How to Add Positive Psychology to Your Practice

April 4, 2013 Webinar: Pearson Assessments

Michael B. Frisch Professor of Psychology at Baylor University Email: frisch@baylor.edu Websites: http://bearspace.baylor.edu/Michael_B_Frisch/downloads/ http://bearspace.baylor.edu/Michael_B_Frisch/www/ www.wiley.com/go/frisch http://www.youtube.com/user/BaylorAcademics Research Fellow of the International Society for Quality of Life Founding Fellow in the Academy of Cognitive Psychotherapy, Aaron T. Beck, Honorary President
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How to Add Positive Psychology to Your Practice

Give a Well-Being Test Develop Positive Goals Apply EBT Interventions

Plan for Today

Go through these steps in an actual case Take your cases and questions

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Definitions
Scientific study and promotion of: Happiness, meaning Positive goals and strengths Satisfaction with Life a la QOLI Subjective Well-being

What Whats Wrong with Health Care Today?

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 whats wrong with people
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Focus

Moaner Lisa

Happy Lisa

Aaron T. Beck and David A. Clark

Our preoccupation has been the relief of suffering, the alleviation of negative emotionsit is clearly not the whole story.

What Whats 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.

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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, wellbeing, and happiness. Assess positive, not just negative mental health

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2. Boost Your Clinical Effectiveness

Therapy + Positive Psychology = or Medication + Positive Psychology = 1. 2. Greater Effectiveness Relapse Prevention Positive Psychology Therapy

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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
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Your Future in Positive Psychology Coaching

R. Biswas-Diener & Ben Dean (2007) Frischs QOLTC: exciting evidence based empirically validated 2. APAs Division 13 - Society of Consulting Psychology 3. International Coach Federation 4. IPPA.org
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1.

EvidenceEvidence-Based Positive Psychology.

Assessment: QOLI or Quality of Life Inventory Intervention: QOLTC or Quality of Life Therapy and Coaching Independent Evaluations Marty Seligmans Flourish, pp. 292 & MAPP Ed Diener 2013 Alan Kazdin Robert Biswas-Diener See Frisch (in press) for details

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Quality of Life Therapy and Coaching (QOLTC) Unique: Two NIH Trials by James R. Rodrigue of Harvard and Beth Israel Superior to comparison treatments/interventions QOLI is sensitive to intervention-related change

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

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RCT Results
Rodrigue et al. 2005await lung transplant: QOLTC >usual, Supportive Tx at: one and three months in qol Move from low to average range on QOLI three months in mood disturbance one month in social intimacy with caregiver/spouse 2006 article Social contagion to caregivers: --caregivers get similar effects as patients in Rodrigue et al. 2005 without being in treatment!

2011replication with kidney transplant patients Abedi & Vostanis: Beleaguered Parents of OCD Kids Study 2010--parents of children with OCD

contagion effect like Rodrigue et al. 2006 where parents improved qol relative to controls is mirrored in children who did not get the QOLTC training.
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Results of RCT:
From page 2430 of Rodrigue et al. 2005: Several primary findings emerged from this study: 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.
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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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QOLTC Four STEP

1. 2. 3. 4.

Give Rationale (and Build Motivation) Positive Psychology Assessment. Positive Psychology Interventions Re-Assessment, Fine Tuning, and Outcome Evaluation

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The Trinity of Happiness Benefits

1. 2. 3. Better HEALTH and greater longevity More rewarding RELATIONSHIPS Greater SUCCESS in Work, School, Retirement, Volunteer Work.
Use to sell Positive Psychology Interventions-Assessments to your clients and groups. Benefits are At Risk with low QOLI scores

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Longevity: The Nun Study

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Worker Satisfaction & Firm Value

Alex Edmans (Wharton)

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

Lower healthcare costs Greater customer loyalty Lower employee turnover Greater productivity and creativity

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Ill-being vs. Well-being: Were missing half the picture!

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Case
Suicide in Texas is Redundant.
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Texas (SITIR) PrePre-Interv

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To make progress, we have to measure it.

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2012, biweekly PROGRESS REPORT REPORT-Pearson Assessments, All Rights Reserved.

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Sweet 16 Recipe for Joy

BASIC NEEDS or WEALTHS

Goals-and-Values Self-Esteem Health Money

RELATIONSHIPS Love Friends Relatives Children

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ACTIVITIES: OCCUPATIONSOCCUPATIONS-AVOCATIONS
Play Work
Traditional Job Homemaker Retirement Pursuits Volunteer, etc.

