Positive psychology focuses on the characteristics of life that lead to happiness, fulfilment and flourishment. It takes the side of scientifically informed perspectives on what gives meaning to life and what makes it worth living (Dunlap, 1923). The aim of positive psychology is to focus on what is right with people rather than what is wrong with them; preventing mental illness rather than treating it (Dunlap, 1923). In the field of positive psychology, there are positive psychology interventions (PPIs) which are considered as a complementary strategy in mental health promotion and treatment (Haverman, Westerhof, Riper, Smit & Bohlmeijer, 2013). In a meta-analysis in 2013, the outcome of 39 studies, using positive psychology interventions, were analysed in terms of subjective well-being, psychological well-being and depression. The study found a small effect on all three domains. At a three and six month follow up, small yet significant effects were present for subjective and psychological well-being (Haverman, et, al., 2013)
In the terms of positive psychology, gratitude is an aspect that can be useful. Gratitude is the acknowledgement of what is valuable and meaningful to oneself; a general state of appreciation (Rash, Matsuba & Prkachin, 2011). An intervention that is used in positive psychology is keeping a gratitude journal. A gratitude journal is a diary that is used by individuals to write down things in their lives they are grateful for (Rash, et, al., 2011). They are often used for people who wish to focus on the positive, less materialistic characteristics of their lives. Gratitude journal templates are available for those who are struggling to write; which contain sub-headings to assist in journaling (Rash, et, al., 2011).
The intervention of keeping a gratitude journal was based off the results of a Person Activity Fit Diagnostic. After completing the diagnostic, the results revealed out of the 12-item scale, item one, counting your blessings: expressing gratitude for what you have or conveying appreciation; was the participants highest Fit Score. A high Fit Score indicates that these activities are likely to feel more natural, be more enjoyable, easier to sustain overtime, and have the greatest impact on happiness to an individual. A gratitude journal was chosen for the participant as she usually writes in a diary each day. Choosing an intervention with a familiar background may help the participant ease into the task and maintain it. Hence, the intervention of keeping a gratitude journal was chosen.
Underlying Theory
The aim of the intervention is to increase gratitude and overall mental health. In a study by Emmons and McCullough at the University of Miami in 2003, participants were asked to write a few sentences each week. One group were asked to write things they were grateful for, the second group wrote about daily irritants and the third were asked to write about events that affect them (not positive nor negative) (Emmons & McCullough, 2003). The results of the study illustrated that after ten weeks, those in the gratitude condition were more optimistic and in general felt better about their lives. It was found that they exercised more and had fewer physician visits then those in the irritant condition. (Emmons & McCullough, 2003)
Gratitude is often difficult to define in a study by … it is defined as gratitude as an affective trait, one’s overall tendency to have a grateful disposition (Emmons & Stern, 2013). The case study followed a female participant struggling to deal with her husband’s gambling addiction with the intervention of keeping a gratitude journal (Emmons & Stern, 2013) . At the end of the study, the participant was able shift her focus from a material crisis to using gratitude to focus on all the positive prospects she still had in her life. The participant was also reported to exercise more often during the gratitude writing period. The study indicates that increased gratitude is associated with increased physical and psychological health, greater happiness and life satisfaction, and reduced materialism (Emmons & Stern, 2013).
Positive psychology research has produced strong and consistent evidence that that gratitude is associated with happiness (Fredickson, 2001). A theory that may provide useful in explaining this relationship is the broaden-and-build theory of positive emotions (Fredrickson, 2001). The theory encompasses that negative emotions are short-lived experiences that can narrow a person’s momentary thoughts and actions, which can promote a quick plan of action. The theory also mentions that the presence of positive emotions results in vague non-specific actions often characterised by a lack of autonomic reactivity. This lack of autonomic reactivity opens the mind (Fredrickson, 2001). Hence, positive emotions may broaden an individuals’ momentary thought-action repertoires which can enable people to be more creative, think of novel ideas and increase problem solving. Over time this builds resilience. In turn this helps people build personal resources including the ability to be in the present moment, the ability to adapt to environmental change, the ability to receive emotional support and increase physical health (Fredrickson, 2001).
The aim of the study is to assess changes on The Mental Health Continuum Short Form (MHC-SF) and changes on a Gratitude questionnaire after implementing a daily gratitude journal. It should be expected that by keeping a gratitude journal which will increase the positive emotion of gratitude, which will broaden the mind increasing resilience and mental health. Hence, scores on both the GQ-6 and MHC-SF should increase during the intervention period.
Procedure
I tested the intervention of keeping a gratitude journal on myself as a single participant study. Over a five-week period, ten minutes per day were allocated to completing a gratitude journal.
