What you'll learn

• How the positive approach understands therapy: building wellbeing, not just reducing symptoms.
• What mindfulness involves and how it can help with stress, rumination and relapse prevention.
• What quality of life therapy involves and how it improves life satisfaction.
• How to evaluate these therapies for AO3, including research evidence, methodology, ethics and application.

The starting point: what makes therapy “positive”?

The positive approach is part of positive psychology, which studies human strengths, happiness, wellbeing and optimal functioning. Instead of only asking “what is wrong with the person?”, it also asks “what helps this person live well?”

Traditional therapies often focus mainly on reducing symptoms such as anxiety, low mood or compulsions. Positive therapies still care about distress, but they also aim to increase wellbeing, meaning, strengths, resilience and life satisfaction.

A useful distinction is:

• Hedonic wellbeing: feeling pleasure, happiness and life satisfaction.
• Eudaimonic wellbeing: feeling that life has meaning, purpose, growth and authenticity.

Positive approach evidence is often linked to Seligman et al. (2005), who tested positive psychology exercises such as “three good things”, and Fredrickson et al. (2008), who found that loving-kindness meditation increased positive emotions and personal resources over time. These studies support the idea that wellbeing can be deliberately developed, although the evidence also needs careful AO3 evaluation.

The two therapy options on the Eduqas spec

For the Positive approach therapy section, centres usually teach one of the following:

• Mindfulness
• Quality of life therapy

You should learn the one your teacher has selected in most depth. However, understanding both helps you see the wider positive approach.

Mindfulness

Mindfulness is strongly associated with Jon Kabat-Zinn, who developed Mindfulness-Based Stress Reduction. It is also used in Mindfulness-Based Cognitive Therapy or MBCT, developed by Segal, Williams and Teasdale, especially to reduce relapse in depression.

The key idea is not to remove thoughts. Instead, the person learns to notice thoughts, feelings and bodily sensations without automatically reacting to them.

For example, a client might notice the thought “I’m going to fail” and learn to see it as a mental event, not as a fact.

How mindfulness works

Mindfulness usually involves repeated practice. Common techniques include:

• Breathing meditation: focusing attention on the breath and gently returning attention when the mind wanders.
• Body scan: noticing sensations across the body without trying to change them.
• Mindful movement: slow movement while noticing bodily sensations.
• Mindful daily activities: bringing attention to ordinary tasks such as eating or walking.

A key mechanism is decentring.

This is especially useful for rumination, which means repeatedly going over negative thoughts. Rumination can maintain depression and anxiety because the person becomes trapped in cycles of self-criticism.

AO1 summary of mindfulness

For AO1, you need to describe the therapy clearly:

• Mindfulness trains present-moment awareness.
• It involves non-judgemental acceptance of thoughts, feelings and sensations.
• It uses practices such as breathing meditation, body scans and mindful movement.
• It aims to reduce rumination and automatic negative reactions.
• It fits the positive approach because it can increase wellbeing, self-awareness and emotional regulation.

Quality of life therapy

Quality of life therapy is more structured and goal-focused than mindfulness. It asks: which parts of life matter most to this person, and how satisfied are they with those areas?

It often uses the Quality of Life Inventory, or QOLI, where clients rate life domains such as:

• health
• self-esteem
• work
• relationships
• money
• home
• learning
• creativity
• community
• leisure

The therapist looks for areas that are both important and low in satisfaction. These become priorities for change.

The CASIO model

Quality of life therapy often uses the CASIO model. This gives five possible routes for improving life satisfaction:

• C — Circumstances: changing the actual situation.
• A — Attitude: changing how the person thinks about the situation.
• S — Standards: changing unrealistic expectations or goals.
• I — Importance: reconsidering how much weight the person gives to that area.
• O — Other areas: improving other life domains to create balance.

AO1 summary of quality of life therapy

For AO1, you could say:

• Quality of life therapy aims to improve subjective wellbeing and life satisfaction.
• It assesses satisfaction across important life domains.
• It identifies areas where the client feels dissatisfied, especially if those areas are highly important.
• It uses goal-setting, problem-solving, cognitive restructuring and activity planning.
• It fits the positive approach because it focuses on flourishing, strengths and meaningful improvement.

Comparing mindfulness and quality of life therapy

AO2: applying therapy to scenarios

In an exam scenario, look at what the person’s difficulty seems to involve.

