The effectiveness of subjective well-being training in a non-patient sample: A follow-up study’.
Introduction
The concept of Quality of Life (QoL) begins to emerge
in industrialized societies since the mid-1960s and it is
opposed to an economic and quantitative vision of our
social development. In the face of a vision of social
well-being as an ever-increasing possession of material
goods, a new perception of well-being and a further
need for individual happiness are seen as a qualitative
improvement of life (Goldwurm et al. 2004). As
pointed out even more recently by Bauman (2011),
often the crucial elements for happiness – love and
friendship, the satisfaction of taking care of our loved
ones, self-esteem, freedom from offenses and humiliation,
etc. – they do not have a market price and can not
be bought in stores. Objective indicators considered
up to the 1960s in QoL studies (eg income, housing,
health) are insufficient and must be accompanied by
subjective indicators that reflect the perception of one's
well-being and the satisfaction of one's own
aspirations
(Goldwurm 1995). Aspects that have become
central to the development of positive psychology.
Different reviews indicate the effectiveness of positive
psychology interventions to promote well-being
among a variety of populations, and in a growing
number of real-world contexts (Bolier et al. 2013;
Hone et al. 2015). Michael W. Fordyce is recognized as
a pioneer in the scientific study of happiness (Friedman
2013). His studies (Fordyce 1972, 2000) focused on the
aspects that happy people share and that can be learned
by most individuals thanks to the program based on
the so-called "The Fourteen Fundamentals":
1. Be more active and keep busy.
2. Spend more time socializing.
3. Be productive at meaningful work.
4. Get better-organized and plan things out.
5. Stop worrying.
6. Lower your expectations and aspirations.
7. Develop positive optimistic thinking.
8. Get present-oriented.
9. WOAHP - work on a healthy personality.
10. Develop an outgoing, social personality.
11. Be yourself.
12. Eliminate the negative feelings and problems.
13. Close relationships are #1 source of happiness.
14. VALHAP – the "secret fundamental".
In the Fordyce model (1977) happiness is considered
a condition characterized by both an active, sociable
and meaningful lifestyle for the person and a style
of thought oriented to the present and to optimism.
Fordyce (1977, 1983, 1988) demonstrated the effectiveness
of the programme of the 14 fundamental of happiness
in a series of empirical studies that verified how
participants can develop the characteristics of happy
people and thus increase their happiness. The intervention
includes a wide range of strategies – ranging from
cognitive restructuring to assertive techniques –based
on a) the observation of oneself, b) the comparison with
others’ behaviour, c) the development of awareness and
environmental contingencies self-control skills.
In Italy, starting from Fordyce's research, a group
training was developed to improve personal well-being,
called Subjective Well-Being Training (SWBT), a path
of change through cognitive-behavioral strategies
(Goldwurm et al. 2003). In previous research, SWBT
has proven effective in promoting subjective well-being
(Colombo et al. 2012; Goldwurm et al. 2007). Aim
of the present study is to verify whether intervention
changes remain effective in the long term.
Material and methods
Participants
The effectiveness of the SWBT intervention was verified
with a quasi-experimental methodology. Participants
(N = 63) voluntarily chose the course to follow.
The experimental group (N = 35; 3 males; 32 females)
consists of 4 SWBT courses which followed the same
program. Participants in the control group (N = 28;
8 males; 20 females) practiced yoga or sports at an
amateur level. The experimental group is made up
of a greater number of women than the control group
(χ2 = 4.317 p<0.05). The two groups showed similar
features as concerns age (mean age of 39.8 std.dev. 6.9),
marital status (25 married), schooling (23 graduated)
and work (32 employee).
Procedures
The inclusion criterion is the will of the subject
to follow the chosen activity (SWBT or Yoga / Sport)
while frankly pathological subjects have been excluded.
Participants (N = 63) were assessed at the same time
before (t1) and after (t2) the SWBT, and then again after
a year follow up (t3). SWBT (8 two-hour meetings, one
every three weeks) explores each “fundamental” in
depth though: giving information, group discussion,
exploration of personal experiences and homework
(Goldwurm et al. 2004).
