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Adding Positive Psychology (PP) to Your Practice

March 18, 2014 Webinar: Pearson Assessments

Michael B. FrischProfessor of Psychology at Baylor University

Email: frisch@baylor.edu

Research Fellow of the International Society for Quality of Life

Founding Fellow in the Academy of Cognitive Psychotherapy,

Aaron T. Beck, Honorary President

Websites

• http://bearspace.baylor.edu/Michael_B_Frisch/www/

• www.wiley.com/go/frisch

• http://www.youtube.com/user/BaylorAcademics

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Plan for Today

• Thanks

• What is PP

• Why add PP

• Evidence based PP research

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Plan for Today

• How to add PP

• PP Using QOLI and QOLTC

• Target Populations for PP

• Tools/Resources

• Your questions, cases, populations

• Evals and goodies

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WHAT IS POSITIVE PSYCHOLOGY

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WHY ADD POSITIVE PSYCHOLOGY

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Ill-being vs. Well-being:

We’re missing half the picture!

Focus on Whole Not Half

Moaner Lisa Happy Lisa

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Tom Pre-Intervention (At Risk) © 2013, QOLI Profile Report, Pearson Assessments, All Rights Reserved.

Redress the Imbalance of Negative Psychology: Aaron T. Beck and David A. Clark

• “Therapists and psychologists have exhibited a depressive thinking style in their theories, research and treatment of psychological disorders.

• “We have tended to focus exclusively on the negative as in symptoms or what’s wrong with people…

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Aaron T. Beck and David A. Clark

• “Our preoccupation has been the relief of suffering, the alleviation of negative emotions…it is clearly not the whole story.

What’s Wrong with Health Care Today?

* “Treating negative mood will not automatically lead to happiness in our patients.

* “A new and expanded therapeutic perspective is needed that directly addresses issues of happiness, meaning, and contentment.

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Aaron T. Beck and David A. Clark

• “At last psychologists like Ed Diener, Martin Seligman and Michael Frisch have begun to redress this imbalance.”

WHY ADD POSITIVE PSYCHOLOGY

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1. Beef Up Your Assessments

Two goals in Healthcare today:

1. Cure /manage disease, disability, disorder

2. Preserve or enhance clients’ quality of life, well-being, and happiness.

Assess positive, not just negative health!

An intervention in itself…

2. Boost Your Clinical Effectiveness

Therapy + Positive Psychology =

or

Medication + Positive Psychology =

1. Greater Effectiveness

2. Relapse Prevention

--essential says Beck, Fava etc.

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3. COACHING: A Whole New Area of Practice and Source of Income.

• Aka Executive-, Professional-, Organizational Coaching

• Personal- and Life-Coaching

• Boost the Bottom Line

• Work with high achievers to be happier and more productive

Your Future inPositive Psychology Coaching

• International Coach Federation

• ippanetwork.org

• APA’s Division 13 - Society of Consulting Psychology

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4. Enliven Your Own Life and Practice

Greater Happiness and Ethics

How to Add Positive Psychology to Your Practice

• Give a Well-Being Test

• Develop Positive Goals

• Apply EBT Interventions

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Evidence-Based Positive Psychology.

Assessment: QOLI or Quality of Life Inventory

Intervention: Quality-of-Life-Therapy or

Quality of Life Therapy and Coaching/QOLTC

Independent Evaluations• Marty Seligman’s Flourish, pp. 292 & MAPP• Rashid & Seligman 2014• Textbooks: Carr; Compton & Hoffman• Ed Diener• Alan Kazdin• Robert Biswas-Diener and Ben Dean• See Frisch (2013) for details

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Quality of Life Therapy

Unique: Two NIH Trials by James R. Rodrigue of Harvard and Beth Israel

-3rd NIH Trial just funded and underway: ICDs-- implantable cardioverter defibrillators

-QOLI is validated too…sensitive to intervention-related change

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Rodrigue and others 2005Rodrigue and others 2006Rodrigue and others 2011Abedi and Vostanis 2010

Results of RCT:

From page 2430 of Rodrigue et al. 2005:

• “Several primary findings emerged from this study:

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1. “A brief, targeted psychological intervention, that is, Quality of Life Therapy, leads to significant improvements in quality of life, mood disturbance, and social intimacy

2.” Improvements in quality of life and mood appear to be maintained for as long as 3 months after treatment.