If the person is overwhelmed by anxious thoughts, stuck in rumination or reacting automatically to feelings, mindfulness may be the stronger application.

If the person feels dissatisfied with life, lacks balance, or has problems in important life domains, quality of life therapy may be the stronger application.

AO3 evaluation of mindfulness

Strengths

Mindfulness has strong real-world application. It is used in schools, workplaces, prisons and clinical services. MBCT is especially associated with preventing relapse in depression, particularly for people with repeated episodes.

It is also empowering because clients learn skills they can practise independently. This supports the positive approach’s emphasis on self-development and resilience.

There is research support. For example, Fredrickson et al. (2008) found that loving-kindness meditation increased positive emotions, which then helped build personal resources such as social support and purpose. This supports the positive psychology idea that positive states can have long-term benefits.

Weaknesses

Mindfulness is not suitable for everyone as a stand-alone treatment. Some people may find silent attention to thoughts or bodily sensations distressing, especially if they have trauma histories or severe mental health difficulties.

Methodologically, mindfulness research can rely heavily on self-report questionnaires. This may reduce objectivity because participants might report improvement due to demand characteristics, expectancy effects or wanting to please the therapist.

There can also be high attrition because mindfulness requires regular practice. If many participants drop out, the final sample may only include people who already found mindfulness acceptable.

AO3 evaluation of quality of life therapy

Strengths

Quality of life therapy is practical and structured. The QOLI helps identify exactly which life areas need attention, so therapy can be personalised.

It also fits well with the positive approach because it focuses on strengths, meaningful goals and life satisfaction rather than only symptom reduction.

A further strength is that it can be combined with cognitive techniques. For example, a therapist may help a client challenge unrealistic beliefs about success, relationships or self-worth.

Weaknesses

One weakness is cultural bias. Ideas about happiness, independence, work and achievement may reflect Western individualistic values. In some cultures, family duty or community harmony may matter more than personal satisfaction.

Another weakness is that quality of life therapy may underestimate social and economic barriers. A person’s life satisfaction may be affected by poverty, discrimination, illness or unsafe housing. Therapy can help coping and goal-setting, but it cannot remove all external constraints.

It may also have a smaller evidence base than longer-established therapies such as CBT. This does not mean it is ineffective, but AO3 answers should avoid overstating the strength of support.

Research methods links for therapy evidence

Therapy effectiveness is often tested using experimental or quasi-experimental designs. For example, researchers might compare a mindfulness group with a control group, or measure life satisfaction before and after quality of life therapy.

The choice of inferential test depends on the design and level of measurement:

• Related t-test: related design with interval data.
• Unrelated t-test: independent groups with interval data.
• Wilcoxon signed-ranks test: related design with ordinal data.
• Mann-Whitney U test: independent groups with ordinal data.
• Spearman’s rho: correlation using ordinal or ranked data.
• Chi-square test: test of association using nominal data.
• Binomial sign test: related design looking at direction of change in nominal data.

Psychology usually uses a significance level of $p\le 0.05$. Researchers compare the observed value with the critical value from a table, while also considering whether the hypothesis is one-tailed or two-tailed.

Ethical issues

Any therapy or therapy research should follow the BPS Code of Ethics and Conduct.

Key issues include:

• Consent: clients or participants should understand what the therapy or research involves.
• Right to withdraw: they should be able to stop without pressure.
• Protection from harm: therapy should not expose people to unnecessary distress.
• Confidentiality: personal disclosures must be protected.
• Debrief: participants in research should be told the purpose of the study afterwards.
• Deception: if used in research, it must be justified and minimised.

In group mindfulness sessions, confidentiality is especially important because participants may hear personal information about others.

Essay structure: how to write about positive therapy

For a 10–15 mark essay-style answer, aim for clear AO1 and AO3 balance.

AO1 points

You could describe:

• the positive approach’s aim to build wellbeing
• the chosen therapy’s main assumptions
• key techniques
• how the therapy is supposed to work
• relevant evidence, such as Seligman et al. (2005) or Fredrickson et al. (2008)

AO3 points

You could evaluate using:

• evidence for effectiveness
• practical applications
• methodological issues, such as self-report and control groups
• individual differences
• cultural bias
• ethical issues
• comparison with other therapies, such as CBT or drug therapy