Helping Learning Creativity

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SURROUNDINGS
Home Neighborhood Community

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Areas of Life Goals And Values

Pre and Post QOLI Comments and Interventions PRE-INTERVENTION I must put aside all my personal goals while I raise my family. POST- INTERVENTION 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)

SelfEsteem

Premorbid low from -Success Path hypercritical mom -Journaling, Thought record - Im a loser who failed My Self-esteem is up. I LIKE ME! I am a to protect my daughter. pretty good Mother. I stood by Annie. I I dont deserve PT, took the blow for Annie, Im a strong therapy, or a lawyer. 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 car, and survive; that is pretty amazing! I am a strong woman in the face of 42 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. Im here to serve othersI 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 WE can 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 caf run with homeless. See Work for mentoring project.

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Work

Ive been promoted out Job Enrichment to make of what I love work a Passionate [high flows]. Calling Too much supervising -Work That Satisfies others! Im the token woman on the -Relationship Skills grievance committee. Id like to mentor girls in science and engineering.
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Learning Play

Nada. None. My brain is mush.

Playlist and Routine -Go to Baylors public lectures.

EX. Titian, Womens studies, Marley and me, Edvard Munch.

-Learn re: advocacy causes

Creativity

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 Bubbaland -YMCA, homeless caf, pottery class --Native Texans like Mother Teresa -- shooting the crap outta stuff at Guns R Us Skypes weekly with Vermont sisters

Relatives

Only call sisters at holidays.

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Love in Country Songs

Beauty's in the Eye of the Beerholder My Wife Ran Off With My Best Friend, and I Miss Him. You're the Reason Our Kids Are So Ugly

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Love

Progress or Fine-Tuning QOLI: Joe ,the Plumber, betrayed me.

Fooled on initial QOLIMating in Captivity -Take a Letter -QOLI Exchange Technique Texas: 2 years to 10 You are uncommitted, out of loveYou dont care that I was run over! Joes Perfect Job: You are my everything The Irish-Jewish wake Ive worked on super., crosswalks CASIO PS and 11/1 -job hunt outside TX -advocate together! -couples friends & guns -FAT Time, Favor Bank, McDates
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SURROUNDINGS:

Home

Cluttered and messy with family, animals, 15 yrs collecting furniture Too conservative.

LOVE IT, LEAVE IT OR FIX IT

Neighborhood

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 -CASIOs Changing Circumstances, Attitude of tolerance, forgiveness

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Five Paths to Happiness

Instructions: 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
Basic Strategy:

Changing Attitudes
Basic Strategy:

Changing Goals and Standards

Basic Strategy:

Changing Priorities or Whats Important Basic Strategy: Re-evaluate priorities in life and emphasize what is most important and controllable.

Boost Satisfaction in Other Areas not Considered Before Basic Strategy: Increase satisfaction in any areas you care about for an overall boost to happiness.

Problem Solve to improve situation.

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

I need to decide whether to make peace with Ashley or keep blowing her off. 50 WAYSJob song

Just cause Stan (husband) wants to sit around and watch the grass grow, doesnt mean I cant travel to see the kids and grandkids.

Set realistic goals and experiment with raising and lowering standards. What new goals and stan-dards can you Try come for a up Good with? Not Great job at

Quit beating my head against the work this week wall. I cant and see if the change Stan (husband). Stop sky falls. 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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Cliff Dancing (At Risk) PrePre-Intervention 2012, Pearson Assessments, All Rights Reserved.

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Cliff Dancing Post-Intervention

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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. Thats 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.

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Add Goals to YOUR QOLI. goals that pull you forward

High, challenging, and specific Intrinsic or from the heart Measureable, written, on the 7 oclock news! Supported by friendsPursued with friends?! Take out a contract (5 Ws, W W W W H)
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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 applications

Cardiac rehab COPD Kidney Disease Cancer TBI Caregivers Occupational therapy Bariatric surgery
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Blessings Count your blessings the big and little things Im grateful for -8-in-1 Powerhouse -start up menu -daily and cumulative

Accomplishments Big and little things I got done today or 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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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=11/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 4/30/13: I2R [cap letters, case sensitive]

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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

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References w/ underlined RCTs

Abedi, 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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References
Eng, 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, 192193. 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, 1,365380. Frisch, M.B. (in press). 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. doi: 10.1007/s11205-012-0140-7. Frisch, M. B. (2009a). Quality of Life Inventory. In S.J. Lopez (Ed.). Encyclopedia Of Positive Psychology (pp. 822-824). New York: Wiley-Blackwell. New York: Wiley-Blackwell. Frisch, M. B. (2009b). Quality of Life Therapy and Coaching (QOLTC). In S.J. Lopez (Ed.). Encyclopedia Of Positive Psychology (pp. 824-826). New York: Wiley-Blackwell. New York: Wiley-Blackwell. 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, 1940. 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 65 65 101.

References
Frisch, 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. 2752). 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, 12031208. 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: WileyBlackwell. 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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References
Heimberg, R. G. (2002). Cognitive-behavioral therapy for social anxiety disorder: Current status and future directions. Biological Psychiatry, 51, 11011108. 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, 1145. 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 Frischs 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). Therapists 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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References
Ogles, 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, 271283. 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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References
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, 126133. 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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