Isfahan. In addition, the frequency of educational elements and components, with considering the limited intervention period, to some extent hinders the complete training of the techniques of positive psychotherapy. The limitedness of the sample size is also among the limitations which could influence some of the findings of the present study. Furthermore, conducting positive psychotherapy in the group did not provide sufficient opportunity for prioritizing techniques and content of the treatment based on the unique needs of each member. Therefore, according to the mentioned limitations, it is suggested that the effectiveness of this intervention be studied on other layers of the society, male students and those students who study in other universities of Iran; and to conduct this educational courses with this expanded content, it is suggested that more sessions and longer duration of the course be considered. In addition, referring to the findings of the present study, clinical psychologists, psychiatrists, and other experts related to psychological services are suggested that positive psychotherapy be used in group and individual counseling sessions, in healthy and unhealthy populations, and among different ages. They also should consider the positive psychotherapy and trainings related to it in line with the increase of happiness and its three routes, including pleasant, engaged, and meaningful life as well as gratitude of patients. In addition, it is likely that the present study can contribute to provide more studies in relation to the role of positive psychological interventions (including positive psychotherapy) in reducing psychological symptom relief, increase in satisfaction with life, happiness, and psychological compatibility as well as improving individuals’ mental health.

In general, it can be said that positive psychotherapy conducted among students causes the increase of positive emotions, happiness, compatibility, and psychological well‑being; the enhancement in life quality, and consequently psychological symptom relief; and improvement of the performance. Therefore, as a part of educational and preventive programs, this intervention is suggested to be along with other positive psychological interventions, in education and treatment centers and agencies such as universities, schools, hospitals, clinics of psychology and psychiatry, and other institutions, to enhance the happiness, well‑being and to improve individuals’ performance.

Acknowledgment

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like to thank the Center of Excellence for Spirituality and Happiness in the University of Isfahan, for its support.

Financial support and sponsorship

Center of excellence for spirituality and happiness in the University of Isfahan.

Conlicts of interest

There are no conflicts of interest.

References

1. Namdari K, Molavi H, Malekpoor M, Kalantary M. The effect of hope enhancing training on behavioral strengths in dysthymic patients. J Shahrekord Univ Med Sci 2011;13:52‑60.

2. Rashid T. Positive interventions in clinical practice. J Clin Psychol 2009;65:461‑6.

3. Seligman ME, Csikszentmihalyi M. Positive psychology. An introduction. Am Psychol 2000;55:5‑14.

4. Magyar‑Moe JL. Therapist’s Guide to Positive Psychological Interventions. San Diego CA: Elsevier Academic Press; 2009. 5. Peterson CH, Seligman ME. Character Strengths and Virtues:

A Handbook and Classification. Washington DC: American Psychological Association; 2004.

6. Ghamarani A. The Effectiveness of Training Gratitude on Hope, Resilience, Optimism and Happiness on Martyr Adolescents and non Martyr Adolescents [Ph.D. Thesis]: University of Isfahan; 2011.

7. Emmons RA, McCullough ME. Counting blessings versus burdens: An experimental investigation of gratitude and subjective well‑being in daily life. J Pers Soc Psychol 2003;84:377‑89. 8. Seligman ME, Steen TA, Park N, Peterson C. Positive psychology

progress: Empirical validation of interventions. Am Psychol 2005;60:410‑21.

9. Rashid T. Positive psychotherapy. In: Lopez SJ, editor. Positive Psychology: Exploring the Best in People. Westport, CT: Praeger Publishers; 2008. p. 187‑217.

10. Seligman ME, Csikszentmihalyi M. Positive psychology. An introduction. Am Psychol 2000;55:5‑14.

11. Seligman ME, Rashid T, Parks AC. Positive psychotherapy. Am Psychol 2006;61:774‑88.

12. Rashid T, Anjum A. Positive psychotherapy for children and adolescents. In: Abela JR, Hankin BL, editors. Depression in Children and Adilescents: Causes, Treatment and Prevention. New York: Guilford Press; 2007.

13. Rashid T, Anjum A, Lennox C. Positive psychotherapy for middle school children. Unpublished manuscript, Toronto District School Board; 2006. Results presented. In: Rashid T, Anjum A. Positive psychotherapy for young adults and children. In: Abela JRZ, Hankin BL, editors. Handbook of Depression in Children and Adolescents. New York: Guilford Press; 2008. p. 250‑87. 14. Recio JR. Adolescents’ Depression and its intervention

through positive psychotherapy. Asia Pac J Multidiscip Res 2014;2:189‑93.

15. Savage JA. Increasing Adolescents’ Subjective Well‑Being: Effects of a Positive Psychology Intervention in Comparison to the Effects of Therapeutic Alliance, Youth Factors, and Expectancy for Change: University of South Florida; 2011.

16. Nikoozadeh EK. Compare the effectiveness of intervention programs based on positive psychology and Adlerian group therapy in promoting resilience. Cult Couns Psychother 2011;(5):1‑28.

17. Vejdani S, Golzari M, Borjali A. Effectiveness of positive psychotherapy on the decrease of depression and the increase of marital satisfaction of depressed women. J Appl Psychol 2014;8:7‑21.

18. Schrank B, Riches S, Coggins T, Rashid T, Tylee A, Slade M. WELLFOCUS PPT – Modified positive psychotherapy to improve well‑being in psychosis: Study protocol for a pilot randomised controlled trial. Trials 2014;15:203.

19. Mccullough ME, Emmons RA, Tsang JA. The grateful disposition: A conceptual and empirical topography. J Pers Soc Psychol 2002;82:112‑27.

20. Aqababai N, Farahani HB, Mehrabadi FM. Measuring gratitude among university and religious students: An enquiry into the psychometric features of the gratitude questionnaire. Biquarterly J Stud Islam Psychol 2010;4:75‑88.

21. Lyubomirsky S, Dickerhoof R, Boehm JK, Sheldon KM. Becoming happier takes both a will and a proper way: An experimental longitudinal intervention to boost well‑being. Emotion 2011;11:391‑402.

Gambar

Table 1: Processes and themes trained in positive psychotherapy sessions
Table 2: Comparing scores of happiness and its components as well as those of gratitude in investigated groups in diferent evaluation stages
Table 3: The results of ANCOVA related to the efect of positive psychotherapy on happiness and its components in diferent evaluation stages

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