Well-being therapy is a short-term, well-being-enhancing psychotherapeutic strategy. It is based on Carol D. Ryff’s multidimensional model of psychological well-being, encompassing environmental mastery, personal growth, purpose in life, autonomy, self-acceptance and positive relations with others. Its conceptual and technical issues are described. It may be applied as a relapse-preventive strategy in the residual phase of affective (mood and anxiety) disorders, as an additional ingredient of cognitive behavioral packages, in patients with affective disorders who failed to respond to standard pharmacological and psychotherapeutic treatments, in body image disorders and in psychosomatic medicine. The first validation studies appeared to be promising. The technique is in its preliminary stage of development and may undergo major changes in the next years. It is hoped it may herald a new trend of psychotherapy research and practice in the current symptom-oriented settings.

Keywords:
Psychological well-being, Well-being therapy, Depressive disorder, Anxiety disorders, Body image disorders, Psychotherapy, Cognitive behavioral therapy
1.
Parloff MB, Kelman HC, Frank JD: Comfort, effectiveness, and self- awareness as criteria of improvement in psychotherapy. Am J Psychiatry 1954;11:343–351.
2.
Ellis A, Becker I: A Guide to Personal Happiness. Hollywood, Melvin Powers Wilshire Book Company, 1982.
3.
Horowitz MJ, Kaltreider NB: Brief therapy of the stress response syndrome. Psychiatr Clin North Am 1979;2:365–377.
4.
Bergin AE, Garfield SL: Handbook of Psychotherapy and Behavior Change. New York, Wiley, 1994.
5.
Ryff CD, Singer B: Psychological well-being: Meaning, measurement, and implications for psychotherapy research. Psychother Psychosom 1996;65:14–23.
6.
Fava GA: Conceptual obstacles to research progress in affective disorders. Psychother Psychosom 1997;66:283–285.
7.
Fava GA: The concept of psychosomatic disorder. Psychother Psychosom 1992;58:1–12.
8.
Ryff CD: Happiness is everything, or is it? Explorations on the meaning of psychological well-being. J Pers Soc Psychol 1989;6:1069–1081.
9.
Antonovsky A: Unraveling the Mystery of Health. San Francisco, Jossey Bass, 1987.
10.
Antonovsky A: The structure and properties of the sense of coherence scale. Soc Sci Med 1993;36:725–733.
11.
Schnyder U, Büchi S, Mörgeli H, Sensky T, Klaghofer R: Sense of coherence as a mediator between disability and handicap. Psychother Psychosom 1999;68:102–110.
12.
Fava GA: The concept of recovery in affective disorders. Psychother Psychosom 1996;65:2–13.
13.
Fava GA: Subclinical symptoms in mood disorders. Pathophysiological and therapeutic implications. Psychol Med 1999;29:47–61.
14.
Fava GA, Kellner R: Staging: A neglected dimension in psychiatric classification. Acta Psychiatr Scand 1993;87:225–230.
15.
Fava GA, Rafanelli C, Cazzaro M, Conti S, Grandi S: Well-being therapy. A novel psychotherapeutic approach for residual symptoms of affective disorders. Psychol Med 1998;28:475–480.
16.
Emmelkamp PMG: Self-observation versus flooding in the treatment of agoraphobia. Behav Res Ther 1974;12:229–237.
17.
Meehl PE: Hedonic capacity: Some conjectures. Bull Menninger Clin 1975;39:295–307.
18.
Beck AT, Rush AJ, Shaw BF, Emery G: Cognitive Therapy of Depression. New York, Guilford Press, 1979.
19.
Debats DL: Meaning in life: Clinical relevance and predictive power. Br J Clin Psychol 1996;35:503–516.
20.
Rafanelli C, Park SK, Ruini C, Ottolini F, Cazzaro M, Fava GA: Rating well-being and distress. Stress Med, in press.
21.
Pava JA, Fava M, Levenson JA: Integrating cognitive therapy and pharmacotherapy in the treatment and prophylaxis of depression. Psychother Psychosom 1994;61:211–219.
22.
Weissman MM, Markowitz JC: Interpersonal psychotherapy. Arch Gen Psychiatry 1994;51:599–606.
23.
Labbate LA, Doyle ME: Recidivism in major depressive disorder. Psychother Psychosom 1997;66:145–149.
24.
Kilic C, Noshirvani H, Basoglu M, Marks I: Agoraphobia and panic disorder. Psychother Psychosom 1997;66:175–178.
25.
Fava GA, Grandi S, Zielezny M, Canestrari R, Morphy MA: Cognitive behavioral treatment of residual symptoms in primary major depressive disorder. Am J Psychiatry 1994;151:1295–1299.
26.
