Well-being therapy

Domain II · Behavioural & cognitive · Giovanni A. Fava · 1990 · Bologna

What it is

Well-being therapy (WBT) is a short-term, structured, manualised psychotherapy developed by Giovanni A. Fava and colleagues at the University of Bologna in the 1990s, originally for residual symptoms and relapse prevention in mood and anxiety disorders after acute treatment. It is based on Carol…

Format

• Session-by-session (2016 manual, as reviewed):
• Session 1: history of distress, illness consequences and treatment; WBT rationale (build on positives, remove what blocks full development); well-being check; start the diary.

Who practises it, and how they are trained or regulated

• Format. Individual, structured, problem-oriented, 8–16 sessions (fewer if WBT follows CBT); in trials 8–12 sessions, weekly or every other week, 30–50 minutes each. A four-session WBT exists for patients who have completed CBT (manual ch. 13; contents not drawn on). Group formats and school/child adaptations exist (manual ch. 19) but are not drawn on here; one US group adaptation for people with physical…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• Does it use a device, heat, cold, water or a physical procedure? Has a medical professional checked that it is safe for you?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• Overwhelm or new avoidance; slow the hierarchy.
• Working — the patient names progress unprompted.
• Restructuring becoming argument; keep it collaborative.
• Goals set by others or by guilt; check whose goal it is.
• Perfectionist over-scheduling (excess environmental mastery).

Problems the guide addresses

• "Nothing good happens" / empty diary
• Patient keeps reporting distress instead
• Severe rumination, obsessions or a new acute episode
• Non-adherence to homework
• Resistance to "positivity"
• Overwhelm
• Ruptures
• Modality-specific difficulties

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.