3. “While the treatment-as-usual protocol appears to yield some short-term benefits in mood, Quality of Life Therapy was found to be a more effective treatment overall for transplant patients.”

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Contagious to Caregivers

• “Caregivers whose spouses received QOLT reported vicarious gains in quality of life, mood, and social intimacy, relative to those who received the usual or standard intervention involving emotional and educational support.

• “These findings suggest that beneficial effects extend beyond the client to their spouses who are often caregivers.

• Rodrigue et al. (2006). Caregivers of patients awaiting lung transplantation: Do they benefit when the patient is receiving psychological services?Progress in Transplantation, 16, 336-342, pp. 336.

Replication of Rodrigue et al., 2005: Rodrigue et al. 2011, pp. 709

“The findings show that it is possible to improve

– quality of life,

– psychological functioning, and

– social intimacy

• with Quality of Life Therapy while patients wait for

[KIDNEY] transplantation.

• “The current study found that the Quality of Life Therapy group had superior quality of life outcomes relative to both Supportive Therapy and Standard Care groups.”

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1. Give Rationale (and Build Motivation)

2. Positive Psychology Assessment.

3. Positive Psychology Interventions

4. Re-Assessment, Fine Tuning, Outcome, Prophylactic Follow-ups.

QOLTC Four STEP

The Trinity of Happiness Benefits

1. H-Better HEALTH and HELPING :greater longevity

2. R-More rewarding RELATIONSHIPS

3. S-Greater SUCCESS in Work, School, Retirement Pursuits

– Use to sell Positive Psychology Interventions/Assessments to your clients and groups.

– Benefits are At Risk with low QOLI scores…1-3yrs advance

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Longevity: The Nun Study

Businesses with Happy Workers

• Lower healthcare costs

• Greater customer loyalty

• Lower employee turnover

• Greater productivity and creativity

• [Workers make more $; > liked by customers, clients]

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Worker Satisfaction & Firm ValueAlex Edmans (Wharton)

Companies with satisfied workers in ensuing years, have higher share prices, controlling for other starting factors.

Case

• Suicide in Texas is Redundant

• or Texas

• See Frisch 2013

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Texas (SITIR) Pre-Interv

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To make progress, we

have tomeasure it.

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© 2014, biweekly “PROGRESS REPORT”-Pearson Assessments, All Rights Reserved.

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Sweet 16 Recipe for Joy: 50-80%

BASIC NEEDS or “WEALTHS”

• Goals-and-Values

• Self-Esteem

• Health

• Money

RELATIONSHIPS

• Love

• Friends

• Relatives

• Children

ACTIVITIES:OCCUPATIONS-AVOCATIONS

• Play

• Work– Traditional Job

– Homemaker

– Retirement Pursuits

– Volunteer, etc.

• Helping

• Learning

• Creativity

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SURROUNDINGS

• Home

• Neighborhood

• Community

Five Paths to HappinessInstructions: Brainstorm possible solutions under each CASIO strategy for managing or solving a problem or for boosting your fulfillment and satisfaction in a valued area of life.

C A S I O

Changing Circumstances

ChangingAttitudes

Changing Goals and Standards

Changing Priorities or What’s Important

Boost Satisfaction in Other Areas not Considered Before

Basic Strategy: Basic Strategy: Basic Strategy: Basic Strategy: Basic Strategy:

Problem Solve to improve situation.

Find out what is really happening and what it means for you and your future.

Set realistic goals and experiment with raising and lowering standards. What new goals and standards can you come up with?

Re-evaluate priorities in life and emphasize what is most important and controllable.

Increase satisfaction in any areas you care about for an overall boost to happiness.

I need to decide whether to make peace with Ashley or keep “blowing” her off.50 WAYS…Job song…

Just ’cause Stan (husband) wantsto sit around and “watch” the grass grow, doesn’t mean I can’t travel to see the kids and grandkids.

Try for a Good NotGreat job at workthis week and seeif “the sky falls.”

Quit beating my head against the wall. I can’t change Stan (husband). Stop trying and “do your own thing” more.

Walking the mall, brings me to people and is the best “antidepressant” I got!

