Until now. But it has been a side note. What is positive psychology?

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1 Positive Psychology for Persons with Intellectual Disabilities and Mental Health Needs Breakout session for IN ABC Conference 2011 Dan Baker, Ph.D. Department of Pediatrics Boggs Center on Developmental Disabilities Robert Wood Johnson Medical School UMDNJ What is positive psychology? A branch of psychological inquiry that focuses on the experience of positive emotion and the role of healthy emotions in daily life Is this new? No Carl Rogers would say it is not (1951) A thank you to Rick Blumberg, Ph.D., of The College of New Jersey, who prepared some of these materials But it has been a side note Until now Psychology as a whole has been criticized as a field in which illness is studied rather than wellness. Negative emotions are the unit of analysis rather than positive emotions.

2 What has changed? Positive psychology researchers have amassed data on the effectiveness of interventions based on positive psychology (Seligmann, Steen, Park, & Peterson, 2005) The philosophy of positive psychology has an intuitive appeal for the general public as measured by the cover story on Time Magazine Another form of validation Cross-cultural studies show similar patterns of positive emotion across different cultures (Peterson & Seligman, 2004) This echoes the pioneering work in Wellness (Cannon, 1997) Strength-based Psychology Positive psychology represents a strength-based point of view a departure from more traditional psychology The focus is on character traits that lead to the experience of happiness whatever that is Do we know it when we see it?

3 Disability Supports Supports for people with disabilities have generally focused on the identification of a disability (a weakness), followed by the application of interventions to remediate that disability Examples Bethlem Royal Hospital (Bedlam) was the first known psychiatric hospital in 1403, with curable wards created in 1725 Oral School for the Deaf established by Samuel Heinicke in 1755 Massachusetts Asylum for the Blind opened in 1832 Establishment of special education classes by the State of New Jersey in 1911 The Idea Build it and they will come Come get your problems addressed Then return to productive life in mainstream society Does This Work for People with Chronic Disabilities? Some things don t go away Deafness is lifelong Deaf being a culture Mental Retardation is lifelong Autism is lifelong We all need to be proud of who we are The Cascade model generally does not cascade The readiness model leave people unready

4 New Philosophies in Disability Supports Community presence Strength-based support Meet preferences Teach access skills An Example with Employment Previously: You have an IDD so you go to a facility-based employment program Supported Employment: What do you want to do, what are you good at doing, and how do we support you in having that job Positive Emotions Case Example: Depression Charles is a 42 year old man with a mild ID and a history of depression. He was living in a group home with 4 other men. He had been treated with a number of anti-depressant medications with modest and non-lasting results. He had become increasingly withdrawn and refused most activities. He was losing weight.

5 A-B-C Analysis A-B-C-D Beliefs which precede negative mood changes are based on pessimistic explanatory styles, while positive mood changes are based on optimistic explanatory styles Skills for changing pessimistic explanatory styles: Distraction Distancing - Disputation Distraction Doing something to stop the internal pessimistic explanation: The person can use thought stopping, write it down, engage in a specific activity (replacement behavior) - listen to music - read or listen to something funny, do something physical (water plants, play with pet) Distancing A strategy for reminding ourselves (or the person) that pessimistic explanations for events are only one possible interpretation

6 Disputation Intervention: Charles An internal (or shared) dialogue to show there is an equally (or more) valid reason for adversity Method- make a list of all the alternative and optimistic reasons for an event or situation Outcomes Mood data (scale of 1-3) increased from a average of 1.1 to 2.5 weekly after 90 days and were maintained Began working a part-time job Maintained gym membership and fitness program A Quick Practice Tony S lives in northern New Jersey. He is in his 50s, uses a wheelchair, and has physical disabilities that are getting worse. He is starting to lose the ability to swallow, which means that he can no longer eat chunks of eggplant parmesan, his favorite food. As his life starts to feel like it is slipping away, he becomes increasingly angry and takes it out on others.

7 Distraction Distancing Disputation Let s divide the room into three parts, and each part gets on of the Ds. How could this D be used for Tony? Best Practices in Mental Health Supports Support for persons with mental illness present an interesting mix of a medical model approach with treatment of mental illness matched with a support-based model SAMHSA s Evidence-based Practices Standardized Pharmacological Treatment Illness Management and Recovery Assertive Community Treatment Family Psychoeducation Supported Employment Co-occurring Disorders: Integrated Dual Diagnosis Treatment Add an IDD and the mix becomes even more interesting An IDD creates the need for significant accommodation for interventions An IDD creates Differential Diagnosis concerns An IDD creates significant risk factors

8 What are some additional best practices for mental health supports? And Relaxation 1. Person-centered thinking (Illness Management and Recovery?) a. Work with individual to identify specific support needs b. Arrange support to address those needs c. Individual supports 2. Wellness approaches a. Support organized into wellness promotion b. Assist with healthy lifestyle and activity 3. Positive behavior supports a. Management of problem behavior relies upon identifying reasons for problem behavior b. Look into different areas of life in terms of understanding problem behaviors c. Intervention targets strength based planning, support identification, teaching and wellness approaches Where is the intersection? Strength-based Support Meet a person where they are Rather than focusing on something going away, focus on adding something What can we learn from Positive Psychology? In disability, supports many of already know a lot of what Positive Psychology teaches, but we do not know the specifics that Positive Psychology is researching

9 Virtues Related to Happiness Wisdom and knowledge Courage Humanity Justice Temperance Transcendence Interventions to Increase Happiness Gratitude visit Three good things in life You at your best Using signature strengths in a new way Identifying signature strengths (Seligman et al., 2005) Detailed instruction on increasing happiness via socialization and activity (Fordyce, 1977) Writing about positive experience (Burton & King, 2004) Gratitude journals (Emmons & McCullough, 2003 Count Your Blessings & Acts of kindess (Lyubomirsky et al., 2005) How Can We Adapt Interventions? Speed Number Abstraction Complexity Morasky, 2007 Reading & instruction on improving your life (Grant et al., 1995)

10 Further resources Carr, A. Positive Psychology (2004): The Science of Happiness and Human Strengths. New York: Routledge Duckworth, A., Steen, T., & Seligman, M. (2005). Positive psychology in clinical practice. Annual Review of Clinical Psychology, Morasky, R. (2007). Making counseling/therapy intellectually attainable. The NADD Bulletin, 10(3), pp Rogers, C. R. (1951). Client-centered therapy: Its current practice, implications, and theory. Boston: Houghton Mifflin. Seligman, M, Steen, T., Park, N., & Peterson, C. (2005). Positive psychology progress: Empirical validation of interventions. American Psychologist, 60, pp