Strengths-based Intervention Research Articles

Development of an evidence‑based, theory‑driven, and culturally appropriate character strengths-based intervention for breast cancer patients, following the Medical Research Council Framework.

To design and develop a complex, evidence‑based, theory‑driven, and culturally appropriate character strengths-based intervention (CSI) for breast cancer patients, following the Medical Research Council (MRC) framework. From 2018 September to 2020 November, a complex intervention perspective was adopted. The rationale, methods, and processes employed in carrying out the study were reported. The acceptability and feasibility of intervention program were evaluated as a part of subsequent pilot study. Based on piloting, a refined and optimized definitive intervention was obtained. The development of the intervention is an iterative process involving input from three key stakeholders: experts, medical staff, and patient representatives. The systematic review revealed CSIs were effective and the selected theory served as a guide and indicated theory-inspired modifications. A representative team of breast cancer patients and oncology nurses collaboratively developed and tailored the intervention content and format with attention to the acceptability and feasibility. Five main strategies, including peripheral, evidential, linguistic, constituent-involving, and sociocultural strategies, were used to achieve and strengthen the cultural appropriateness. After the pilot phase, several refinements were made on the CSI program, such as editorial changes in the booklet or alternative suggestions for difficult strengths-based activities (e.g., outdoor activities). All participants not only expressed satisfaction with the program in process evaluation, but also reported perceived benefits such as enjoyable and sociable experience, better well-being, and increased confidence. Consideration of the MRC framework, theory guidance, and suggestions from stakeholders during intervention development can optimize uptake and sustainability in the clinical setting. It is recommended that randomized controlled trial be used in future studies to assess the intervention, the process and the mechanisms of the intervention. Our approach may offer implications for the design and implementation of similar initiatives to support cancer patients. ClinicalTrials.gov Register Identifier: NCT04219267, 07/01/2020, retrospectively registered.

Character Strengths as a Predictor of Adult Friendship Quality and Satisfaction: Implications for Psychological Interventions

Since the birth of positive psychology, character strengths-based interventions aiming at promoting wellbeing have become very popular. However, there are only a few previous studies focusing on the associations of character strengths with social wellbeing, e.g., positive outcomes in close relationships. The aim of the present study was to investigate the associations between character strengths and positive adult friendship outcomes (i.e., friendship quality, satisfaction, and number of friends). The effects of age and gender were also examined. A total of 3051 adults aged from 18 to 65 years participated in the study. The Values-In-Action Inventory of Strengths-120 and the McGill Friendship Questionnaires (measuring friendship quality and satisfaction) were used. The results indicated that all character strengths positively correlated with friendship variables, while specific strengths predicted adult friendship quality (love, kindness, honesty, and curiosity), satisfaction (kindness, honesty, modesty, spirituality, love, and bravery), and number of friends (curiosity and persistence). Age, gender, and gender of the friend dyad (same and opposite-sex friendships) moderated only three of these effects. Practical implications for designing and implementing strengths-based positive friendship interventions in several contexts, such as university, workplace, and counselling are discussed.

DEVELOPMENT OF FAMILY SOCIAL WORK (review of the monograph by O. Stoliaryk, T. Semigina «Social work with families raising children with autism: a strengths-based intervention»)

«Social work with families raising children with autism: an intervention for the development of strengths» is a scientific work that reveals the features and content of social work strategies with families raising children with autism available in domestic and foreign literature. The research work was aimed at improving the subjective quality of life of families raising children with autism.The monograph provides data that indicate the effectiveness of the authors' use of a strengths-based approach in experimental social work with families raising children with autism. Through discussion, the authors discussed the obtained results, formulated recommendations that elaborately reveal the specifics of using an approach focused on client strengths in social work with families raising children with autism.