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Areas of Life

Pre and Post QOLI Comments and Interventions

PRE-INTERVENTION POST- INTERVENTION

GoalsAndValues

“I must put aside all my personal goals while I raise my family.”

Vision Quest Exercise-Life goals for valued areas of the QOLI-- Spiritual Life improved with Dzogchen

Master from Austin and Austin Zen Center

-” I forgive Morticia, my perp; she is dumb not malevolent” (Take A Letter)

Self-Esteem

Premorbid low from hypercritical mom

-” I’m a loser who failed to protect my daughter. I don’t deserve PT, therapy, or a lawyer”.

-Success Path-Journaling, Thought record

“My Self-esteem is up. I LIKE ME! I am a pretty good Mother. I stood by Annie. I took the blow for Annie, I’m a strong woman, who protected her kid like a cop taking a bullet for the president!

Now I know that I can get KNOCKED DOWN by a truck, and survive; that is pretty amazing!

I am a strong woman in the face of adversity.

Helping “ I wish I had something here.”

Helping Routine

“I know that I am here to teach others . This accident presented itself to me for my use. I’m here to serve others…I see much work to be done. I am not sure where to begin! Schools, sidewalks, crossing guards, city park, recycling, bike paths.

-“In ten years, the agony surrounding this injustice will have subsided. Hopefully WEcan look back and see that many measures were undertaken to better protect the thousands of children who walk to and from school every day.

-SAFETY ADVOCATE w/ husband. - cross walks at “scene of the crime”

Makes friends while volunteering at café run with homeless.

- See “Work” for mentoring project.

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Work “ I’ve been promoted out of what I love [high flows]. Too much supervising others!”

“ I’m the token woman on the grievance committee.”

“I’d like to mentor girls in science and engineering.”

Job Enrichment to make work a “Passionate Calling”

-“Work That Satisfies”

-Relationship Skills

LearningPlay

“Nada. None. My brain is mush”.

Playlist and Routine-Go to Baylor’s public lectures. EX. Titian, Women’s studies, Marley and me,

Edvard Munch.

-Learn re: advocacy causesCreativity “None” Pottery class at comm. college.

-lunch with instructor

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Friends “I have no friends in Texas and have been here eight years.”

Relationship skills-EXPERT friends or transplanted

Yankees doing well in “Bubba-land”

-YMCA, homeless café, pottery class

--Native Texans like “Mother Teresa”

-- ”shooting the crap outta stuff” at Guns R’ Us

Relatives Only call sisters at holidays.

“Skypes” weekly with Vermont sisters

Love Progress or Fine-Tuning QOLI: “Joe ,the Plumber,

betrayed me.”

Fooled on initial QOLI…Mating in Captivity

-Take a Letter-QOLI Exchange TechniqueTexas: 2 years to 10“You are uncommitted, out of

love…You don’t care that I was run over!

Joe’s Perfect Job: “You are my everything…-job hunt outside TX-advocate together!-couples friends & guns-FAT Time, Favor Bank, McDates,

Five Paths to Happiness

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SURROUN-

DINGS:

Home Cluttered and messy with family, animals, 15 yrs collecting furniture

LOVE IT, LEAVE IT OR FIX IT

Neighbor-hood

“Too conservative.” LOVE IT, LEAVE IT OR FIX IT

Community “Too redneck, conservative, dumb cowboys with no brains, hopeless dummy rednecks w/ no culture or brains or liberal values.”

LOVE IT, LEAVE IT OR FIX IT-learn to ferret out and appreciate the good

parts…

clinical psychology and mental health applications

Couples Therapy--QOLI Exchange Technique

MDD

GAD

Social phobia

Panic

Group therapy

Caregivers

Chemical dependency

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medical/behavioral medicine/OT applications

Cardiac rehab COPDKidney DiseaseCancerTBICaregiversOccupational therapyBariatric surgery

What you need to get started

• QOLI materials– “QOLI STARTER KIT”– QOLI Handbook

• Quality of Life Therapy (Frisch 2006)• http://www.amazon.com/exec/obidos/tg/detail/-/0471213519/qid=1116019877/sr=1-

1/ref=sr_1_1/103-4814745-3565452?v=glance&s=books

– Toolbox CD now online at wiley.com

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To Order QOLI

• Pearson Assessments– 800-627-7271 (7 AM – 6 PM Central Time

– www.psychcorp.com

• Use 10% Discount Code until 4/30/14:

“ I3E” [cap letters, case sensitive]

“You owe it to all of us to get on

with what you are good at!“

--W.H. Auden

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Thank You!!

