New Applications of Well-Being Therapy

Titolo Rivista RIVISTA SPERIMENTALE DI FRENIATRIA
Autori/Curatori Giada Benasi, Jenny Guidi, Chiara Rafanelli, Giovanni A. Fava
Anno di pubblicazione 2019 Fascicolo 2019/1
Lingua Inglese Numero pagine 20 P. 87-106 Dimensione file 1827 KB
DOI 10.3280/RSF2019-001006
Il DOI è il codice a barre della proprietà intellettuale: per saperne di più clicca qui

Qui sotto puoi vedere in anteprima la prima pagina di questo articolo.

Se questo articolo ti interessa, lo puoi acquistare (e scaricare in formato pdf) seguendo le facili indicazioni per acquistare il download credit. Acquista Download Credits per scaricare questo Articolo in formato PDF

Anteprima articolo

FrancoAngeli è membro della Publishers International Linking Association, Inc (PILA)associazione indipendente e non profit per facilitare (attraverso i servizi tecnologici implementati da CrossRef.org) l’accesso degli studiosi ai contenuti digitali nelle pubblicazioni professionali e scientifiche

Well-Being Therapy (WBT) is a short-term psychotherapeutic strategy that emphasizes self-observation of psychological well-being, with the use of a structured diary, cognitive restructuring of interfering thoughts and/or behaviors through cognitive behavioral techniques, and homework assignments (i.e., pursuing optimal experiences). It is based on a multidimensional model of psychological wellbeing that was originally developed by Marie Jahoda and it is aimed at achieving a state of euthymia. An important characteristic is self-observation of psychological well-being associated with specific homework. Such perspective is different from interventions that are labelled as positive but are actually distress oriented. WBT has been validated in a number of randomized controlled trials concerned with relapse prevention in depression and with increasing the level of recovery in affective disorders. An important feature of WBT is the assumption that imbalances in well-being and distress may vary from patient to patient and need specific assessment strategies. The aim of this paper was to provide an updated review of WBT and to illustrate how the clinical insights gained by the use of WBT may unravel innovative approaches in the setting of medical disease. A clinical case that exemplifies its application and potential role in producing lifestyle changes in metabolic syndrome is illustrated. It is argued that lifestyle changes can only be achieved with a personalized approach that targets psychological well-being.

La Well-Being Therapy (WBT) è una strategia psicoterapeutica breve che incoraggia l’autosservazione del benessere psicologico per mezzo di un diario strutturato, di tecniche cognitivo-comportamentali per la ristrutturazione cognitiva di pensieri e/o comportamenti che interferiscono con il raggiungimento del benessere, e l’assegnazione di compiti a casa (ovvero, perseguendo esperienze ottimali). La WBT si fonda su un modello multidimensionale di benessere psicologico, che è stato originariamente sviluppato da Marie Jahoda, e il cui obiettivo è quello di raggiungere uno stato di eutimia. Un’importante caratteristica della terapia è l’autosservazione del benessere psicologico associata alla messa in atto di specifici compiti. Tale prospettiva è diversa da quella di interventi psicologici che vengono classificati come "positivi" ma che in realtà si focalizzano sulla sofferenza. La WBT è stata validata in diversi studi randomizzati e controllati riguardanti la prevenzione delle ricadute nella depressione e il miglioramento dei livelli di guarigione nei disturbi affettivi. Un aspetto importante della WBT è l’assunzione che gli squilibri nei livelli di benessere e sofferenza possano variare da paziente a paziente e necessitino di strategie di valutazione specifiche. L’obiettivo di questo articolo è quello di fornire una rassegna aggiornata della WBT e di illustrare come le intuizioni cliniche ottenute con l’utilizzo della WBT possano svelare modalità di approccio innovative nell’ambito delle condizioni mediche. Viene inoltre presentato un caso clinico che esemplifica l’applicazione e il ruolo potenziale della WBT nel produrre cambiamenti nello stile di vita nella sindrome metabolica. Si sostiene che i cambiamenti nello stile di vita possono essere ottenuti solo attraverso un approccio personalizzato rivolto al benessere psicologico.

Keywords:Benessere psicologico, Well-Being Therapy, psicoterapia, stile di vita.

