Does gratitude writing improve the mental health of psychotherapy clients? Evidence from a randomized controlled trial
Abstract
Although the past decade has witnessed growing research interest in positive psychological interventions (PPIs), their potential as adjunctive interventions for psychotherapy remains relatively unexplored. Therefore, this article expands the frontiers of PPI research by reporting the first randomized controlled trial to test a gratitude writing adjunctive intervention for psychotherapy clients. Participants were 293 adults seeking university-based psychotherapy services. Participants were randomly assigned to one of three conditions: (a) control (psychotherapy only), (b) a psychotherapy plus expressive writing, and (c) a psychotherapy plus gratitude writing. Participants in the gratitude condition wrote letters expressing gratitude to others, whereas those in the expressive writing condition wrote about their deepest thoughts and feelings about stressful experiences. About 4 weeks as well as 12 weeks after the conclusion of the writing intervention, participants in the gratitude condition reported significantly better mental health than those in the expressive and control conditions, whereas those in the expressive and control conditions did not differ significantly. Moreover, lower proportions of negative emotion words in participants' writing mediated the positive effect of condition (gratitude versus expressive writing) on mental health. These findings are discussed in light of the use of gratitude interventions as adjunctive interventions for psychotherapy clients.
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There is rising evidence for the effectiveness of therapeutic writing interventions oriented towards more positive approaches.
“Currently, there is rising evidence for the effectiveness of therapeutic writing interventions oriented towards more positive approaches (e.g. writing about positive experiences (Burton and King, 2004) or gratitude (Wong et al., 2018)).”
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Skrzelinska, J., Ferreira, J. A., Linharelhos, M., Aguiar, E., & Matos, M. (2024) · Current Psychology · doi:10.1007/s12144-024-06974-7 · Cited by 5 · see citing works
Kotsoni, A., Kanellakis, K., & Stalikas, A. (2019) · Psychology · doi:10.4236/psych.2020.111002 · Cited by 3 · see citing works
The cultural improvement theory and the social sciences’ intellectual crisis
Oyarzo, F. (2020) · New Trends and Issues Proceedings on Humanities and Social Sciences · doi:10.18844/prosoc.v7i3.5226 · Cited by 3 · see citing works
Krysinska, K. E. (2018) · Advances in mental health and addiction · doi:10.1007/978-3-030-03225-8_5 · Cited by 3 · see citing works
Pangaribuan, H., & Qonitatin, N. (2021) · Jurnal EMPATI · doi:10.14710/empati.2021.32605 · Cited by 2 · see citing works
Gratitude Interventions in a Biology Course to Foster Student Persistence and Success
Gleason, L. U. (2022) · CourseSource · doi:10.24918/cs.2022.41 · Cited by 3 · see citing works
Positive Education: A New Way to Look at Learning
Jacobs, G. M., & Renandya, W. A. (2019) · Springer briefs in education · doi:10.1007/978-981-13-7213-1_8 · Cited by 2 · see citing works
Giving Thanks at Thanksgiving Point
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META ANALISIS GRATITUDE INTERVENTION PADA WELL-BEING
Wicaksono, L. (2021) · PSIKOLOGI KONSELING · doi:10.24114/konseling.v19i2.30439 · Cited by 2 · see citing works
From Emotion Beliefs to Regulatory Behavior: Gratitude Journaling Initiation and Outcomes
Yu, C.-W. F., Chang, Y.-P., Li, C.-H., & Wu, H.-Y. (2022) · Journal of Happiness Studies · doi:10.1007/s10902-022-00584-5 · Cited by 2 · see citing works
Yager, J., & Kay, J. (2023) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0000000000001717 · Cited by 2 · see citing works
Thornton, S. (2021) · British Journal of Child Health · doi:10.12968/chhe.2021.2.3.114 · Cited by 2 · see citing works
Davis, D. E., Ballantyne, N., Hook, J. N., & Tongeren, D. R. V. (2023) · The Journal of Positive Psychology · doi:10.1080/17439760.2022.2155231 · Cited by 2 · see citing works
Beliefs and Experience of Journaling in Mothers of Adult Children With Substance Use Problems
Kim‐Godwin, Y. S. (2021) · Journal of Addictions Nursing · doi:10.1097/jan.0000000000000410 · Cited by 1 · see citing works
Forum: Die Emotionalkörper-Therapie (EKT)
Neumann, M. (2022) · körper – tanz – bewegung · doi:10.2378/ktb2022.art10d · Cited by 1 · see citing works
TY: Facilitating social engagement to mitigate loneliness during transitory periods
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Strengthening the heart by means of a gratitude intervention?