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Case Conference: Your Questions, Cases, IA, EBTs from each Sweet 16

http://www.youtube.com/user/BaylorAcademics

Cliff Dancing (At Risk)Pre-Intervention © 2012, Pearson Assessments, All Rights Reserved.

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Cliff Dancing Post-Intervention

Cliff Dancing Takes the QOLI, Part I:When Assessment is Treatment or Causes An Epiphany

“After taking the QOLI for the first time I began to think about what I considered to be really important in my life. It is important for me to begin thinking this way considering that I am not far from the end of my life. Knowing what I consider to be most important will help me lead the life I really want. I believe that if I can figure out what is most important I can focus on that more. That’s how I can account for such different scores the second time around. I think that in my case taking the QOLI helped me to get into the mindset needed in order to make important decisions about how I would like to live my life”.

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Cliff Dancing Takes the QOLI, Part II:Put it in Writing!

• The QOLI forced me to look at each area of my life, evaluate my weaknesses in it, and devise a plan to strengthen those areas. I have never physically written down problems or goals for different aspects of my life. I found that the written word holds me more accountable than do my thoughts. Although I did not stay true to some of my goals, the quality of my life in other areas where I did pursue my goals increased.

Blessings

Count your blessings—the big and little things I’m grateful for

-8-in-1Powerhouse-start up menu-daily and cumulative

Accomplishments

Big and little things I got done todayor accomplished in the past.

Talents and Traits

Big and little things that I am good at

and that people like about me.

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References w/ underlined RCTsAbedi, M.R. and Vostanis, P. (2010). Evaluation of Quality of Life Therapy for parents of children with

obsessive-compulsive disorders in Iran. European Child and Adolescent Psychiatry. doi: 10.1007/s00787-010-0098-4 .

Ben-Porath, Y.S. (1997). Use of personality assessment instruments in empirically guided treatment planning. Psychological Assessment, 9, 361-367.

Biswas-Diener, R. and Dean, B. (2007) Positive Psychology Coaching. Hoboken, NJ: John Wiley and Sons.

Biswas-Diener, R. (2010) Practicing Positive Psychology Coaching. Hoboken, NJ: John Wiley and Sons.

Clark, D.A. Foreword. (2006). In M.B. Frisch, Quality of Life Therapy: Applying a Life Satisfaction Approach to Positive Psychology and Cognitive Therapy (pp. xi-x). Hoboken, New Jersey: John Wiley & Sons.

Clark, D. A., & Beck, A. T. (with Alford, B.) (1999). Scientific foundations of cognitive theory and therapy of depression. New York: Wiley.

Clark, M.P. & Mason, T.W. (2001). Implementation of a comprehensive system of program evaluation: The Iowa State University experience. Journal of College Student Development, 42, 28-35.

Crowley, M.J. & Kazdin, A.E. (1998). Evaluation in clinical practice: Critically sensitive and systematic methods of treatment delivery. Journal of Child and Family Studies, 7, 233-251.

Danovitch, I. and Endicott, J. (2008). Quality of life measures. In A. J. Rush & H. A. Pincus (Eds.), Handbook of psychiatric measures (2nd Edition). (pp. 125-140). Washington, DC: American Psychiatric Association.

Diener, E. Ng, W., Harter, J. & Arora (in press). Wealth and happiness across the world: Material prosperity predicts life evaluation, while psychosocial prosperity predicts positive feeling., Journal of Personality and Social Psychology.

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ReferencesEng, W., Coles, M. C., Heimberg, R. G., & Safren, S. A. (2001a). Quality of life following cognitive

behavioral treatment for social anxiety disorder. Depression and Anxiety, 13, 192–193.

Eng, W., Heimberg, R. G., Hart, T. A., Schneider, F. R., & Liebowitz, M. R. (2001b). Attachment in individuals with social anxiety disorder: The relationship among adult attachment styles, social anxiety, and depression. Emotion, 1,365–380.