  1. [1] Fava GA. Well-being therapy: conceptual and technical issues. Psychotherapy and Psychosomatics 1999; 68(4): 171-9. DOI: 10.1159/000012329
  2. [2] Fava GA. Well-being therapy treatment manual and clinical applications. Basel: Karger; 2016.
  3. [3] Jahoda M. Current concepts of positive mental health. New York, NY, US: Basic Books; 1958.
  4. [4] Ryff CD. Psychological well-being revisited: advances in the science and practice of eudaimonia. Psychotherapy and Psychosomatics 2014; 83(1): 10-28. DOI: 10.1159/000353263
  5. [5] Rafanelli C, Park SK, and Fava GA. New psychotherapeutic approaches to residual symptoms and relapse prevention in unipolar depression. Clinical Psychology & Psychotherapy 1999; 6(3): 194–201.
  6. [6] Fava GA. Well-Being Therapy: current indications and emerging perspectives. Psychotherapy and Psychosomatics 2016; 85(3): 136–145. DOI: 10.1159/000444114
  7. [7] Fava GA, Cosci F, Guidi J, Tomba E. Well-being therapy in depression: new insights into the role of psychological well-being in the clinical process. Depression and Anxiety 2017; 34(9): 801-8.
  8. [8] Quoidbach J, Mikolajczak M, Gross JJ. Positive interventions: an emotion regulation perspective. Psychological Bulletin 2015; 141(3): 655-693.
  9. [9] Csikszentmihalyi M, Csikszentmihalyi IS. Optimal experience : psychological studies of flow in consciousness. New York, NY: Cambridge University Press; 1988.
  10. [10] Fava GA, Bech P. The concept of euthymia. Psychotherapy and Psychosomatics 2016; 85(1): 1-5. DOI: 10.1159/000441244
  11. [11] Fava GA, Rafanelli C, Tomba E. The clinical process in psychiatry: a clinimetric approach. Journal of Clinical Psychiatry 2012; 73(2): 177-184.
  12. [12] Moeenizadeh M, Salagame KK. The impact of well-being therapy on symptoms of depression. International Journal of Psychological Studies 2010; 2(2): 223-230.
  13. [13] Emmelkamp P, Bouman T, Scholing A. Anxiety Disorders: a practitioner’s guide. Chichester, UK: John Wiley & Sons, Ltd; 1992.
  14. [14] Cosci F, Fava GA. Staging of mental disorders: systematic review. Psychotherapy and Psychosomatics 2013; 82(1): 20-34. DOI: 10.1159/000342243
  15. [15] Guidi J, Tomba E, Cosci F, Park SK, Fava GA. The role of staging in planning psychotherapeutic interventions in depression. Journal of Clinical Psychiatry 2017; 78(4): 456-463.
  16. [16] Fava GA, Ruini C, Rafanelli C, Finos L, Conti S, Grandi S. Six-year outcome of cognitive behavior therapy for prevention of recurrent depression. American Journal of Psychiatry 2004; 161(10): 1872-6.
  17. [17] Stangier U, Hilling C, Heidenreich T, Risch AK, Barocka A, Schlösser R et al. Maintenance cognitive-behavioral therapy and manualized psychoeducation in the treatment of recurrent depression: a multicenter prospective randomized controlled trial. American Journal of Psychiatry 2013; 170(6): 624-632.
  18. [18] Kennard BD, Emslie GJ, Mayes TL, Nakonezny PA, Jones JM, Foxwell AA et al. Sequential treatment with fluoxetine and relapse-prevention CBT to improve outcomes in pediatric depression. American Journal of Psychiatry 2014; 171(10): 1083-1090.
  19. [19] Fava GA, Ruini C, Rafanelli C, Finos L, Salmaso L, Mangelli L et al. Well-being therapy of generalized anxiety disorder. Psychotherapy and Psychosomatics 2005; 74(1): 26-30. DOI: 10.1159/000082023
  20. [20] Ramana R, Paykel ES, Cooper Z, Hayhurst H, Saxty M, Surtees PG. Remission and relapse in major depression: a two-year prospective follow-up study. Psychological Medicine 1995; 25(6): 1161-70.
  21. [21] Fava GA, Ruini C, Belaise C. The concept of recovery in major depression. Psychological Medicine 2007; 37(3): 307-317. DOI: 10.1017/S0033291706008981