Positive psychology in neurodiversity: An investigation of character strengths in autistic adults in the United Kingdom in a community setting

BackgroundThe positive psychology and neurodiversity movements both aim to promote and improve wellbeing through strengths-based approaches. However, little is known about how positive psychology can support the wellbeing of autistic people. The present study investigated character strengths profiles as a potential tool to identify strengths-based interventions that could enhance wellbeing outcomes for autistic adults. To our knowledge, this is first study to use this method as a possible way of improving the wellbeing of autistic adults in the community in the UK. MethodForty-seven self-reported formally diagnosed (83%) and self-identifying (17%) autistic adults completed online self-rated standardised questionnaires about their character strengths and life satisfaction. Descriptive statistics and correlational analyses were used to evaluate the profile of character strengths and their relationship to overall life satisfaction. ResultsCharacter strengths most frequently reported by autistic adults were Honesty, Appreciation of Beauty and Excellence, Love of Learning, Fairness, and Kindness. Higher levels of life satisfaction were associated with character strengths of Gratitude, Hope, and Honesty. ConclusionsThe most frequent character strengths were consistent with autistic traits reported in the wider body of autism literature, such as intense interests and strong attention to detail. The present study provides preliminary findings and recommendations for potential future strengths-based interventions that could enhance life satisfaction of autistic adults in a community setting. Further investigation with larger samples is needed to replicate the emerging findings on this topic.

“It’s a family matter”: A strengths-based intervention for parents of sexual minority individuals

Introduction Parenting a sexual minority child can pose both challenges and opportunities for growth. This study explored the effects of a strength-based parenting (SBP) intervention in helping parents of sexual minority children to develop (1) psychological growth and (2) a stronger parent–child bond. Method Six parents participated in the intervention, interviews were conducted before and after the intervention from parents and children. Thematic analysis was used as the qualitative method. Results SBP facilitated identity exploration, empathy, and cognitive flexibility in parents, and bolstered trust and appreciation in the parent–child relationship. Conclusion Strength-based approaches hold much potential for supporting growth outcomes in LGB-membered families.

Kick-starting youth wellbeing and access to mental health care: Efficacy of an integrated model of care within a junior sports development program

One productive avenue for building adolescents' personal strengths and reducing mental health problems is integrating assessment and intervention into organised sports programs. We investigated the efficacy of the RISE program, a rugby league development program for 12- to 15-year-old boys, which integrated a mental health and wellbeing system called Life-Fit-Learning. The Life-Fit System is designed to measure youth's strengths and mental health symptoms and sends mental health feedback to parents, provides group-based workshops, connects youth and parents to online psychoeducation resources, and provides individual telephone follow-up and referral with parents of youth at high-risk for mental health problems. In this study, mental health and wellbeing outcomes were compared in participants who did (RISE, N = 94) and did not (Comparison, N = 82) receive the RISE/Life-Fit-Learning program. RISE players reported their self-satisfaction, grit, gratitude, prosocial behaviour, anxiety, depression, and behavioural problems using the Life-Fit System pre- and post-program. Comparison participants completed measures twice, 6-months apart. Self-satisfaction did not change in RISE participants but declined among comparison participants. In both groups, 26% of players scored in the high-risk range on at least one mental health measure. On mental health measures, high-risk RISE players' depression and behavioural problems improved from pre-to post-program relative to no change among Comparison players. Among participants who were not high-risk, RISE players' anxiety, depression, and behavioural problems did not change whereas Comparison players' behavioural problems increased significantly. Results underscore the value of integrating strengths-based interventions and targeting youth mental health problems within the context of junior sports development programs.

“Your status cannot hinder you”: the importance of resilience among adolescents engaged in HIV care in Kenya

BackgroundApproximately 40% of the 110,000 adolescents living with HIV (ALHIV) in Kenya have not achieved viral suppression. Despite the increasing availability of adolescent-friendly services, adolescents face barriers that impact ART adherence. This study aimed to identify key stigma-related barriers to ART adherence and strategies used by adolescents in overcoming these barriers.MethodsData were collected by LVCT Health, a Kenyan organization with a programmatic focus on HIV testing, prevention, and care. 122 participants were recruited from 3 clinical sites affiliated with LVCT Health in Nairobi, Kisumu, and Mombasa. In-depth interviews were conducted with ALHIV (n = 12). Focus group discussions were conducted with ALHIV (n = 5), peer leaders (n = 3), and adolescents receiving HIV services in community settings (AIC) irrespective of HIV status (n = 3). Interviews and focus groups were audio recorded, translated, and transcribed. Data were analyzed thematically, with a focus on stigma and resilience.ResultsWhile AIC primarily focused on adherence barriers and stigma, ALHIV and, to some extent, peer leaders, also identified resilience factors that helped overcome stigma. Four major themes emerged: 1) knowledge and future-oriented goals can drive motivation for ALHIV to remain healthy; 2) disclosure to others strengthens support systems for ALHIV; 3) medication-taking strategies and strategic disclosure can overcome adherence challenges in school; and 4) a supportive clinic environment promotes continuous adolescent engagement in HIV care. These concepts were used to develop a conceptual stigma/resilience model depicting how resilience moderates negative effects of stigma among ALHIV.ConclusionsThis study demonstrates the positive effects of ALHIV resilience on ART adherence and illuminates how stigma impacts ALHIV differently depending on their resilience. Strengths-based interventions, focused on increasing resilience among ALHIV in Kenya, and more formal involvement of adolescent peers to bolster adolescent support, have the potential to improve ART adherence among ALHIV.