Measures
The Mental Health Continuum Short Form (MHC-SF) (Keyes, 2009) has 14 items rated from 0 to 5, designed to measure emotional well-being (Keyes, 2006). The three dimensions of well-being measured are emotional (hedonic), social (eudaimonic) and psychological (eudaimonic) well-being. People can be classified as flourishing or languishing in regard to emotional well-being, or classified as moderate mental health if they are somewhere in between (Keyes, 2006). A higher score indicates greater emotional well-being. When the results of the MHC-SF were compared with an outcome questionnaire before treatment, a confirmatory factor analysis confirmed that the three-factor structure of emotional, psychological, and social well-being were present in the MHC-SF. The study concluded that it was a reliable and valid instrument in measuring well-being (Franken, Lamers, Klooste, Bohlmeijer & Westerhof, 2018).
The Gratitude Questionnaire-Six Item Form (GQ-6) (McCullough, Emmons & Tsang, 2002) has six items rated from 1 to 7 (where 1= strongly disagree and 7= strongly disagree). The GQ-6 was designed to gauge individual differences in the proneness to the experience gratitude in everyday life(Jans-Beken, Lataster, Leontjevas & Jacobs, 2015). In a 2015 study, it was discovered that high scores on the GQ-6 were strongly correlated with feeling more grateful, appreciative and thankful. GQ-6 scores was also found to be positively correlated with peers’ ratings of targets’ amount of dispositional gratitude (Jans-Beken, et, al., 2015). The GQ-6 has good internal consistency.
The measures were recorded one week before the intervention to gauge a baseline, at the end of each intervention week and one a week after the intervention had ceased.
Results
Overall, GQ-6 and MHF-SF scores increased in the study. Both variables increased steadily until week five except for a fluctuation in week three. GQ-6 and MHC-SF scores both slightly decreased in this week.
GQ-6 scores increased by 11.54% from a baseline level of 26 to a post-intervention measure of 29. The MHC-SF scores increased by 15.91% from a baseline measure of 44 to a post-intervention score of 51.
The main struggle I encountered when carrying out the intervention was lack of motivation. I would sit down in front of my journal for the ten minutes and struggle to write more than a sentence or two. After the first week it began to get a slightly easier, but, my motivation did not increase until I printed out a gratitude journal template. This template was a factor that supported my effort to continue the study and was implemented in week three of the intervention. The template allowed me to focus on ideas of what I have been grateful for as I was struggling to know exactly what to write. Implementing these print outs helped to increase my motivation towards the task.
Another factor that assisted me was my roommate would also check to make sure that I had written in my journal each day and during the last two weeks joined me in keeping a gratitude journal. I found this aided in increasing my motivation towards the task as doing it with someone else made the task feel more natural.
Although I struggled with the intervention at first, keeping a gratitude journal helped me to appreciate all the good things I have in my life and everything I have to look forward to each day. When taking a second to appreciate the good things in life, it made my attitude towards existence a lot more positive. The intervention overall made me feel happy and appreciative in general.
At the beginning of the intervention it felt quite forced and unnatural. When completing the journal each day it made me feel uncomfortable and quite agitated after the ten minutes were up. Although, it was difficult to continue the intervention at week two, as week three came it felt a lot more natural and I overcame the initial discomfort. However, as the weeks went on I began to enjoy keeping a journal. The time spent writing in the journal at the end of the five weeks was relaxing and made me feel positive.
Despite the struggle to maintain writing in the gratitude journal, there was only one day in week two that I did not write in the gratitude journal as I was busy with work, university and other commitments.
Discussion
The aim of the case study is to calculate changes on The Mental Health Continuum Short Form (MHC-SF) and changes on a Gratitude questionnaire after implementing a daily gratitude journal. In the study there was an increase of scores on the MHC-SF and an increase on Gratitude scores.
A strength of the study is that it contains detailed information that can provide insight into further research. The steps undertaken are high replicable to use on a bigger sample size. Another strength of the study is that everyday people can undergo the intervention at home. This is the case as the intervention was not costly nor very time consuming and can be replicated with only a piece of paper and a pen. A limitation of the study is that with a case-study method, it is difficult to generalise the results to a wider population as only one participant was used. This person results may be atypical from a general population, meaning although an effect was detected it may not be true for the majority of people. Another limitation of the study is that it is susceptible to experimenter bias. Experimenter bias is when the experimenter performing the research influences the result to portray an expected outcome. Hence, the experimenter (who was also the participant) may have biased the results by unconsciously or consciously recording higher MHC-SF and GQ-6 scores in the later weeks.
In future research a larger study should be conducted to examination if the effect is present among the general population. When commencing a gratitude journal in the future participants should receive a print out of a template to help guide them. This should help to increase motivation towards the task.
The goal of the study was to assess changes in Gratitude and MHC-SF scores during a five-week positive psychology intervention of keeping a gratitude journal. The study concluded that after this five-week period both gratitude and MHC-SF scores increased.
References
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GQ-6 Baseline Week 1 Week 2 Week 3 Week 4 Week 5 Post-test 26 26 29 27 29 31 29 MHC-SF Baseline Week 1 Week 2 Week 3 Week 4 Week 5 Post-test 44 46 49 48 52 55 51