  22. [22] Clarke K, Mayo-Wilson E, Kenny J, Pilling S. Can non-pharmacological interventions prevent relapse in adults who have recovered from depression? A systematic review and meta-analysis of randomised controlled trials. Clinical Psychology Review 2015; 39: 8-70.
  23. [24] Fava GA. Sequential treatment: a new way of integrating pharmacotherapy and psychotherapy. Psychotherapy and Psychosomatics 1999; 68(5): 227-9. DOI: 10.1159/000012338
  24. [25] Guidi J, Tomba E, Fava GA. The sequential integration of pharmacotherapy and psychotherapy in the treatment of major depressive disorder: a metaanalysis of the sequential model and a critical review of the literature. American Journal of Psychiatry 2016; 173(2): 128-137.
  25. [26] Wood AM, Joseph S. The absence of positive psychological (eudemonic) well-being as a risk factor for depression: a ten year cohort study. Journal of Affective Disorders 2010; 122(3): 213-7.
  26. [27] Risch AK, Taeger S, Brüdern J, Stangier U. Psychological well-being in remitted patients with recurrent depression. Psychotherapy and Psychosomatics 2013; 82,(6): 404-5. DOI: 10.1159/000351808
  27. [28] Penn DL, Mueser KT, Tarrier N, Gloege A, Cather C, Serrano D et al. Supportive therapy for schizophrenia: possible mechanisms and implications for adjunctive psychosocial treatments. Schizophrenia Bulletin 2004; 30(1): 101-12.
  28. [29] Fava GA, Rafanelli C, Tomba E, Guidi J, Grandi S. The sequential combination of cognitive behavioral treatment and well-being therapy in cyclothymic disorder. Psychotherapy and Psychosomatics 2011; 80(3): 136-143. DOI: 10.1159/000321575
  29. [30] Ruini C, Belaise C, Brombin C, Caffo E, Fava GA. Well-being therapy in school settings: a pilot study. Psychotherapy and Psychosomatics 2006; 75(6): 331-6. DOI: 10.1159/000095438
  30. [31] Ruini C, Ottolini F, Tomba E, Belaise C, Albieri E, Visani D et al. School intervention for promoting psychological well-being in adolescence. Journal of Behavior Therapy and Experimental Psychiatry 2009; 40(4):522-532.
  31. [32] Tomba E, Belaise C, Ottolini F, Ruini C, Bravi A, Albieri E, et al. Differential effects of well-being promoting and anxiety-management strategies in a nonclinical school setting. Journal of Anxiety Disorders 2010; 24(3): 326-333.
  32. [33] Fava GA, Savron G, Zielezny M, Grandi S, Rafanelli C, Conti S. Overcoming resistance to exposure in panic disorder with agoraphobia. Acta Psychiatrica Scandinavica 1997; 95(4): 306-312.
  33. [34] Cosci F. Well-being therapy in a patient with panic disorder who failed to respond to paroxetine and cognitive behavior therapy. Psychotherapy and Psychosomatics 2015; 84(5): 318-9. DOI: 10.1159/000430789.
  34. [35] Sonino N, Fava GA. Tolerance to antidepressant treatment may be overcome by ketoconazole. Report of two cases. Journal of Psychiatric Research 2003; 37(2): 171-3. DOI: 10.1016/S0022-3956(02)00089-4
  35. [36] Meulenbeek P, Christenhusz L, Bohlmeijer E. Well-being therapy in the Netherlands. Psychotherapy and Psychosomatics 2015; 84(5): 316-7. DOI: 10.1159/000381552
  36. [37] Tomba E, Tecuta L. Well-being therapy in a patient with anorexia nervosa. Psychotherapy and Psychosomatics 2016; 85(6): 369-370. DOI: 10.1159/000448052
  37. [38] Fava GA, Ruini C, Rafanelli C, Grandi S. Cognitive behavior approach to loss of clinical effect during long-term antidepressant treatment: a pilot study. American Journal of Psychiatry 2002; 159(12): 2094-5.
  38. [39] Belaise C, Fava GA, Marks IM. Alternatives to debriefing and modifications to cognitive behavior therapy for posttraumatic stress disorder. Psychotherapy and Psychosomatics 2005; 74(4): 212-7. DOI: 10.1159/000085144
  39. [40] Vazquez C, Pérez-Sales P, Ochoa C. Post-traumatic growth. In: Fava GA, Ruini C ed. Increasing psychological well-being in clinical and educational settings. Intervention and cultural contexts. Dordrecht: Springer; 2014. p. 57-74.