Measures
Subjective well-being scales and general self-report
inventory assessing pathological symptoms were
administered to all participants.
The Satisfaction with Life Scale (SWLS) is a 5-Items
self-report instrument on a 7-point Likert scale. It
assesses personal satisfaction, the cognitive aspect
of happiness (Diener et al. 1985).
The 80 items Psychap Inventory (PHI) which
consists of forced choice statements, each sampling a
characteristic useful to distinguish happy from unhappy
people. It has four subscales investigating: Achieved
Happiness (Ach), Happy Personality (Per), Happy Attitudes
and Values (Att), Happiness Life-style (Life). The
subscales are combined to create the Total Score for the
test (Fordyce 1988).
The Happiness Measure (HM) evaluates emotional
well-being (Fordyce 1985) consists of two items: a) an
11-point happiness/unhappiness scale; b) a question
investigating the amount of the time spent in happy,
unhappy and neutral moods. These two items are
combined to create the Combination Score (HM-Co).
The Symptom Checklist-90-R (SCL-90-R) consists
of 90 items to assess nine primary symptom dimensions
(somatization, obsessive-compulsive, interpersonal
sensitivity, depression, anxiety, hostility, phobic anxiety,
paranoid ideation, psychoticism) and it offers a general
index (Derogatis 1994).
Statistical analysis
The use of non-parametric statistics appears more suitable
in the case of limited number of samples. Nonparametric
tests must respect fewer constraints than
parametric ones (such as checking the shape of population
distribution) but they can be just as powerful (Siegel
& Castellan 1988). Statistical analysis (Wilcoxon Signed
Ranks Test, Friedman Test, Kolmogorov-Smirnov) was
conducted using SPSS 13.0 software for Windows.
Results
Table 1 shows the means and standard deviations for
well-being and pathological measures for the experimental
and the control group pre, post and follow up
treatment, and Friedman Test. It also shows Wilcoxon
Signed Ranks Test for pre and follow up treatment
comparison. Participants who attended the SWBT
reported a significant global improvement in happiness,
satisfaction with life and emotional well-being (the
only subscale did not maintain the improvement at the
follow-up is Att). The control group report a significant
worsening.
Table 2 shows Kolmogorov-Smirnov for betweengroup
analysis at pre, post and follow-up treatment. The performance of the experimental group was lower than
that of the control group at the pre test, but better at the
follow-up.
Discussion
Happiness could be considered a fleeting emotion,
out of the individual’s control. Otherwise, it could be
considered as a lasting condition based on personality,
attitudes, values, and life-style. This second point
of view, which is certainly more useful to scientific
research, can be used to promote health and psychological
well-being, a desirable goal according to the
World Health Organization (WHO): “Mental wellbeing
is a fundamental component of WHO’s definition
of health. Good mental health enables people to realize
their potential, cope with the normal stresses of life,
work productively, and contribute to their communities"
(WHO 2013).
The outcomes of this study confirm that the SWBT
proves effective in improving subjective well-being both
in its emotional and cognitive aspects in a non-patient
sample. This improvement is achieved with 8 two-hour
meetings (16 total hours) and it is confirmed afterwards
a one year follow up. Our study has substantial limitations
that should be considered. We must remember
that the decision to attend SWBT could be related
to a higher motivation to change, and this could have
influenced the results of these participants who asked
to attend the training. A further limitation of our study
is the relatively small sample size.
The Fordyce model has been used also in clinical
settings, for example to help multiple sclerosis patients
manage symptoms of depression, stress and fatigue
(Khayeri et al. 2016), to increase the quality of life in
hospitalized patients diagnosed with diabetes and
cancer (Karimaali & Saba 2013) or on postpartum
depression (Rabiei et al. 2014). Future research should
implement the SWBT in clinical and therapeutic
contexts.
Conclusion
The need for an integrated perspective, which overcomes
the positive / negative contrast, is increasingly
evident: positive psychology can also contribute to clinical
psychology and psychotherapy (Maddux et al. 2004; Rashid 2015).
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