Frisch, M.B. (2013). Evidence-Based Well-Being/Positive Psychology Assessment and Intervention with Quality of Life Therapy and Coaching and the Quality of Life Inventory (QOLI). Social

Indicators Research, 114, 193-227. doi: 10.1007/s11205-012-0140-7.

Frisch, M.B. (2006). Quality of Life Therapy. Hoboken, NJ: John Wiley & Sons.

Frisch, M. B. (1998). Quality of life therapy and assessment in health care. Clinical Psychology: Science and Practice, 5, 19–40.

Frisch, M. B., & Sanford, K. P. (2005). Construct validity and the search for a unidimensional factor solution: Factor analysis of the Quality of Life Inventory in a large clinical sample. Unpublished paper. Baylor University, Waco, TX.

Frisch, M. B., Clark, M. P., Rouse, S. V., Rudd, M. D., Paweleck, J., & Greenstone, A. (2005). Predictive and treatment validity of life satisfaction and the Quality of Life Inventory. Assessment, 12(1), 66-78.

Frisch, M. B., Cornell, J., Villanueva, M., & Retzlaff, P. J. (1992). Clinical validation of the Quality of Life Inventory: A measure of life satisfaction for use in treatment planning and outcome assessment. Psychological Assessment: A Journal of Consulting and Clinical Psychology, 4, 92–101.

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ReferencesFrisch, M. B. (1992). Use of the Quality of Life Inventory in problem assessment and treatment planning for cognitive therapy of depression. In A. Freeman & F. Dattilio (Eds.), Comprehensive casebook of cognitive therapy (pp. 27–52). New York: Plenum Press.

Frisch, M.B. (2009). QUALITY OF LIFE INVENTORY HANDBOOK For Laypersons, Clients, And Coaches. Minneapolis, MN: Pearson, Inc.

Frisch, M.B. (1994). QUALITY OF LIFE INVENTORY MANUAL and Treatment Guide.Minneapolis, MN: Pearson, Inc.

Furey R. Beyond Feeling Better: Adding Happiness to the Treatment Plan. PsycCRITIQUES [serial online]. 2007;52(5).

Grant, G., Salcedo, V., Hynan, L. S., & Frisch, M. B. (1995). Effectiveness of quality of life therapy. Psychological Reports, 76, 1203–1208.

Greene-Shortridge, T.M. and Odle-Dusseau, H.N. (2009). Quality of life. In S.J. Lopez (Ed.). Encyclopedia Of Positive Psychology (pp. 817-821). New York: Wiley-Blackwell. New York: Wiley-Blackwell.

Harter, J. K., Schmidt, F. L., & Hayes, T. L. (2002). Business-unit-level relationship between employee satisfaction, employee engagement, and business outcomes: A meta-analysis. Journal of Applied Psychology, 87, 268-279.

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ReferencesHeimberg, R. G. (2002). Cognitive-behavioral therapy for social anxiety disorder: Current status and

future directions. Biological Psychiatry, 51, 1101–1108.

Henning, E., Turk, C., Mennin, D., Fresco, D., & Heimberg, R. (2007). Impairment and quality of life in individuals with generalized anxiety disorder. Depression and Anxiety, 24(5), 342-349.

Judge, T., & Klinger, R. (2008). Job satisfaction: Subjective well-being at work. The science of subjective well-being (pp. 393-413). New York, NY US: Guilford Press

Kazdin, A. E. (1993). Evaluation in clinical practice: Clinically sensitive and systematic methods of treatment delivery. Behavior Therapy, 24, 11–45.

Kazdin, A. E. (2003). Research design in clinical psychology (4th ed.). Boston: Allyn & Bacon.

Koocher, G.P. & Keith-Spiegel, P. (2008). Ethics in Psychology: Professional standards and cases(3rd Ed.). New York: Oxford University Press.

Land, K. C. (2006). Quality of Life Therapy for All!: A review of Frisch’s approach to positive psychology, Quality of Life Therapy. SINET (Social Indicators Network News), 85, 1-4.

Lyubomirsky, S., King, L., & Diener, E. (2005). Happiness is a good thing: A model of the benefits of chronic positive affect. Psychological Bulletin, 131(6), 803-855.

Magyar-Moe, J.L. (2009). Therapist’s Guide to Positive Psychological Interventions. New York: Academic Press.