A Mental Imagery Micro-Intervention to Increase Positive Affect in Outpatient CBT Sessions (PACIfIC): Study Protocol of a Randomized Controlled Implementation Trial.

Recent findings indicated that mental disorders are associated with both an up-regulation of negative affect and a down-regulation of positive affect (PA) as distinct processes. Established treatment approaches focus on the modification of problems and negative affect only. Experimental paradigms in healthy samples and research on strengths-based approaches showed that fostering PA may improve psychotherapy process and outcome. Specific and easily implementable interventions targeting PA in treatment sessions are scarce. Mental imagery was shown to be a promising strategy for boosting positive emotional experiences. The PACIfIC-study is planned as a longitudinal randomized-controlled trial in the context of cognitive behavioral therapy, implemented at a German outpatient training and research center. In the process analysis, trajectories of PA over the first twelve treatment sessions will be examined with weekly questionnaires. In the intervention analysis, a six-minute positive mental imagery intervention to enhance PA will be developed and tested. The intervention is implemented with loudspeakers at the beginning of each session for a standardized induction of PA. The experimental group will be compared to an active control group (neutral mental imagery) and treatment as usual. Procedures in all treatment arms are parallelized. Main outcomes after twelve sessions of psychotherapy will be psychosocial resources, resilience and self-esteem (theory-driven), as well as psychopathology and working alliance (secondary outcome). Multilevel modeling will be conducted to address the nested data structure. Study results may have implications on the consideration of positive constructs in mental disorders and the implementation of strengths-based interventions in psychotherapy.

A Familial Case Study Exploring the Effects of a Strengths-Based Camp Intervention on Children’s Self-Perception

Childhood victimization can negatively affect children’s self-perception, a multifaceted developmental asset that can be delineated into Global Self-Worth, Social Competence, and Behavioral Conduct. Despite the importance of self-perception, few studies have examined how strengths-based interventions impact self-perception among youth experiencing victimization. Using a familial case study design, the current study evaluated how a camp-based intervention, known as Camp HOPE, affected self-perception among siblings who experienced childhood victimization. Participants included three siblings and their mother who all identify as Black/African American and reside in the Midsouth, United States. The siblings participated in a week-long, overnight camp with other children exposed to victimization. The family was evaluated across three timepoints: pre-camp, 1 month post-camp, and 4 months post-camp. Participating in Camp HOPE appeared to have differential effects on the siblings’ self-perception. Specifically, all three children endorsed small to medium improvements in perceived Behavioral Conduct, but the camp differentially impacted their Global Self-Worth and Social Competence. Findings suggest that Camp HOPE may enhance self-perception among Black/African American children who have experienced victimization. This intervention may also be more accessible and acceptable, compared to traditional treatment formats.

