Positive Regard and Affirmation

Abstract

This chapter meta-analytically reviews the research on the association between therapist positive regard and treatment outcome. The history of the construct of unconditional positive regard in client-centered theory, as well as the efforts to operationalize and measure this construct, are reviewed. Several clinical examples are presented. The meta-analysis, which features 64 studies, yielded a small positive association between positive regard and treatment outcome, g = 0.28. To control for the repeated use of data sets and study samples within the database, a multilevel meta-analysis was adopted that indicated a stronger relation between positive regard and clinical outcome, g = 0.36. These analyses support positive regard’s standing as a significant component of the therapy relationship that leads to improved clinical outcomes. The chapter concludes with limitations of the research, patient contributions, diversity considerations, and practice recommendations.

“Take a sad song and make it better”: What makes an interpretation growth facilitating for the patient?

“…Supportive attitude is considered to be essential in SE as a basis for interpretation (Book, 1998). It is also consistent with the positive psychology notion of the importance of acceptance, positive regard, and the emphasis on the patient’s strengths (Farber et al, 2019; Wong, 2006). Another component of providing a good context was working harder to connect the interpretation with whatever went on before it.…”

“…The findings demonstrate one approach to integrating positive psychology conceptualizations and terms into psychodynamic frameworks to facilitate growth. We showed how more competent delivery of psychodynamic techniques can be characterized by a more collaborative, hopeful, and empowering attitude (Bartholomew et al, 2019; Coppock et al, 2010; Vilhauer et al, 2013) on the part of the therapist, stressing the patient’s strengths (Duckworth et al, 2005; Flückiger & Grosse Holtforth, 2008; Scheel et al, 2013), and offering acceptance and positive regard (Farber et al, 2019). These characteristics are consistent with the literature on positive psychology techniques for promoting well-being, specifically for helping with depressive symptoms (Layous et al, 2011; Sin & Lyubomirsky, 2009).…”

“…Next, we examined what the therapist was doing while delivering the interpretations. We found that she became better at encouraging collaboration with the patient and showing positive regard, being supportive, accepting, and attributing the insight to the patient herself, rather than delivering it from outside (Farber et al, 2019; Wachtel, 2011). The therapist was generally more inviting of the patient to collaborate in latter sessions, but she was less so in Session 8 than in Session 6.…”

“…The aim of GFI was to code for elements that are expected to affect the extent to which a given interpretation has the potential to facilitate growth and development, the context of the interpretation, and its immediate outcome. The GFI is based on the literature on psychodynamic techniques that facilitate growth (Leibovich & Zilcha-Mano, 2017; Leichsenring & Schauenburg, 2014; Safran & Muran, 2000; Wachtel, 2011), as well as on the positive psychology vantage point of growth-facilitating techniques (Bartholomew et al, 2019; Duckworth et al, 2005; Farber et al, 2019). The coding system was developed as follows: Initially, based on theoretical and clinical knowledge, the most important factors contributing to a growth-facilitating interpretation were chosen.…”

“…Supportive techniques are part of SE psychotherapy and may be a means to strengthen the alliance (Leibovich, Front, McCarthy, & Zilcha-Mano, 2019; Leibovich, Nof, Auerbach-Barber, & Zilcha-Mano, 2018), attenuate anxiety, and create a comfortable atmosphere of being understood and appreciated, thereby paving the way for further exploration (Book, 1998; Carsky, 2013; Wachtel, 2011). Consistent with the positive psychology framework, the supportive attitude creates an opportunity for experiencing a positive trusting relationship, a core component of the well-being experience (Keyes, 2005; Seligman, 2018), and for acceptance and positive regard, another core component of well-being experience (Farber, Suzuki, & Lynch, 2019). The SE framework suggests that interpretations that are provided together with a supportive platform are essential for the curative process of therapy (Book, 1998).…”