Jeana L. Magyar- Moe, Ph.D. University of Wisconsin Stevens Point

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1 Jeana L. Magyar- Moe, Ph.D. University of Wisconsin Stevens Point

2 What Do You See? Perspective on Human Behavior Determines the Routes Taken In Pursuit of Psychological Data Information Gathering Routes = Data Reflecting Psychological Weaknesses, Strengths, or Combo. of Both (Lopez, Snyder, & Rasmussen 2003)

3 Four- Front Approach to Client Assessment Weaknesses/Deficiencies Strengths/Assets Environmental Deficits/Destructive Forces Environmental Resources/Opportunities Helps one to avoid: Fundamental Attribution Error Fundamental Negative Bias Overpathologizing of behavior (Wright & Lopez, 2002)

4 Finding More Balance via Small Changes to Current DSM Assessment System DSM Diagnostic Framework 5 Axes I. Clinical Syndromes II. Personality Disorders & Mental Retardation III. General Medical Conditions IV. Psychosocial & Environmental Problems V. Global Assessment of Functioning (GAF) Framework is incomplete, yet firmly grounded in psych. Neglects environmental resources, well-being, & strengths

5 Seven- Axis System of Posi?ve Psychological Assessment Alterations to the DSM System to Include the Positive Side of Functioning: * Broadening Axis IV * Broadening Axis V * Creating Axis VI * Creating Axis VII (Snyder et al., 2003; Magyar-Moe, 2009)

6 Addi?ons to Current DSM Assessment System to Create Balanced Conceptualiza?ons Broaden Axis IV (Snyder et al., 2003)

7

8 Addi?ons to Current DSM Assessment System to Create Balanced Conceptualiza?ons Broaden Axis IV Broaden Axis V GAF 1 = Severe Pathology 100 = Absence of Pathology

9 Complete State Model of Mental Health The Absence of Mental Illness does NOT equal the Presence of Mental Health More to mental health than repairing damage or fixing what is broken Also need to consider building positive emotions, strengths, and nurturing what is best Attend to indicators of psychological, social, and emotional well- being

10 Reconceptualizing Outcome Baseline Measure therapy outcome as a Complete State = Absence of Mental Illness AND Presence of Well- Being High- Subjective Well- Being Symptoms Incomplete Mental Illness: Struggling High Mental Illness Symptoms Complete Mental Illness: Floundering Complete Mental Health: Flourishing Low Incomplete Mental Health: Languishing Low (Keyes & Lopez, 2002)

11 Ra7ng Scales to Assess Where One Fits Within the Complete State Model Global Assessment of Functioning Scale (GAF) Global Assessment of Positive Functioning Scale (GAPF)

12 (Magyar- Moe, 2009)

13 (Magyar- Moe, 2009)

14 Measures To Assess Where One Fits Within the Complete State Model Outcome Questionnaire 45.2 (Lambert et al., 1996) subjective discomfort, problems with interpersonal relations, and problems with social role performance Mental Health Continuum Long Form (Keyes, 2008) to assess growth and improvement beyond symptom relief: emotional, psychological, and social well- being

15 (Magyar- Moe, 2009)

16 Case Examples What type of person might fit into each of the categories of the Complete State Model?

17 Winnie The Pooh Characters Based on Shea et al., (2001) = all are affected by mental illness or psychosocial problems and all are labeled negatively with strengths and resources being ignored/overlooked/explained away:

18

19 What if we work from the Complete State Model? Tigger = Struggling? Flourishing when symptoms are under control? Kanga and Roo - Flourishing High-Subjective Well-Being Symptoms Incomplete Mental Illness: Struggling Symptoms of Mental Illness - High Complete Mental Illness: Floundering Complete Mental Health: Flourishing Low Incomplete Mental Health: Languishing Low (Keyes & Lopez, 2002)

20 The Power of Labels & Naming Negative Effects of Diagnostic Labeling: Deindividuation/Dehumanization Self- Fulfilling Prophecy

21 Deindividua?on/Dehumaniza?on Labels create in- groups (i.e., those with mental illness) and out- groups (i.e., those without mental illness) Fail to see differences amongst those labeled (the in- group); emphasize differences amongst those labeled and not labeled (the out- group) Consider the language often used to describe people with various mental illnesses!