Strengths-building through life purpose, self-care goal setting and social support: Study protocol for Caregiver Support

BackgroundFor caregivers of people with heart failure, addressing a range of care recipient needs at home can potentially be burdensome, but caregivers may also gain meaning from caregiving. The Caregiver Support Program, a multicomponent strengths-based intervention, is designed to improve outcomes of heart failure caregivers. Objectives1) Test the feasibility and gauge an initial effect size of the Caregiver Support Program to improve caregiver quality of life (primary outcome), and fatigue and burden (secondary outcomes) from baseline to 16 weeks, 2) test whether fatigue and caregiver burden are associated with objective measures of resilience (sweat inflammatory cytokines (Il-6 and IL-10) and self-reported resilience, 3) evaluate changes in heart rate variability, IL-6 and IL-10, pre- and post-intervention. MethodsThis is a single-blind, two group, waitlist control trial. Eligible caregivers are 1) ≥ 18 years, 2) English speaking, 3) live with the person with heart failure or visit them at least 3 days per week to provide care, 4) provide support for at least 1 instrumental activity of daily living (IADL), 5) live within a 1 h driving radius of the Johns Hopkins Hospital, and 6) the care-recipient has been hospitalized within the last 6 months. Trial participants are randomized into the immediate intervention (n = 24) or waitlist control group (n = 24). Data collection is at baseline, 16 weeks, and 32 weeks. ConclusionThe Caregiver Support program has the potential to increase quality of life and decrease fatigue and caregiver burden for caregivers of people with heart failure and multiple co-morbidities.

A Cross-Sectional Study of Individual Learning Passion in Medical Education: Understanding Self-Development in Positive Psychology.

BackgroundBoosting the individual learning passion of medical students is a novel approach to improve their academic performance. It facilitates the medical education reform, motivating both policymakers and educators to focus on the function of positive psychology in the career development of medical students. Therefore, this study aimed (1) to assess the status of two types of learning passion; (2) to clarify the relationship between self-esteem and two types of learning passion among Chinese medical students; (3) to examine the mediating role of psychological capital (PsyCap) in the relationship between self-esteem and two types of learning passion, respectively; and (4) to identify the moderating role of professional identity in the relationship between PsyCap and two types of learning passion, respectively.MethodsA cross-sectional online survey was conducted from April to June 2016 in China. A total of 1,218 valid questionnaires (effective completion rate: 67.93%) were collected from four medical schools.ResultsSelf-esteem significantly and positively influenced medical students’ PsyCap (β = 0.637, P < 0.01) and two types of learning passion, including harmonious learning passion (β = 0.589, P < 0.01) and obsessive learning passion (β = 0.436, P < 0.01). PsyCap fully mediated the relationship (β = 0.578, P < 0.01) between self-esteem and harmonious learning passion positively, whereas it suppressed the relationship (β = 0.490, P < 0.01) between self-esteem and obsessive learning passion. Further, professional identity significantly moderated the correlation between PsyCap and harmonious learning passion (β = −0.554, P < 0.05), rather than obsessive learning passion (P > 0.05).ConclusionTwo types of learning passion of medical students are positively influenced by self-esteem and PsyCap. Medical students with high-level self-esteem should possess strong PsyCap, which augments their harmonious as well as obsessive learning passion. Moreover, the positive effect of medical students’ PsyCap on harmonious learning passion is more notable among those with a lower professional identity. Finally, this study argues that strengths-based interventions of self-esteem and PsyCap are a beneficial approach for future enhancing learning passion in the domain of medical education.

The meaning of "strengths" for strengths-based mental health practice in Hong Kong Chinese culture: A qualitative exploratory study.

Background: Recovery-oriented, strengths-based intervention engages service users' strengths and resources to support their recovery process. This model was developed in an American context and has been applied in Hong Kong. It is important to formulate an understanding of strengths better fit to Hong Kong Chinese. Aims: This exploratory qualitative study examined Hong Kong Chinese service users' views on strengths and preferred translation for the word strengths, along with its cultural nuances. Method: Twenty-six people with serious mental illnesses were individually interviewed at a mental health center in Hong Kong, based on a photo-elicitation technique and reflection on Chinese terms related to strengths. Analysis of data employed the constant comparative method. Results: Participants reported that social factors, such as support by helping professionals and engagement in family roles, as well as spiritual beliefs and practices, are important for recovery. These insights and their preferred translations of strengths generate a culturally nuanced understanding of strengths. Conclusions & Implications for Practice: The strengths model applied in Hong Kong can be enhanced by a more culturally nuanced perspective, for example, including the importance of family-based identity and filial piety, beliefs related to harmony and fate, and practices such as a temple or church attendance. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Abstract P4-11-12: Integrating the patient and partner distress and perceptions about prognosis in women with metastatic breast cancer guides the medical oncology consultation

