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Synthesizing positive psychological interventions: Suggestions for conducting and interpreting meta-analyses

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Abstract

Systematic reviews, such as meta-analyses, are highly valued within scientific, professional, and lay communities because they provide an easily digestible aggregate of a large body of work. A recently published meta-analysis of positive psychology interventions concluded that these interventions have small effects and argued for the use of these interventions in diverse populations (Bolier et al., 2013). We caution researchers against drawing conclusions from this study because of the unusual definition of what is (and is not) a positive psychological intervention. Bolier and colleagues (2013) define their area of inquiry as “pure positive psychology interventions” and limit their sample to studies conducted within the years following the formal founding of the positive psychology movement. This decision – while well intentioned, as it provides specificity to their criteria for inclusion – is, in our view, too narrow, excluding a host of studies that use the same intervention strategies and target the same outcomes but do not explicitly reference “positive psychology”. The inclusion criteria of a systematic review directly impact its findings and conclusions. Using the criterion of papers that explicitly reference positive psychology creates an arbitrary boundary that reflects neither the research nor practice of the field; the best practitioners prioritize effectiveness and efficiency over explicit ties to “positive psychology”. Arbitrary boundaries hinder science and impair the ability of researchers, clinicians, and the general public to draw accurate conclusions from the findings. It also limits the meta-analyst’s ability to conduct moderation analysis that can help drive the field forward by answering research questions that are difficult to address in a single study. Positive psychology and psychology more generally would benefit from definitions of terms that are conceptually-based and thus meta-analyses that are theoretically sound.
Schueller, S. M.., Kashdan, T. B., & Parks, A. C., (2014). Synthesizing positive psychological
interventions: Suggestions for conducting and interpreting meta-analyses. International Journal of
Wellbeing, 4(1), 91-98. doi:10.5502/ijw.v4i1.5
Stephen Schueller
First Author’s University
First Author’s Email
Copyright belongs to the author(s)
www.internationaljournalofwellbeing.org
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ARTICLE
Synthesizing positive psychological interventions:
Suggestions for conducting and interpreting meta-
analyses
Stephen M. Schueller · Todd B. Kashdan · Acacia C. Parks
Abstract: Systematic reviews, such as meta-analyses, are highly valued within scientific,
professional, and lay communities because they provide an easily digestible aggregate of a large
body of work. A recently published meta-analysis of positive psychology interventions concluded
that these interventions have small effects and argued for the use of these interventions in diverse
populations (Bolier et al., 2013). We caution researchers against drawing conclusions from this
study because of the unusual definition of what is (and is not) a positive psychological
intervention. Bolier and colleagues (2013) define their area of inquiry as “pure positive psychology
interventions” and limit their sample to studies conducted within the years following the formal
founding of the positive psychology movement. This decision while well intentioned, as it
provides specificity to their criteria for inclusion is, in our view, too narrow, excluding a host of
studies that use the same intervention strategies and target the same outcomes but do not
explicitly reference “positive psychology”. The inclusion criteria of a systematic review directly
impact its findings and conclusions. Using the criterion of papers that explicitly reference positive
psychology creates an arbitrary boundary that reflects neither the research nor practice of the field;
the best practitioners prioritize effectiveness and efficiency over explicit ties to “positive
psychology”. Arbitrary boundaries hinder science and impair the ability of researchers, clinicians,
and the general public to draw accurate conclusions from the findings. It also limits the meta-
analyst’s ability to conduct moderation analysis that can help drive the field forward by answering
research questions that are difficult to address in a single study. Positive psychology and
psychology more generally would benefit from definitions of terms that are conceptually-based
and thus meta-analyses that are theoretically sound.
Keywords: meta-analysis, positive psychology, moderator analysis, interventions, definition
1. Background
The proliferation of interventions aimed at increasing positive emotions, behaviors, and thoughts
has led to increasingly nuanced questions about the efficacy of such interventions (Lyubomirsky
& Layous, 2013), the application of such interventions to new, unique populations (Froh,
Kashdan, Ozimkowski, & Miller, 2009; Meyer, Johnson, Parks, Iwanski, & Penn, 2012), new
settings (Huppert & Johnson, 2010; Reivich, Seligman, & McBride, 2011; Seligman, Rashid, &
Parks, 2006), and new modes of delivery (Parks & Szanto, 2013; Schueller & Parks, 2012).