  40. [41] Tossani E. The concept of mental pain. Psychotherapy and Psychosomatics 2013; 82(2): 67-73, 2013. DOI: 10.1159/000343003
  41. [42] Meerwijk EL, Weiss SJ. Toward a unifying definition: response to ‘the concept of mental pain. Psychotherapy and Psychosomatics 2014; 83(1): 62-3. DOI: 10.1159/000348869
  42. [43] Blasco-Fontecilla H, Baca- García E, Courtet P, García Nieto R, de Leon J. Horror vacui: emptiness might distinguish between major suicide repeaters and nonmajor suicide repeaters: a pilot study. Psychotherapy and Psychosomatics 2015; 84(2): 117-9. DOI: 10.1159/000369937
  43. [44] de Leon J, Baca-García E, Blasco-Fontecilla H. From the serotonin model of suicide to a mental pain model of suicide. Psychotherapy and Psychosomatics 2015; 84(6): 323-9. DOI: 10.1159/000438510
  44. [45] MacLeod AK. Suicidal behavior: the power of prospection. In: The Wiley Handbook of Positive Clinical Psychology. Chichester, UK: John Wiley & Sons, Ltd; 2016. p. 293-304.
  45. [46] Chouinard G, Chouinard VA. New classification of selective serotonin reuptake inhibitor withdrawal. Psychotherapy and Psychosomatics 2015; 84(2): 63-71. DOI: 10.1159/000371865
  46. [47] Chouinard G, Samaha AN, Chouinard VA, Peretti CS, Kanahara N, Takase M et al. Antipsychotic-induced dopamine supersensitivity psychosis: pharmacology, criteria, and therapy. Psychotherapy and Psychosomatics 2017; 86(4): 189-219. DOI: 10.1159/000477313.
  47. [48] Fava GA, Cosci F, Offidani E, Guidi J. Behavioral toxicity revisited: iatrogenic comorbidity in psychiatric evaluation and treatment. Journal of Clinical Psychopharmacology 2016; 36(6): 550-3. DOI: 10.1097/JCP.0000000000000570
  48. [49] Fava GA, Gatti A, Belaise C, Guidi J, Offidani E. Withdrawal symptoms after selective serotonin reuptake inhibitor discontinuation: a systematic review. Psychotherapy and Psychosomatics 2015; 84(2): 72-81. DOI: 10.1159/000370338
  49. [50] Fava GA, Benasi G, Lucente M, Offidani E, Cosci F, Guidi J. Withdrawal symptoms after serotonin-noradrenaline reuptake inhibitor discontinuation: systematic review. Psychotherapy and Psychosomatics 2018; 87(4): 195-203. DOI: 10.1159/000491524
  50. [51] Belaise C, Gatti A, Chouinard VA, Chouinard G. Persistent postwithdrawal disorders induced by paroxetine, a selective serotonin reuptake inhibitor, and treated with specific cognitive behavioral therapy. Psychotherapy and Psychosomatics 2014; 83(4): 247-8. DOI: 10.1159/000362317
  51. [52] Chopin MV, Peretti CS, Gisquet-Verrier P, Hoffmann C, Belaïd A, Chouinard G. Cocaine use disorder treated with specific cognitive behavioral therapy and adjunctive propranolol. Psychotherapy and Psychosomatics 2016; 85(1): 61-3. DOI: 10.1159/000441036
  52. [53] Fava GA, Sonino N. Psychosomatic medicine. Internationa Journal of Clinical Practice 2010; 64(8): 1155-1161.
  53. [54] Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA et al. Harmonizing the Metabolic Syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation 2009; 120(16): 1640-5. DOI: 10.1161/CIRCULATIONAHA.109.192644
  54. [55] O’Neill S, O’Driscoll L. Metabolic syndrome: a closer look at the growing epidemic and its associated pathologies. Obesity Review 2015; 16(1):1-12.
  55. [56] World Health Organization. Obesity and overweight. Geneva: WHO, 2018. -- Available: http://www.who.int/en/news-room/fact-sheets/detail/obesity-andoverweight.
  56. [57] American Psychiatry Association. Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: American Psychiatric Association; 2013.
  57. [58] Fava GA, Cosci F, Sonino N. Current psychosomatic practice. Psychotherapy and Psychosomatics 2017; 86(1): 13-30. DOI: 10.1159/000448856