Abstract Methods: Women with metastatic breast cancer and their partners completed couples’ tailored biopsychosocial screening and alignment in perception of prognosis immediately before consultation with a Medical Oncologist. In addition, couples were offered a standardized couples’ session before the medical consultation, individual couples’ counseling, and a strengths-based group intervention. As a component of biopsychosocial screening, each patient and her partner were asked individually their understanding of prognosis. They were asked their perception of likelihood of cure with supporting text and percentages provided: 76-100%; 51-75%; 26-50%, or 0-25%. Results: To date 254 women were considered eligible for this program. Complete data for both partners is available on 205. All the patients had metastatic breast cancer prior to their Medical Oncology appointment. The average age of the patient was 54 years (Range 25-84) and 55 years (Range 26-84) for the partner. In the perception of prognosis, 48.7% of patients and their partner were aligned and 51.3% were misaligned. The patient was more likely to have considered their prognosis worse in 59% and the partner 41%. The most commonly endorsed distress items for the patient were: Worry about the future 61%; Side effects of treatment 60%; Fatigue 59%; How my family will cope 58%; and Sleeping 49%. Distress for the partner included: Feeling anxious or fearful 49%; Wanting to best help my partner 37% and Sleeping 37%. Both the patient and partner sought assistance with Understanding treatment options 73.6%; Feeling anxious or fearful 62.5%, Worry about the future 57.3% Fatigue 56.3%, and Pain 56.3%- Partner practical distress was significantly higher for those couples who were not in alignment, p&amp;lt;.05. Conclusions: It is possible to openly ask patients and their partners about prognosis. In women with metastatic breast cancer, lack of alignment with understanding prognosis was common with the patient being more likely to have realistic expectations than their partner. A better understanding of the patient/partner’s expectations about treatment outcome has the potential to guide the Medical Oncologist to individualize communications including discussion about goals of care. Citation Format: Joanne Mortimer, James Waisman, Yuan, Sayeh Lavasani, Daphne Stewart, Mina Sedrak, Niki Patel, Courtney Bitz, Karen Clark, Marianne Razavi, Matthew J Loscalzo. Integrating the patient and partner distress and perceptions about prognosis in women with metastatic breast cancer guides the medical oncology consultation [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P4-11-12.

Clinical applications of the VIA Inventory of Strengths with Individuals with Intellectual/Developmental Disabilities

ABSTRACT Strengths-based clinical practices are critical for supporting the wellbeing of individuals with intellectual and/or developmental disabilities. The VIA Inventory of Strengths (‘VIA Survey’) is an assessment grounded in positive psychology that may contribute to strengths-based practices. To identify how this assessment is used in clinical practice with individuals with intellectual and/or developmental disabilities, we conducted focus groups (n = 15) with clinicians who have used this survey with this population. We also asked individuals with intellectual and/or developmental disabilities (n = 36) to comment on the process of completing the VIA Survey. We found that clinicians utilize the VIA Survey with individuals with intellectual and/or developmental disability to foster self-esteem and self-understanding, provide a framework for understanding strengths, communicate across service systems and shape strengths-based interventions. Individuals with intellectual and/or developmental disabilities also endorsed use of the survey to increase their self-knowledge and self-esteem. Future research should address accessibility of the survey to foster greater uptake and propose standard protocols for independent survey completion.

The Hispanic Paradox: A Moderated Mediation Analysis of Health Conditions, Self-Rated Health, and Mental Health among Mexicans and Mexican Americans

ABSTRACT This study investigates how mediating (e.g. history of health conditions) and moderating (e.g. self-rated health) factors are associated with nativity status on depression and anxiety in Mexican immigrants. Using data from the 2019 National Health Interview Survey (NHIS), results found a significant direct association between nativity status and anxiety and depression. Additionally, the association between nativity status and mental health was mediated by the history of health conditions, and self-rated health was a significant moderator in both mediation models. Study findings are discussed within the context of barriers to care, current literature, and strengths-based interventions. Future research can expand upon these findings by examining the specific types of physical and mental health conditions that may support the Hispanic Paradox, as well as how self-efficacy and internal locus of control are associated with the paradox within this population.

