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Assessing Strengths in Clinical Practice 

Assessing Strengths in Clinical Practice
Chapter:
Assessing Strengths in Clinical Practice
Author(s):

Tayyab Rashid

DOI:
10.1093/med:psych/9780199845491.003.0011
Page of

date: 23 November 2017

Human beings are unique in their ability to contemplate themselves. They can recall the past vividly, interpret the present intelligently, and predict the future. This remarkable ability, however, is characterized by negativity. Humans are probably hard-wired to sharply attend, select, discern, and remember weaknesses more clearly than strengths. Evidence supports that humans are more risk aversive than gain sensitive (Kahneman & Tversky, 1984). Evolution has conditioned humans in such a way that they are more adept at processing grudges than gratitude, competition than cooperation, criticism than praising, and hubris than humility. When humans encounter challenges, they are more likely to recall shortcomings, failures, and setbacks—their own and those of others—and when they do it persistently, they often experience psychological distress.

Positive Psychology has made concerted empirical efforts to advance the science that build strengths, in addition to undoing symptoms and stress. Most prominent among these efforts is the field of character strengths, which includes capacities of cognition, affect, volition, and behavior. They are the basic psychological ingredients that enable us to act in ways that contribute to our well-being and that of others.

Christopher Peterson and Martin Seligman (2004) spearheaded the first systematic effort in psychology to classify core human strengths, acknowledging that character strengths are morally desired traits of human existence but at the same time descriptive traits open to empirical examination. Table 11.1 presents brief descriptions of 24 core character strengths, which are subsumed under six broader categories called virtues.

Table 11.1. VIA Classification of Virtues and Character Strengths

Wisdom

  • Creativity: Originality; adaptive; ingenuity

  • Curiosity: Interest; novelty seeking; exploration; openness to experience

  • Judgment: Critical thinking; thinking things through; open-minded

  • Love of learning: Mastering new skills and topics; systematically adding to knowledge

  • Perspective: Wisdom; providing wise counsel; taking the big-picture view

Courage

  • Bravery: Valor; not shrinking from fear; speaking up for what’s right

  • Perseverance: Persistence; industry; finishing what one starts

  • Honesty: Authenticity; integrity

  • Zest: Vitality; enthusiasm; vigor; energy; feeling alive and activated

Humanity

  • Love: Both loving and being loved; valuing close relations with others

  • Kindness: Generosity; nurturance; care; compassion; altruism; “niceness”

  • Social intelligence: Emotional intelligence; aware of the motives/feelings of self/others, knowing what makes other people tick

Justice

  • Teamwork: Citizenship; social responsibility; loyalty

  • Fairness: Just; not letting feelings bias decisions about others

  • Leadership: Organizing group activities; encouraging a group to get things done

Temperance

  • Forgiveness: Mercy; accepting others’ shortcomings; giving people a second chance

  • Humility: Modesty; letting one’s accomplishments speak for themselves

  • Prudence: Careful; cautious; not taking undue risks

  • Self-regulation: Self-control; disciplined; managing impulses and emotions

Source: Peterson & Seligman, 2004. Reprinted with permission of the VIA Institute.

Assessing strengths along symptoms is critical for balanced, comprehensive practice with the underlying goal that psychotherapy is as much about cultivation of wellness as it is about alleviation of distress. Clients seeking psychotherapy do not just want less worry or anxiety; they also want to be happy, fulfilled, and satisfied. Psychotherapy is also a place (p. 65) for exploration of strengths. Focusing on clients’ strengths can initiate and maintain positive feedback circuits that potentially foster the therapeutic alliance, augment the clients’ receptiveness, and support the implementation of adaptive coping strategies (Flückiger, Franz, Grosse, & Willutzki, 2009).

Following are some reasons for assessing strengths in clinical practice:

  • Repairing or fixing weakness does not necessarily make clients stronger. The traditional assumption in psychotherapy that alleviation of symptoms will make clients happier understates the evidence which supports that being symptom-free is not synonymous with fulfillment and flourishing.

  • Using strengths helps to reinterpret and reframe problems adaptively. Using strengths increases clients’ self-efficacy and confidence in ways focusing on weakness cannot. Being aware of strengths, in addition to weaknesses, helps clients to reinterpret and reframe problems from a strengths perspective rather than from a deficits perspective.

  • Fixing weakness does not necessarily cultivate happiness. Much like weaknesses require fixing, strengths require nurturance. Fixing weakness yields remediation, while strengths nurturance produces growth and, most likely, greater happiness.

  • Strength awareness builds a cumulative advantage. Evidence shows that people who are aware of their strengths can build self-confidence at a young age and tend to reap a “cumulative advantage” that continues to grow over a lifetime (Judge & Hurst, 2008). The broaden-and-build theory of positive emotions (Fredrickson, 2001) applied to clinical practice argues that strengths broaden the repertoire of action potentials in the present and build resources in the future.

  • Using strengths to promote resilience. Knowing and using strengths in good times helps clients to learn strategies to use during tough times. Being aware of and using strengths not only promotes resilience but also prepares clients to encounter challenges adaptively.

  • Using strengths to find balance in daily interactions and manage relational challenges. A balanced therapeutic approach to sour interactions will focus equally on criticism as well on complements, on eliciting and (p. 66) savoring positive memories as well as recalling resentments, on self-centeredness as well as empathy. This balance will likely lessen interpersonal tension and create opportunities to adaptively adjust these interactions.