Although these interventions first surfaced in the research literature 35 years ago (Fordyce, 1977),
their presence has multiplied over the last decade thanks to an increasing interest by researchers
within the positive psychology community in their design and application and a growing
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appreciation of the importance of positive behaviors, cognitions, and emotions in mental health
care. Given the number of studies, researchers and practitioners require updated, accurate
summaries of the field. A recently published meta-analysis concluded that positive psychology
interventions are effective in increasing subjective wellbeing, psychological wellbeing, and in
reducing depressive symptoms with small effect sizes, on average (Bolier et al., 2013). These
findings are consistent with a previous meta-analysis (Sin & Lyubomirsky, 2009) and with other
qualitative reviews of the field (Lyubomirsky & Layous, 2013; Schueller & Parks, 2014). However,
the usefulness of the meta-analysis by Bolier and colleagues (2013) is hampered by its narrow
conception of which interventions to include. We argue for the consideration of positive
psychological interventions rather than positive psychology interventions to emphasize the
importance of including interventions that are conceptually aligned with the goals of the positive
psychology movement rather than only those that explicitly identify positive psychology within
their published studies (Parks & Biswas-Diener, 2013). We want to promote a discussion of what
positive psychological interventions, defined more inclusively, would entail and to encourage
those interested to read Bolier and colleagues (2013), available as an open-access journal article,
and to consider our commentary in light of their work.
2. What is a Positive Psychological Intervention?
A positive psychological intervention promotes positive emotions, behaviors, and/or thoughts,
thereby increasing the wellbeing of an individual or group (Parks & Biswas-Diener, 2013). This
definition underscores two essential components of positive psychological intervention: (1) the
intervention’s goal and (2) the pathways via which the intervention operates.
In order to be considered a positive psychological intervention, an intervention’s goal must
target wellbeing, broadly defined. In intervention studies, wellbeing is commonly defined and
measured from a subjective wellbeing approach. In this perspective, wellbeing is a sum of
positive evaluations of one’s life (cognitive) and frequent experiences of positive emotions and
infrequent experiences of negative emotions (affective) (Diener, 2000). Raising one’s wellbeing
thus increases positive facets and decreases negative facets. Intervention studies use diverse
outcomes to cover these facets including increases in happiness, satisfaction with life, and
positive emotions and decreases in depressive symptoms and negative emotions. Both existing
meta-analyses on interventions within positive psychology summarize these outcomes (Bolier et
al., 2013; Sin & Lyubomirsky, 2009). Other facets of wellbeing, however, are equally important
and even measures commonly associated uniquely with either hedonic or eudaimonic
approaches to wellbeing, often proposed as distinct concepts, often work and move in tandem
(Kashdan, Biswas-Diener, & King, 2008).
Meeting the goal criterion alone, however, does not suffice to differentiate positive
psychological interventions from many other interventions (e.g., cognitive-behavioral therapies),
and so the pathway by which the intervention operates must also be evaluated. Positive
psychological interventions must operate via mechanisms that are known to promote positive
emotions, behaviors, and/or thoughts rather than fixing deficits or addressing maladaptive
patterns. To incorporate this pathway aspect, Bolier and colleagues’ (2013) specify that
interventions must “have been explicitly developed with the theoretical tradition of positive
psychology (usually reported in the introduction section of the article)” (pg. 3). Bolier and
colleagues (2013) further operationalize this in their search criteria by including only
interventions “covering the period from 1998 (the start of the positive psychology movement) to
November 2012” (one article, Lichter, Haye, and Kammann (1980), included in the analysis was
published prior to this date). Although Bolier and colleagues (2013) drew on Sin and
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Lyubomirsky’s (2009) criteria, this criterion is more selective than Sin and Lyubomirsky’s (2009),
which only required that a study test “an intervention, therapy, or activity primarily aimed at
increasing positive feelings, positive behaviors, or positive cognitions” (pg. 469). Indeed, of the
51 studies included in Sin and Lyubomirsky (2009) and 39 included by Bolier and colleagues, 16
overlapped.
As an alternative to the approach used by Bolier and colleagues (2013), we posit that this
pathways component be based on accumulated knowledge of the affective, behavioral, cognitive,
and motivational processes that support wellbeing. Indeed, sufficient evidence exists to detail
some of these differences (Lyubomirsky, 2001), highlighting strategies such as gratitude,
kindness, optimism, savoring, and mindfulness to name a few. Other alternatives could include
a thorough conceptual mapping of the field of positive psychology (e.g., Rusk & Waters, 2013).
Conceptual and empirical considerations would provide a better representation of the practices
of the field than an explicit reference to “positive psychology”, which might merely represent
biases, preferences, or interests of the publishing author or journal.