22 Self- Fulfilling Prophecy Labels influence how others treat the person with the label as well how the person who is labeled comes to view him/herself. On Being Sane In Insane Places (Rosenhan, 1973) Clinicians and clients succumb to this prophecy when they highlight that which is consistent with the deviant label (that which is negative) and ignore that which is not consistent (that which is positive) = Negative Collaborative Illusion

23 Posi?ve Effects of Labeling Validation/Normalization Treatment Planning Insurance Coverage When labeling the positive self- fulfilling prophecy works as an asset

24 Addi?ons to Current DSM Assessment System to Create Balanced Conceptualiza?ons Broaden Axis IV Broaden Axis V Add Axis VI (Snyder et al., 2003)

25 Axis VI: Client Strengths Values in Action Inventory of Character Strengths: Clifton Strengthsfinder 2.0: (versions available for children & adolescents) Many other measures of strengths in Lopez & Snyder s (2003) Positive Psychological Assessment text and at

26 Addi?ons to Current DSM Assessment System to Create Balanced Conceptualiza?ons Broaden Axis IV Broaden Axis V Add Axis VI Add Axis VII

27 Axis VII: Client Cultural Iden??es ADDRESSING Model of Cultural Assessment (Hayes, 1996; 2001) - use in a complementary manner to assess both strengths and weaknesses associated with each of the 10 components of cultural identity Age and generational influences Disability status (developmental disabilities) Disability status (acquired physical/cognitive/psychological disabilities) Religion and spiritual orientation Ethnicity Socioeconomic status Sexual orientation Indigenous heritage National origin Gender

28 Culture is Crucial! D Andrea (2005) : failure to define and control for race and ethnicity in positive psychology research has resulted in incomplete information and understandings of people from different racial and ethnic groups, thereby serving to inadvertently perpetuate a scientific form of racism. Christopher, Richardson, and Slife (2008) : many positive psychology scholars endorse mental health ideals of the dominant American ideals of personal autonomy and individual definitions of happiness and fulfilment. Furthermore, they note that positive psychology overly hastily and somewhat naively universalizes its particular cultural preferences and ideals as good for or applicable to all human communities (pg. 557) Sandage and Hill (2001) : in order for positive psychology to be culturally relevant, scholars must ask questions that acknowledge multicultural awareness of difference. Such questions must include consideration of whose view of strengths, well- being, and happiness will be privileged, who will benefit from certain definitions of positive psychological constructs, how can multiple definitions of the good life be placed in a cultural context, and which cultural views of human strength, resilience, or virtue risk being overlooked or ignored.

29 Culture is Crucial! Christopher and Hickinbottom (2008) endorse the importance of alternate interpretations of the meaning of values, strengths, and well- being. Downey & Chang (2012) acknowledge that positive psychological research is becoming more culturally relevant, however, there are still many who are worried that appropriate application of these findings remains a challenge for practitioners (Conway Madding, 2000; Hays et al., 2010; Orsi et al., 2010; Stuart, 2004). Downy and Chang (2012) propose that changes in clinical training will help to create multiculturally relevant therapeutic applications of positive psychology, noting that training of practitioners to date has not sufficiently, regularly, or explicitly incorporated positive psychology, multiculturalism, and lifespan perspectives.

30 (Magyar- Moe, 2009)

31 Posi?ve Psychological Assessment and Conceptualiza?on: To Show Client You Are Trying To Understand the Whole Person To Show Client that She/He is Not Being Equated With the Problem Client is Not Reinforced for Having A Problem, but Rather Encouraged to Look at His/Her Assets Client Can Recall and Claim Some of the Personal Worth That May Have Been Depleted Prior To Seeking Assistance To Facilitate an Alliance of Trust and Mutuality; in turn, the Client is Open and Giving of Info. That May Yield The Best Conceptualizations, Diagnoses, and Treatment Planning Sets the stage for treatment planning, including the use of positive psychological interventions, activities, and

32 Treatment Planning Use data from 7- Axis System of Positive Psychological Assessment and Client Conceptualization Based on the Complete State Model of Mental Health as a Guide: For Complete Mental Illness Use PP to Supplement Treatment As Usual For Incomplete Mental Illness Use PP as the Core of Treatment

33 For More Informa?on: Sample Treatment Plans Client Handouts, Activities, and Exercises informed by Positive Psychology Thorough reviews of complete forms of therapy based on Positive Psychology: - Positive Psychotherapy, Well- Being Therapy, Quality of Life Therapy, Hope Therapy, Strengths- Based Counseling, Strengths- Centered Therapy Companion Website with print- ready forms

34 Implementa?on Keys: - Build in opportunities for clients to use their strengths to manage their struggles - Provide rationales for PP activities/exercises - Always use people- first language - Be flexible in choosing what aspects of PP to incorporate tailor this to the client - Never invalidate struggles/problems

35 Ques?ons?

36 THANK YOU!

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