McAlinden, N., & Oei, T. (2006). Validation of the Quality of Life Inventory for patients with anxiety and depression. Comprehensive Psychiatry, 47(4), 307-314.

Mendlowicz, M.V. & Stein, M.B. (2000). Quality of life in individuals with anxiety disorders. American Journal of Psychiatry, 157, 669-682.

Miller, C.A. & Frisch, M.B. (2009). Creating Your Best Life: The Ultimate Life List Guide. New York: Sterling Publishing Co., Inc.

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ReferencesOgles, B. M., Lambert, M., & Masters, K. (1996). Assessing outcome in clinical practice. Boston: Allyn

& Bacon.

Parks-Shreiner, A. (2009). Applied positive psychology. In S.J. Lopez (Ed.). Encyclopedia Of Positive Psychology (pp. 58-62). New York: Wiley-Blackwell.

Persons, J. B., & Bertagnolli, A. (1999). Inter-rater reliability of cognitive-behavioral case formulations of depression: A replication. Cognitive Therapy and Research, 23, 271–283.

Peterson, C. (2006a). Back cover. In M.B. Frisch, Quality of Life Therapy: Applying a Life Satisfaction Approach to Positive Psychology and Cognitive Therapy (pp. back cover of book). Hoboken, New Jersey: John Wiley & Sons.

Peterson, C., & Rouse, S. (2006). Brief book, software, & test announcements. Journal of Personality Assessment, 87(3), 354-354.

Peterson, Christopher (2006b). A primer in positive psychology; New York, US: Oxford University Press.

Peterson, C., & Park, N. (in press). Positive psychology. In B. J. Sadock, V. A. Sadock, & P. Ruiz (Eds.), Comprehensive textbook of psychiatry (9th ed.). Baltimore: Lippincott, Williams, & Wilkins.

Peterson, C., Park, N., & Brunwasser, S. M. (in press). Positive therapy. In N. Kazantzis, M. A. Reinecke, & A. Freeman (Eds.), Cognitive behavior therapy: Using theory and philosophy to strengthen science and practice. New York: Guilford.

Pope, K.S. & Vasquez, M.J.T. (2007). Ethics in Psychotherapy and Counseling: A Practical Guide. New York: Jossey-Bass.

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ReferencesRashid, T. & Seligman, M. (2014). Positive psychotherapy (pp. 466; 461-498). In Raymond J. Corsini

(Author), Danny Wedding. Current Psychotherapies (10th Ed.). Belmont, CA: Brooks/Cole, Cengage Learning. ISBN: 978-1-285-08371-1.

Rodrigue, J. R., Baz, M.A., Widows, M.R. , & Ehlers, S.L. (2005). A Randomized Evaluation of Quality of Life Therapy with Patients Awaiting Lung Transplantation. American Journal of Transplantation, 5(10), 2425-2432.

Rodrigue, J.R., Widows, M.R., & Baz, M.A. (2006). Caregivers of patients awaiting lung transplantation: Do they benefit when the patient is receiving psychological services? Progress in Transplantation, 16, 336-342.

Rodrigue, J.R. Mandelbrot, D.A., and Pavlakis, M. (2011). A psychological intervention to improve quality of life and reduce psychological distress in adults awaiting kidney transplantation.

Nephrology Dialysis Transplantation, 26(2): 709-715. doi:10.1093/ndt/gfq382.

Safren, S. A., Heimberg, R. G., Brown, E. J., & Holle, C. (1997). Quality of life in social phobia. Depression and Anxiety, 4, 126–133.

Scogin, F., Morthland, M., Kaufman, A., Burgio, L., Chaplin, W., & Kong, G. (2007, December). Improving quality of life in diverse rural older adults: A randomized trial of a psychological treatment. Psychology and Aging, 22(4), 657-665.

Salek, S. (Ed.). (1998). Compendium of quality of life instruments. New York: Wiley.

Seligman, M.E.P. (2011). Flourish. New York: Free Press. See pp. 292 for Quality of Life Therapy and Coaching as an evidence-based approach that “works”.

Valois, R.F., Zullig, K.J., Huebner, E.S., Drane, J.W. (2001). Relationship between life satisfaction and violent behaviors among adolescents. American Journal of Health Behavior, 25, 353-366.

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