Fava GA, Grandi S, Zielezny M, Rafanelli C, Canestrari R: Four-year outcome for cognitive behavioral treatment of residual symptoms in major depression. Am J Psychiatry 1996;153:945–947.
27.
Colom F, Vieta E, Martinez A, Jonquera A, Gasto C: What is the role of psychotherapy in the treatment of bipolar disorder? Psychother Psychosom 1998;67:3–9.
28.
Pollack MH, Otto MW, Rosenbaum JF (eds): Challenges in Clinical Practice. New York, Guilford Press, 1996.
29.
Ananth J: Treatment-resistant depression. Psychother Psychosom 1998;67:61–70.
30.
Fava GA, Savron G, Grandi S, Rafanelli C: Cognitive behavioral management of drug-resistant major depressive disorder. J Clin Psychiatry 1997;58:278–282.
31.
Fava GA, Savron G, Zielezny M, Grandi S, Rafanelli C, Conti S: Overcoming resistance to exposure in panic disorder with agoraphobia. Acta Psychiatr Scand 1997;95:306–312.
32.
Strean HS: Resolving Resistances in Psychotherapy. New York, Wiley, 1985.
33.
Snaith P: Body image disorders. Psychother Psychosom 1992;58:119–124.
34.
Ryff CD, Singer BD: The contours of positive human health. Psychol Inquiry 1998;9:1–28.
35.
Engel GL: From biomedical to biopsychosocial. Psychother Psychosom 1997;66:57–62.
36.
Leiberich P, Engeter M, Olbrich E, Rubbert A, Schumaker K, Brieger M, Kalden JR, Joraschky P: Longitudinal development of distress, coping and quality of life in HIV-positive persons. Psychother Psychosom 1997;66:237–247.
37.
Sonino N, Fava GA: Psychosomatic aspects of Cushing’s disease. Psychother Psychosom 1998;67:140–146.
38.
Weitzner MA, Knutzen R: The impact of pituitary disease on the family caregiver and overall family functioning. Psychother Psychosom 1998;67:181–188.
39.
Viemero V, Krause C: Quality of life in individuals with physical disabilities. Psychother Psychosom 1998;67:317–322.
40.
Emmelkamp PGM, Van Oppen P: Cognitive interventions in behavioral medicine. Psychother Psychosom 1993;59:116–130.
41.
Van der-Feltz Cornelis CM, Van Dyck R: The notion of somatization. Psychother Psychosom 1997;66:117–127.
42.
Farley M, Barkan H: Somatization, dissociation, and tension-reducing behaviors in psychiatric outpatients. Psychother Psychosom 1997;66:133–140.
43.
Lipowski ZJ: Somatization. Psychother Psychosom 1987;47:160–167.
44.
Marks I: Behaviour therapy for obsessive-compulsive disorder: A decade of progress. Can J Psychiatry 1997;42:1021–1027.
45.
Amir N, Cashman L, Foa EB: Strategies of thought control in obsessive-compulsive disorder. Behav Res Ther 1997;35:775–779.
46.
Paykel ES: The clinical interview for depression. J Affect Disord 1985;9:85–96.
47.
Kellner R: A symptom questionnaire. J Clin Psychiatry 1987;48:269–274.
48.
Fava GA, Rafanelli C, Grandi S, Conti S, Belluardo P: Prevention of recurrent depression with cognitive behavioral therapy. Arch Gen Psychiatry 1998;55:816–820.
49.
Frank E, Kupfer DJ, Perel JM, Cornes C, Jarrett DB, Mallinger AG, Thase ME, McEachran AB, Grochocinski VJ: Three year outcomes for maintenance therapies in recurrent depression. Arch Gen Psychiatry 1990;47:1093–1099.
50.
Fava GA, Zielezny M, Savron G, Grandi S: Long-term effects of behavioral treatment for panic disorder with agoraphobia. Br J Psychiatry 1995;166:87–92.
51.
Marks IM, Mathews AM: Brief standard self-rating for phobic patients. Behav Res Ther 1979;17:263–267.
52.
Fava GA: Psychotherapy research: Clinical trials versus clinical reality. Psychother Psychosom 1986;46:6–12.
53.
Tedlow J, Fava M, Uebelacker L, Nierenberg AA, Alpert JE, Rosenbaum J: Outcome definitions and predictors in depression. Psychother Psychosom 1998;67:266–270.
54.
MacLeod AK, Pankhania B, Lee M, Mitchell D: Parasuicide, depression and the anticipation of positive and negative future experiences. Psychol Med 1997;27:973–977.
55.
Lam DH, Green B, Power MJ, Checkley S: The impact of social cognitive variables on the initial level of depression and recovery. J Affect Disord 1994;32:75–83.
1999
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.