Gratitude practice

Domain XV · Nature, philosophy, social & rites of passage · Emmons, McCullough, Seligman · 2003

What it is

Gratitude practice is not a psychotherapy and has no guideline-recommended clinical protocol. It is a family of brief, mostly written, self-administered exercises (positive psychology interventions) that a therapist can teach, assign, rehearse and debrief inside ordinary treatment. Its proposed…

Format

• Published protocol formats
• Counting blessings, weekly: up to five things the person felt grateful for over the past week, written at the end of a weekly report; 10 weekly reports in the student study.

Evidence status, as the guide reports it

• Format: individual delivery produced larger effects than group or self-administered positive psychology interventions in a practice-oriented meta-analysis that did not analyse gratitude separately.

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?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• How do you and the practitioner understand what is happening, in spiritual or cultural terms? Is that a source of comfort, worry, or both?
• 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

• overload; too many homework tasks reduce adherence to the core treatment.
• the practice becoming a test the client "fails"; frame it as optional and adjustable.
• as for 4.4 and 4.5; obtain training in the manual before delivering it as a protocol.
• the exercise turning into self-criticism; aim for balanced, not inflated, attributions.
• feeling pressured to appear positive for carers or clinicians; grief for lost function (address directly).

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.