Quality Of Life Theory

QUALITY OF LIFE THERAPYApplying a Life Satisfaction Approach to

Positive Psychology and Cognitive TherapyMICHAEL B. FRISCH

QOL, HAPPINESS, AND LIFE SATISFACTION AS QUALITY OF CONSCIOUSNESS

• Greatest challenge to clinical psychologists : control of our consciousness, our thoughts, feelings, and physical sensations

• “Are you basically happy, content, or satisfied with your life?”

• The affects usually associated with SWB : contentment,satisfaction, happiness, enjoyment, pleasure,and enthusiasm

THE BENEFITS OF HAPPINESS ANDLIFE SATISFACTION

Characteristics of the very happy↓

stably happy people (those who experience positive emotions most of the time)

↓more successful at achieving additional goals in

valued areas of life

TOWARD AUNIFIED CONCEPTION OF QOL

Inconsistency in Measurement and in Conceptualization

The pervasive lack of articulated theory and the methodological inconsistency (social work,

nursing, psychology, medicine, gerontology)

KEY FEATURES OF QOL THEORY

1. Offers the Five Paths or CASIO rubric or model of life satisfaction

2. Spells out how positive psychology interventions can be incorporated into clinical practice

3. Delineates how QOLT can be used clinically4. Suggests how activation of Beck’s constructive

mode with QOLT can benefit nonclinical or “pure” positive psychology populations

DEFINING QUALITY OF LIFE

• Quality of life refers to the degree of excellence in life (or living) relative to some expressed or implied standard of comparison, such as most people in a particular society

• “Social Indicators Movement,” measurement in gerontology, Clinical and health

DEFINING HAPPINESS, WELL-BEING,AND QOL

• Affective theorists define SWB as either positive affect alone or as a preponderance of positive affect (such as joy, contentment, or pleasure) over negative affect (such as sadness, depression, anxiety, or anger) in an individual’s experience (Andrews & Robinson, 1991; Bradburn, 1969).

LIFE SATISFACTION APPROACH

• life satisfaction is defined as a “cognitive judgmental process dependent upon a comparison of one’s circumstances with what is thought to be an appropriate standard”

QOL AS THE LIFE SATISFACTIONPART OF HAPPINESS

life satisfaction refers to our subjective evaluation of the degree to which our most important needs,

goals, and wishes have been fulfilled

Quality Of Life↕

Life Satisfaction

The 16 Areas of Life That May Constitute a Person’s Overall Quality of Life

1. Health2. Self-Esteem3. Goals-and-Values/Spiritual Life4. Money (or Standard of Living)5. Work6. Play (or Recreation)7. Learning8. Creativity

The 16 Areas of Life That May Constitute a Person’s Overall Quality of Life

9. Helping10.Love (or Love Relationship)11.Friends (or Friendships)12.Children13.Relatives14.Home15.Neighborhood16.Community

LIFE SATISFACTION AS A PREDICTOROF HEALTH PROBLEMS AND HEALTHRELATED

EXPENDITURES AS WELL AS FUTURE JOB PERFORMANCE AND SATISFACTION

• Job performance and satisfaction as much as 5 years in advance

• Job accidents, unit profitability, and productivity• School performance• Healthcare expenditures• Suicide• Deaths due to fatal injuries• Response of depressed clients to pharmacotherapy

• Chronic pain syndrome• Cardiovascular diseases such as myocardial

infarction• Other physical illnesses such as respiratory tract

infections and colds• Willingness to participate in prevention programs

aimed at eliminating unhealthy behaviors like smoking

• Adolescent substance abuse

LIFE SATISFACTION AS A PREDICTOROF HEALTH PROBLEMS AND HEALTHRELATED

EXPENDITURES AS WELL AS FUTURE JOB PERFORMANCE AND SATISFACTION

• Adolescent and adult violent and aggressive behaviors

• Peer relationship problems in adolescents• Impulsive, reckless behavior such as unsafe sex

practices• Somatoform disorders• Anxiety disorders• Major depression—initial onset and relapse

LIFE SATISFACTION AS A PREDICTOROF HEALTH PROBLEMS AND HEALTHRELATED

EXPENDITURES AS WELL AS FUTURE JOB PERFORMANCE AND SATISFACTION

FIVE PATH OR “CASIO” MODEL OF LIFE SATISFACTION AND QOL INTERVENTIONS

Five Path or CASIO model of life satisfaction, happiness, and positive psychology intervention. Note: The O element ofCASIO refers to the assumption that overall satisfaction may be increased by boosting satisfaction in any valued area of life, even areasOther than those of immediate concern. Interventions in any CASIO element may boost happiness in an area of life like love or work.In Beck’s cognitive theory, moderate to high happiness or life satisfaction may be seen as part the positive schema cluster called theconstructive mode.