3. Impact on the Field
We believe that the definition employed by Bolier et al. (2013), restricted to “positive psychology”
interventions, is conceptually limited and left uncorrected will stand to weaken subsequent
research. The first problem is that how a meta-analysis defines a construct sets a precedent for
how that construct should be defined in future studies. It is important, then, to address any
problems with Bolier and colleagues’ (2013) definition before it becomes widely used. Their
narrow definition has the potential to significantly silo the field by including only work
conducted by those who explicitly acknowledge positive psychology. Positive psychology would
benefit from being more inclusive and integrated with research that shares clear conceptual
overlap.
As an example, consider the research on values affirmations (Cohen & Sherman, 2014). In
laboratory intervention studies, researchers ask people to reflect on the self-defined, abstract, life
principles that serve to guide personal goals and the dedication of effort to what is most
meaningful and important to them (Cook, Purdie-Vaughns, Garcia, & Cohen, 2012; Creswell et
al., 2005). After this act, participants enter a threatening environment. Across multiple studies,
researchers have found that value affirmations lessen psychological and physiological indices of
stress and improve performance compared to control conditions (Martens, Johns, Greenberg, &
Schimel, 2006; Schmeichel & Vohs, 2009). In none of these studies is “positive psychology
mentioned and there are no citations to papers seminal to the positive psychology movement.
Bolier and colleagues’ (2013) inclusion criteria also do not allow for including any work in
relevant areas that preceded the founding of the field. Positive psychology did not create the
exploration of increasing wellbeing and a substantial base of empirical work existed prior to its
inception (e.g., Fordyce, 1977).
As another example, a rapidly expanding body of literature is accumulating on the “Best
Possible Self” intervention (Austenfeld, Paolo, & Stanton, 2006; Austenfeld & Stanton, 2008;
Boehm, Lyubormirsky, & Sheldon, 2011; Hanssen, Peters, Vlaeyen, Meevissen, & Vancleef, 2013;
King, 2001; King & Miner, 2000; Layous, Nelson, & Lyubomirsky, 2013; Lyubomirsky,
Dickerhoof, Boehm, & Sheldon, 2011; Meevissen, Peters, & Alberts, 2011; Oyserman, Bybee, &
Terry, 2006; Peters, Flink, Boersma, & Linton, 2010; Peters, Meevissen, & Hanssen, 2013; Sheldon
& Lyubomirsky, 2006), a positive psychological intervention that promotes optimistic thinking
by having individuals imagine a future where everything has gone as well as it possibly could.
Promoting optimism is clearly in line with the goals of positive psychological practices and
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theoretical and empirical support exists for its inclusion using the pathways criterion we
proposed earlier. Indeed, Bolier and colleagues (2013) included several studies of this
intervention in their meta-analysis (Boehm et al., 2011; King, 2001; Layous et al., 2013;
Lyubomirsky et al., 2011; Peters et al., 2010; Sheldon & Lyubomirsky, 2006) but omitted others
(e.g., Austenfeld et al., 2006; Austenfeld & Stanton, 2008; Hanssen et al., 2013; King & Miner,
2000; Meevissen et al. 2011; Oyserman et al., 2006; Peters et al., 2013). As such, one cannot make
conclusions whether the “Best Possible Self” is efficacious or understand how this intervention
might compare to positive psychological interventions using different pathways (e.g., kindness,
gratitude, etc.). Bolier and colleagues’ (2013) proposed solution is to conduct meta-analyses that
are restricted to specific types of interventions; however, approaching the field in this way limits
the ability to make comparisons within a meta-analysis and ignoring specific research areas
might bias a meta-analysis of positive psychological interventions (e.g., Bolier et al., 2013).
The importance of comparisons within a meta-analysis relates to another consequence of
using a narrow definition of positive psychology interventions. Such an approach limits
confidence in the conclusions, especially with regards to moderating factors. Bolier and
colleagues’ (2013) conclusion was that interventions produced small effects on subjective
wellbeing (d = .34), which was considerably smaller than the medium-sized effect (r = .29, which
corresponds to d = .61) found by Sin and Lyubomirsky (2009). This difference was even more
pronounced for depressive symptoms (d = .23 for Bolier et al., 2013; r = .31 for Sin & Lyubomirsky,
2009, which corresponds to d = .65). Bolier and colleagues (2013) also concluded that longer,
individual interventions delivered to people experiencing psychosocial problems and recruited
via the healthcare system were the most effective interventions (Bolier et al., 2013). It is unclear
if these results would hold if other interventions were included (e.g., mindfulness, reminiscence,
forgiveness, value affirmation). An open question here is whether interventions labeled explicitly
as positive psychology interventions have any bias in their design, reporting, or likelihood of
publication that would subsequently bias findings using only these studies as a basis for analysis.
This could be explored in a subsequent review if its answer is deemed valuable to the field.