Promoting Self-Determination in Parents With Mental Illness in Adult Mental Health Settings.

This article reports a strengths-based intervention to support parents with mental illness and their children in adult mental health settings: "Let's Talk About Children" (LTC) intervention. A qualitative methodology was adopted with parent participants receiving LTC in adult mental health and family services. The benefits for parents receiving LTC were described through in-depth interviews with 25 parents following the delivery of the program. Interview data identified an impact on parental self-regulation-mainly through a change in a sense of agency as a parent-and skill building, once a clearer picture of their child's everyday life was understood. This study outlines the benefits of talking with parents about the strengths and vulnerabilities of their children during routine mental health treatment. The role for self-determination of parents in preventive interventions for children is an important consideration for mental health recovery, and it also helps to break the cycle of transgenerational mental illness within families.

The My Strengths Training for Life™ program: Rationale, logic model, and description of a strengths-based intervention for young people experiencing homelessness

Traditionally, UK housing services have focused on providing temporary accommodation, identifying risk factors, and preventing negative outcomes to young people experiencing homelessness. However, deficit approaches may lead young people to becoming dependent on services and face greater marginalization and stigmatization. Meeting long-standing calls to focus more on young people’s positive attributes and abilities, the My Strengths Training for Life™ (MST4Life™) program was developed as a community partnership with a large housing service. This paper describes the rationale, logic model, and content of the MST4Life™ program using the TIDieR (Template for Intervention Description and Replication) checklist. MST4Life™ is a strengths-based and experiential psychoeducation intervention for young people aged 16–24 years who are homeless or at risk. Grounded in positive youth development and basic psychological needs theory, its aim is to provide meaningful opportunities for participants to recognize, use, and further develop their mental skills and strengths. In turn, enhancing intentional self-regulation is expected to improve physical, mental, and social health and wellbeing, and support positive transitions to independent living. The potential long-term impacts include a reduction in the number of young people returning as homeless, lower rates of mental illness and mortality, and a cost saving to the public purse.

Neurodiversity and Opportunities in Psychiatry

Neurodiversity and Opportunities in Psychiatry

“Does Change Last?”: Evaluating the Strengths-Based Intervention for Families Raising Children with Autism

The study evaluated the effectiveness of the intervention for families raising children with autism aimed to improve the family’s quality of life, strengthen its capacity, and expand rights and opportunities. The experimental intervention was implemented at the Educational and Rehabilitation Center for Children with Autism “Trust” (Lviv, Ukraine). It had one experimental group (30 people) and two control groups (60 people). The effectiveness and duration of the intervention effects were assessed using a before/after study design with the same questionnaire. Findings from the survey evidence the effectiveness of the intervention, in particular, for expanding the family’s capabilities, its capacity, improving relationships in family subsystems, increasing parental competence, and improving well-being. Limitations of the intervention are discussed.

Developmental Assets in South African Adolescents Exposed to Violence: a Qualitative Study on Resilience

Violence exposure is associated with psychological and behavioural maladjustment in adolescents. Yet, not all adolescents exposed to violence experience negative symptoms. Resilience is an outcome that is in part determined by multiple protective factors, or developmental assets, that protect adolescents from the negative influence of encountered stressors and allow them to attain positive developmental outcomes. A qualitative study was conducted to acquire an in-depth understanding of the developmental assets across different layers in the ecological system that promote positive psychological and behavioural functioning in South African adolescents exposed to violence. Semi-structured individual interviews were conducted with a multi-ethnic group (black, white, and people of mixed heritage) of South African adolescents (boy: n = 17; girl: n = 13; age: 14–19 years) from seven schools in Cape Town. Adolescents reported both internal and external assets that helped them adaptively cope with violence exposure. The internal assets entailed individual characteristics and skills, including commitment to learning, positive values, positive identity, social competencies, and emotional insight. The external assets were boundaries and expectations, social support from adolescents’ peers, family, school, and community, and adolescents’ constructive use of time. The findings of the study may inform strengths-based interventions to enhance emotional and behavioural skills in adolescents at risk for violence exposure. Moreover, involving key stakeholders in the interventions from major developmental domains can be particularly helpful to optimise the social support that are needed for adolescents to be resilient.