The C in the CASIO Model: ObjectiveCharacteristics and Living Conditions

Objective life circumstances or living conditions refer to the objective physical and social

characteristics of an area of life whose ef fects on life satisfaction and SWB are cognitively

mediated

A in CASIO Model: Attitude

• how a person interprets reality or a set of circumstances once it is perceived

• This interpretation includes deciding the implications that a given set of circumstances has for a person’s self-esteem (e.g., causal attributions) and present or future well-being.

The S in the CASIO Model: Standardsof Fulfillment

• People will feel more satisfied when they perceive that their standards of fulfillment have been met and less satisfied when they have not been met.

↓16 area

The I in the CASIO Model: Weighing AreaSatisfaction by Importance

• satisfaction in highly valued areas of life is assumed to have a greater influence on evaluations of overall life satisfaction than areas of equal satisfaction judged of lesser importance

• Ex :

work ≈ recreational

The O in the CASIO Model:Overall Satisfaction

• The gist of the O positive psychology strategy is to focus on these areas of lesser concern or focus in order to increase overall positive affect.

RISK AND PROTECTIVE FACTORS FORLIFE SATISFACTION AND HIGH QOL:“TOP-DOWN” AND “BOTTOM-UP”INFLUENCES ON LIFE SATISFACTION

1. inadequate coping skills or functional abilities, especially social skills related to valued areas of life;

2. any of the following generalized cognitive styles or personality traits

3. biological (heritable) vulnerabilities to anxiety, depression, and low trait SWB/unhappiness

4. Social isolation or lack of social support, especially close friends, mates, or confidant

5. early experiences with loss, uncontrollable events, and unpredictable events

• Integration of QOL Theory with Beck’s Cognitive Theory of Depression and Related Disorders. Note: Based on Barlow (2002), Beck (1995), D. A. Clark and Beck (1999), and Persons et al. (2001).

• Related disorders include anxiety, anger, substance abuse, and personality disorders. Weakness in the schemas of the constructive or satisfaction mode may be a maintaining factor in depression just as their strengthening may be an essential part of cognitive therapy treatment

QOLTHEORY: VULNERABILITIES AND PROTECTIVE FACTORS TO DISSATISFACTION,UNHAPPINESS, DEPRESSION, AND RELATED

DISORDERS

1. inadequate coping skills, problem-solving skills, and/or social skills related to valued areas of life

2. any of the following generalized cognitive styles or personality traits

3. Biological (heritable) vulnerabilities to anxiety, depression, low SWB/unhappiness or exaggerated neuroendrocrine reactions to stress

4. lack of social support, especially a close friend or confidant;

QOLTHEORY: VULNERABILITIES AND PROTECTIVE FACTORS TO DISSATISFACTION,UNHAPPINESS, DEPRESSION, AND RELATED

DISORDERS

5. Early experiences with loss, uncontrollable events, and unpredictable events

6. negative parenting experiences with unengaged, neglectful or overprotective, and emotionally reactive caretakers who model ineffective coping skills and who fail to foster autonomy and self-efficacy;

7. a low frequency of pleasant events

LIFE MANAGEMENT SKILLS

small steps of progress toward long-term goals are made every day, then we will feel happier

and more content instead of dysphoric and frustrated, the feelings associated with unsuccessful goal-strivings and coping.

Indeed, successful goal striving is negatively reinforced to the extent that dysphoria and

frustration are reduced with goal attainment.

USE OF THE CASIO MODEL OF LIFESATISFACTION IN FORMULATING POSITIVE

PSYCHOLOGY AND CLINICAL INTERVENTIONS FOR CLINICALLY DISTURBED AND NONCLINICAL

CLIENT POPULATIONS

CASIO rubric for problem solving and QOL enhancement :Happiness comes largely from achieving one’s goals and living one’s values in the areas of life

that one cares about.