4. Advancing Positive Psychological Interventions
Meta-analyses serve as summaries of the state of the field (i.e., what works, what does not work)
and highlight potential avenues for future exploration (e.g., moderator findings suggest design
considerations for future studies and possible mechanisms of action). As such, inclusion criteria
require conceptual sophistication, as many others will use these criteria to define what does and
does not belong within the scope of a field. The meta-analysis by Bolier and colleagues (2013)
surveyed a narrow selection of positive psychology interventions. Specifically, their criteria silo
the field by examining only those interventions that explicitly reference positive psychology and
that occurred after the formal founding of the field.
This approach is inconsistent with how positive psychology operates in both research and in
practice. Positive psychology draws heavily from previous movements including humanistic
psychology, community psychology, and virtue ethics. Its practices overlap with techniques
developed and practiced elsewhere including mindfulness (from Buddhist tradition), goal
pursuit (from cognitive therapy), and exploring values (from acceptance and commitment
therapy). It draws from traditions of research that long predate the term “positive psychology,”
but that are clearly relevant, including humor, positive emotion, forgiveness, savoring and
gratitude, among others. Researchers and practitioners in positive psychology do not draw the
arbitrary boundaries used by Bolier and colleagues (2013). Enforcing such a boundary, therefore,
paints a picture of the state of the field that is inaccurate.
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One goal of positive psychology is to provide “a balanced, empirically grounded, and
theoretically rich view of human experience” (Gable & Haidt, 2005, pg. 109). In light of this goal,
we should strive to be integrative and comprehensive in our methods rather than narrow and
specific. As an alternative to the approach used by Bolier and colleagues (2013), we posit that this
pathways component be based on accumulated knowledge of what impacts wellbeing. Positive
psychology is a broad tent and positive psychological interventions encompass a range of
techniques. Systematic reviews should address how well all of these practices work on average
and seek to gain advice about the best ways to design, explore, and implement these practices.
Conceptualizing what constitutes a positive psychological intervention, however, is just one
challenge for the field revealed by these recent meta-analyses. Another related issue, revealed by
the existing meta-analysis, as well as our definition, is what are the targets of interventions. Both
Bolier and colleagues (2013) and Sin and Lyubomirsky (2009) required that studies include
measures of wellbeing or depressive symptoms. Although wellbeing makes conceptual sense
from the framework of positive psychology, the use of depressive symptoms is a bizarre
attachment of intervention research in the field. After all, a core assumption of positive
psychology is that applied psychology (clinical, counseling, etc.) is insufficient for improving the
human condition, with its lengthy attachment to moving people from suffering (-5) to a normal
range of distress (-1). In addition, there is a need for interventions that move people from average
psychological and physical health (0) to a state of flourishing (+3 or higher) (Duckworth, Steen,
& Seligman, 2005). Based on this clearly articulated framework of positive psychology,
reductions in depressive symptoms (capturing nothing more than a reduction in psychological
distress) over the course of a positive psychological intervention offers nothing beyond the
primary outcomes being used in clinical psychology and psychiatry. Increasingly, positive
psychological interventions are being aimed at clinical populations, such as people with
schizophrenia (Meyer et al., 2012), smokers who wish to stop smoking (Kahler et al., 2014), and
suicidal inpatients (Huffman et al., 2013), but with the focus being on building the positive
aspects in these individuals as opposed to reducing the negative. A broader definition focusing
on positive psychological interventions will undoubtedly capture a broader range of targets and
outcomes and future analyses should ensure that outcome measures are aligned with the
conceptual framework of the interventions.
Conflict of Interest Statement
The authors declare that they have no competing interests.
Authors
Steven M. Schueller
Northwestern University
schueller@northwestern.edu
Todd Kashdan
George Mason University
tkashdan@gmu.edu
Acacia Parks
Hiram College
parksac@hiram.edu
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Publishing Timeline
Received 1 April 2014
Accepted 3 April 2014
Published 5 June 2014
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positive psychological interventions: A practice-friendly metaanalysis. Journal of Clinical Psychology,
65, 467-487. http://dx.doi.org/10.1002/jclp.20593
... Examples of well-known PPIs are interventions that try to enhance feelings of gratitude (Davis et al., 2016), optimism (Malouff and Schutte, 2017), or kind behavior (Curry et al., 2018). Whereas the ultimate aim of PPIs is to increase the well-being of an individual or group (Schueller et al., 2014), when considered in an organizational context PPIs may also be applied to indirectly enhance outcomes such as performance, job satisfaction, leadership skills, and worklife balance (Meyers et al., 2013). A recent meta-analysis on PPIs in a wide variety of contexts (Carr et al., 2020) concluded that PPIs have small to medium positive effects on outcomes related to well-being, and small to medium negative effects on outcomes related to ill-being. ...
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