Assessment Methods

Strengths in clinical practice are mostly assessed through self-report measures (e.g., Values in Action Survey-Inventory of Strengths [VIA-IS], Strengths Finder, Realise 2). It entails clients completing a free online measure (mostly VIA-IS; www.viacharacter.org). Their top-five scores are regarded as signature strengths, which are those strengths that an individual self-consciously owns and celebrates, and for which he or she feels a sense of ownership and authenticity (e.g., “This is the real me”). The individual feels excited while displaying these signature strengths, learns quickly as they are practiced, feels more invigorated than exhausted when using them, and creates and pursues projects that revolve around them. Generally, top-five VIA-IS scores are regarded as clients’ signature strengths. Clients are then asked to find new ways to use their signature strengths.

Reliance on this approach, although useful in a nonclinical setting, may not meet critical clinical needs. For example, exclusive focus on top-ranked strength scores could give an inadvertent message to clients that weaknesses and deficits, which are equally real and inevitable, do not deserve clinical attention. Clinicians can obtain a deeper understanding of their client’s strengths through feedback reports on various strengths measures. For example, Values in Action Institute www.viacharacter.org) currently offers two comprehensive reports on VIA. First, VIA Me is an 18-page report with description of signature strengths, related activities, quotes, benefit statement, and an overview of one’s middle and lower strengths. Those who already have completed the VIA can also obtain this report. Second, VIA Pro is a 24-page report that includes various graphic representations of signature strengths with raw score averages for each of them, research findings about signature strengths, underuse and overuse of strengths, and a graphic description of one’s signature strengths on a continuum of head/heart and self/others. Also included in the report is a comprehensive list of behavioral exercises for using and further building each of the 24 strengths. VIA also offers shorter versions for adults and youth.

An alternative is a dynamic strength assessment. In this approach (Table 11.2), the client is provided with a sheet of brief descriptions (approximately 20–25 words per strength) of core strengths, without their titles. I use the Values in Action classification model (Peterson & Seligman, 2004). The client is asked to identify (not rank) up to five strengths that best illustrate her or her personality. Identical collateral data are collected from a loved one. The client is then provided descriptions with titles to give strengths names and specific contexts. The client is asked to share memories, experiences, real-life stories, anecdotes, accomplishments, and skills that illustrate development and use these strengths. Then the client is asked to complete the self-report measure of strengths (e.g., Values in Action—Inventory of Strengths; Peterson & Seligman, 2004). This leads to discussion of all strengths identified (p. 67) thus far, in terms of their usage, which could be tonic (kindness is displayed in nearly all situations) or phasic (kindness is displayed only at work but not at home, fairness only in few situations, or teamwork only with preferred group). The client can also identify underuse or overuse of strengths (e.g., underuse of kindness in close relationships, or overuse of curiosity about sports or fashion but not in close relationships, assuming that one has completely figured out his or her partner). After exploring such nuances and subtleties of strengths, the client is asked to identify five desired strengths, which could be deployed adaptively to solve presenting concerns. Each column is independent, and each cell is marked with X to denote corresponding strength. All the Xs across rows are summed to derive a composite. The top-five strength scores across rows are generally regarded as signature strengths.

Table 11.2. Dynamic Strength Assessment: A Sample

Strength

Self

Other

VIA

Tonic/Phasic

Under/Over

Desired

Composite

1

Appreciation of beauty

2

Authenticity and honesty

3

Bravery and valor

4

Creativity

5

Curiosity

Another approach to assess clients’ strengths is by means of the clinical interview. Flückiger and colleagues (2009) have used the clinical interview to elicit clients’ strengths in the therapeutic process. Following are several of their resource activation questions that can be readily incorporated into a Life History Questionnaire or clinical interview in routine practice:

  • What do you enjoy most? Please describe your most enjoyable experiences.

  • What are you good at? Please describe experiences that brought out the best in you.

  • What are your inspirations for the future?

  • What makes a satisfying day for you?

  • What experiences give you a sense of authenticity?

  • Please describe a time when you felt “the real you.”

Clinicians can incorporate strengths in the therapeutic process by reflecting upon the following questions:

  • Which specific strengths of your clients can facilitate their therapeutic progress and how can you assess these strengths?

  • Do you view clients primarily as individuals entangled in persistent negative emotions and experiences, which obviously stand out more in treatment, or do you also view clients as capable of exploring and developing their strengths?

  • Do you view strengths as potential buffers against psychological distress?

  • Finally, do you consciously and deliberately make efforts to elicit and incorporate strengths in the therapeutic process?

References and Readings

Flückiger, C., Caspar,, F. H., Grosse, M., & Willutzki, U. (2009). Working with patients strengths: A microprocess approach, Psychotherapy Research, 19, 213–223Find this resource:

Fredrickson, B. (2001). The role of positive emotions in positive psychology: The broaden-and-build theory of positive emotions. American Psychologist, 56, 218–226.Find this resource:

Judge, T. A., & Hurst, C. (2008). How the rich (and happy) get richer (and happier): Relationship of core self-evaluations to trajectories in attaining work success. Journal of Applied Psychology, 93, 849–863.Find this resource:

Kahneman, D., & Tversky, A. (1984). Choices, values, and frames. American Psychologist, 39, 341–350.Find this resource:

Peterson, C., & Seligman, M. E. P. (2004). Character strengths and virtues: A handbook and classification. New York: Oxford University Press.Find this resource:

Schwartz, B., & Sharpe, K. E. (2006). Practical wisdom: Aristotle meets positive psychology. Journal of Happiness Studies, 7, 377–395.Find this resource:

Seligman, M. E. P. (2002). Authentic happiness: Using the new positive psychology to realize your potential for lasting fulfillment. New York: Free Press.Find this resource:

Related Topics

Chapter 3, “Improving Diagnostic and Clinical Interviewing”

Chapter 4, “Increasing the Accuracy of Clinical Judgment”

Chapter 32, “Compendium of Treatment Adaptations”