  58. [59] Fava GA, Tomba E. Increasing psychological well-being and resilience by psychotherapeutic methods. Journal of Persality 2009; 77(6): 1903-1934.
  59. [60] Phillips-Caesar EG, Winston G, Peterson JC, Wansink B, Devine CM, Kanna B, et al. Small changes and lasting effects (SCALE) trial: the formation of a weight loss behavioral intervention using EVOLVE. Contemporary Clinical Trials 2015; 41: 118-28.
  60. [61] Phillips EG, Wells MT, Winston G, Ramos R, Devine CM, Wethington E et al. Innovative approaches to weight loss in a high-risk population: the small changes and lasting effects (SCALE) trial. Obesity 2017; 25(5): 833-841.
  61. [62] Hill JO. Can a small-changes approach help address the obesity epidemic? A report of the Joint Task Force of the American Society for Nutrition, Institute of Food Technologists, and International Food Information Council. The America Journal of Clinical Nutrition 2009; 89(2): 477-84.
  62. [63] Van Gaal LF, Mertens IL, Ballaux D. What is the relationship between risk factor reduction and degree of weight loss? European Heart Journal Supplements 2005; 7(Suppl L): L21-L26.
  63. [64] Wing RR, Lang W, Wadden TA, Safford M, Knowler WC, Bertoni AG et al. Benefits of modest weight loss in improving cardiovascular risk factors in overweight and obese individuals with type 2 diabetes. Diabetes Care 2011; 34(7): 1481-6.
  64. [65] Brown JD, Buscemi J, Milsom V, Malcolm R, O’Neil PM. Effects on cardiovascular risk factors of weight losses limited to 5-10%. Translational Behavioral Medicine 2016; 6(3): 339–346.
  65. [66] International Diabetes Federations. Recommendations for managing type 2 diabetes in primary care, 2017. -- Available: http://www.idf.org/managingtype2-diabetes.
  66. [67] Kalra S, Jena BN, Yeravdekar R. Emotional and psychological needs of people with diabetes. Indian Journal of Endocrinology and Metabolism 2018; 22(5): 696-704.
  67. [68] Geiker NRW, Astrup A, Hjorth MF, Sjödin A, Pijls L, Markus CR. Does stress influence sleep patterns, food intake, weight gain, abdominal obesity and weight loss interventions and vice versa? Obesity Review 2018; 19(1): 81-97.
  68. [69] Rafanelli C, Park SK, Ruini C, Ottolini F, Cazzaro M, Fava GA. Rating well-being and distress. Stress & Health 2000; 16(1): 55-61.
  69. [70] Ruini C, Ottolini F, Rafanelli C, Tossani E, Ryff CD, Fava GA. The relationship of psychological well-being to distress and personality. Psychotherapy and Psychosomatics 2003; 72(5): 268-275. DOI: 10.1159/000071898
  70. [71] Kalra S, Balhara YPS, Bathla M. Euthymia in Diabetes. European Endocrinology 2018; 14(2): 18-19.
  71. [73] Pressman and SD, Cohen S. Does positive affect influence health? Psychological Bulletin, 2005; 131(6): 925-971. DOI: 10.1037/0033-2909.131.6.925
  72. [74] Chida Y, Steptoe A. Positive psychological well-being and mortality: a quantitative review of prospective observational studies. Psychosomatic Medicine 2008; 70(7): 741-756.
  73. [75] Cole SW. Human social genomics. PLoS Genetics 2014; 10(8): e1004601, 2014.
  74. [76] Currier MB, Nemeroff CB. Depression as a risk factor for cancer: from pathophysiological advances to treatment implications. Annual Review of Medicine 2014; 65(1): 203-221.
  75. [77] Nemeroff CB, Goldschmidt-Clermont PJ. Heartache and heartbreak-the link between depression and cardiovascular disease. Nature Reviews. Cardiology 2012; 9(9): 526-539.
  76. [78] Fredrickson BL, Grewen KM, Algoe SB, Firestine AM, Arevalo JM, Ma J et al. Psychological well-being and the human conserved transcriptional response to adversity. PLoS One 2015; 10(3): e0121839.

Giada Benasi, Jenny Guidi, Chiara Rafanelli, Giovanni A. Fava, New Applications of Well-Being Therapy in "RIVISTA SPERIMENTALE DI FRENIATRIA" 1/2019, pp 87-106, DOI: 10.3280/RSF2019-001006