Positive Psychology Progress in India: Accomplishments and Pathways Ahead

A character-strengths based coaching intervention to improve wellbeing of rural community health workers in Madhya Pradesh, India: Protocol for a single-blind randomized controlled trial

Background

There is scarce knowledge on the use of structured positive psychology interventions for reducing work-stress and improving wellbeing of rural community health workers in India, particularly the Accredited Social Health Activists (ASHAs) who are village-level (resident women, incentivised) lay health workers. This trial will test the effectiveness of a 'character-strengths' based coaching intervention compared to routine supervision on wellbeing ('authentic happiness') of ASHAs.

Methods

This protocol is for a single-blind, parallel group randomized controlled trial comparing the effectiveness of a five-day residential workshop focusing on the use of character-strengths and subsequent 8- to 10-week remote telephonic coaching (weekly) to individually support ASHAs to improve their wellbeing, against routine health system support. The arms are intervention added to routine ASHA supervision (weekly, by the ASHA supervisor), and routine supervision alone (control arm). The target sample comprises 330 rural ASHAs in Madhya Pradesh, India. The primary outcome of mean Authentic Happiness Inventory (AHI) scores will be compared between arms at 3-month follow-up. Secondary outcomes will include an assessment of ASHA's self-reported affect, self-efficacy, flourishing, burnout, motivation, physical health symptoms, quality of life, and routine work performance indicators, and the consequent patient-level outcomes [e.g., service satisfaction and depression remission rates after receiving brief psychological treatment by trained ASHAs]. We will also evaluate the costs of developing and delivering the intervention.

Discussion

This trial will determine whether a character-strengths based coaching intervention is an effective and scalable approach for reducing work-stress and improving wellbeing of rural ASHAs in low-resource settings.

The Catalyst Model of Change: Gratitude Interventions with Positive Long-Term Effects

How can gratitude interventions be designed to produce meaningful and enduring effects on people's well-being? To address this question, the author proposes the Catalyst Model of Change-this novel, practical, and empirically testable model posits five socially oriented behavioral pathways that channel the long-term effects of gratitude interventions as well as how to augment gratitude experiences in interventions to boost treatment effects and catalyze these behavioral pathways. Specifically, interventions that enhance the frequency, skills, intensity, temporal span, and variety of gratitude experiences are likely to catalyze the following post-intervention socially oriented behaviors: (a) social support-seeking behaviors, (b) prosocial behaviors, (c) relationship initiation and enhancement behaviors, (d) participation in mastery-oriented social activities, and (e) reduced maladaptive interpersonal behaviors, which, in turn, produce long-term psychological well-being. A unique feature of the Catalyst Model of Change is that gratitude experiences are broadly conceptualized to include not just gratitude emotions, cognitions, and disclosures, but also expressing, receiving, witnessing, and responding to interpersonal gratitude. To this end, gratitude interventions that provide multiple opportunities for social experiences of gratitude (e.g., members expressing gratitude to each other in a group) might offer the greatest promise for fostering durable, positive effects on people's psychological well-being.

Explanatory Styles of Counsellors in Training

Explanatory style is based on how one explains good and bad events according to three dimensions: personalization, permanence, and pervasiveness. With an optimistic explanatory style, good events are explained as personal, permanent, and pervasive, whereas bad events are explained as external, temporary, and specific. For counsellors, an optimistic explanatory style creates positive expectancy judgments about the possibilities and opportunities for successful client outcomes. In this research study, we explored the explanatory styles expressed in 400 events (200 good events and 200 bad events) extracted from 38,013 writing samples of first year and final year graduate level counsellors in training. Across the three optimism dimensions and within good and bad events, there was one occurrence of a positive relationship between counsellor training time and the amount of expressed optimism. The implications of this study include the need to cultivate optimistic explanatory styles of counsellors in training and practicing counsellors.