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Session One: Positive Introduction and Gratitude Journal
Rashid, T., & Seligman, M. E. P. (2018) · Oxford University Press eBooks · doi:10.1093/med-psych/9780195325386.003.0007 · Cited by 1 · see citing works
Gil, M., Kim, S., Kim, D., & Kim, S. (2023) · Family Process · doi:10.1111/famp.12924 · Cited by 1 · see citing works
Recognizing the Past to Facilitate Healing in the Future: The ALLOW Model
Mete, R. E. (2024) · The Family Journal · doi:10.1177/10664807241300706 · Cited by 1 · see citing works
Rashid, T., & Seligman, M. (2018) · Oxford University Press eBooks · doi:10.1093/med-psych/9780195325386.003.0001 · Cited by 1 · see citing works
Rashid, T., & Seligman, M. (2018) · Oxford University Press eBooks · doi:10.1093/med-psych/9780195325386.003.0003 · Cited by 1 · see citing works
Rashid, T., & Seligman, M. (2018) · Oxford University Press eBooks · doi:10.1093/med-psych/9780195325386.003.0005 · Cited by 1 · see citing works
Selected Happiness-Increasing Interventions for Tourism and Hospitality Workers
Ehrlich, C., Milston, S., & van der Veen, R. (2021) · Advances in hospitality, tourism and the services industry (AHTSI) book series · doi:10.4018/978-1-7998-7239-9.ch005 · Cited by 1 · see citing works
Проявления благодарности во время эпидемии COVID-19
Сурдейкин, Е., & Нартова-Бочавер, С. (2023) · Психологические исследования · doi:10.54359/ps.v16i87.1347 · Cited by 1 · see citing works
Words and Action: Measuring Interpersonal Expressions of GratitudePreprint
Wong, Y. J., Cauble, M. R., Davis, D. E., Pandelios, A. L., Li, P. F. J., & Cho, N. (2023) · SSRN Electronic Journal · doi:10.2139/ssrn.4671277 · Cited by 1 · see citing works
Self-citationPositive Psychotherapy Inventory
Rashid, T., & Seligman, M. (2018) · Oxford University Press eBooks · doi:10.1093/med-psych/9780195325386.005.0003 · Cited by 1 · see citing works
Sessions, Practices, and the Therapeutic Process
Rashid, T., & Seligman, M. (2018) · Oxford University Press eBooks · doi:10.1093/med-psych/9780195325386.003.0006
The Centrality of Character Strengths and How to Use Them in Positive Psychotherapy
Rashid, T., & Seligman, M. (2018) · Oxford University Press eBooks · doi:10.1093/med-psych/9780195325386.003.0004
Positive Interventions and Theoretical Assumptions
Rashid, T., & Seligman, M. (2018) · Oxford University Press eBooks · doi:10.1093/med-psych/9780195325386.003.0002
Necesitamos un periodismo honesto.
Castellano, N. (2013) · Mugak
Session Fifteen: Meaning and Purpose
Rashid, T., & Seligman, M. E. P. (2018) · Oxford University Press eBooks · doi:10.1093/med-psych/9780195325386.003.0021
Session Eleven: Slowness and Savoring
Rashid, T., & Seligman, M. E. P. (2018) · Oxford University Press eBooks · doi:10.1093/med-psych/9780195325386.003.0017
Rashid, T., & Seligman, M. E. P. (2018) · Oxford University Press eBooks · doi:10.1093/med-psych/9780195325386.003.0012
Session Four: A Better Version of Me
Rashid, T., & Seligman, M. E. P. (2018) · Oxford University Press eBooks · doi:10.1093/med-psych/9780195325386.003.0010
Session Three: Practical Wisdom
Rashid, T., & Seligman, M. E. P. (2018) · Oxford University Press eBooks · doi:10.1093/med-psych/9780195325386.003.0009
Session Five: Open and Closed Memories
Rashid, T., & Seligman, M. E. P. (2018) · Oxford University Press eBooks · doi:10.1093/med-psych/9780195325386.003.0011
Session Ten: Posttraumatic Growth
Rashid, T., & Seligman, M. E. P. (2018) · Oxford University Press eBooks · doi:10.1093/med-psych/9780195325386.003.0016
Session Two: Character Strengths and Signature Strengths
Rashid, T., & Seligman, M. E. P. (2018) · Oxford University Press eBooks · doi:10.1093/med-psych/9780195325386.003.0008
Session Twelve: Positive Relationships
Rashid, T., & Seligman, M. E. P. (2018) · Oxford University Press eBooks · doi:10.1093/med-psych/9780195325386.003.0018
Session Nine: Hope and Optimism
Rashid, T., & Seligman, M. E. P. (2018) · Oxford University Press eBooks · doi:10.1093/med-psych/9780195325386.003.0015
Session Seven: Maximizing versus Satisficing
Rashid, T., & Seligman, M. E. P. (2018) · Oxford University Press eBooks · doi:10.1093/med-psych/9780195325386.003.0013
- Authors
- Wong, Y. J., Owen, J., Gabana, N. T., Brown, J. W., McInnis, S., Toth, P., & Gilman, L.
- Affiliations
- Indiana University Bloomington (US)
- University of Denver (US)
- University of Mississippi Medical Center (US)
- Corresponding author
- Wong, Y. Joel
- Venue
- Psychotherapy Research
- Publisher
- Informa UK Limited
- Published
- 2016-05-03
- Volume
- 28
- Issue
- 2
- Pages
- 192-202
- ISSN
- 1050-3307 (ISSN-L)
- 1468-4381
- OpenAlex
- W2345774771
- Cited by
- 127
- References
- 53
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 16 · 2023: 16 · 2022: 9 · 2021: 11 · 2020: 12 · 2019: 10 · 2018: 36 · 2017: 3 · 2016: 2 · 2015: 1 · 2013: 1
- FWCI
- 26.69
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychotherapy Research (publishedVersion)
- PubMed (publishedVersion)
- Digital Commons - DU (University of Denver) (submittedVersion)
- Funders
- John Templeton Foundation
- Topics
- Social Sciences › Psychology › Social Psychology › Psychological Well-being and Life Satisfaction
- Social Sciences › Psychology › Social Psychology › Mental Health via Writing
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- expressive writing, positive psychology interventions, adjunctive psychotherapy, mental health, negative emotion words, mediation, gratitude letter
- MeSH terms
- Adult, Mental Disorders, Emotions, Female, Humans, Interpersonal Relations, Male, Psychotherapy, Writing, Outcome Assessment, Health Care, Young Adult
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