Feasibility, acceptability, and impact of a web-based gratitude exercise among individuals in outpatient treatment for alcohol use disorder

Abstract

This mixed-methods pilot study examined the feasibility, acceptability, and impact of a web-based gratitude exercise (the ‘Three Good Things’ exercise (TGT)) among 23 adults in outpatient treatment for alcohol use disorder (AUD). Participants were randomized to TGT or a placebo condition. The intervention was feasible with high rates of completion. Participants found TGT acceptable and welcomed the structure of daily emails; however, they found it difficult at times and discontinued TGT when the study ended. Participants associated TGT with gratitude, although there were no observed changes in grateful disposition over time. TGT had a significant effect on decreasing negative affect and increasing unactivated (e.g., feeling calm, at ease) positive affect, although there were no differences between groups at the 8 week follow up. Qualitative results converged on quantitative findings that TGT was convenient, feasible, and acceptable, and additionally suggested that TGT was beneficial for engendering positive cognitions and reinforcing recovery.

Gratitude, abstinence, and alcohol use disorders: Report of a preliminary finding

“…In previous work, participants in recovery regularly expressed gratitude for sobriety (Krentzman et al, 2015). Perhaps gratitude for sobriety functions differently in its effects on drinking than more general trait gratitude, but the scale used to measure gratitude would not have differentiated between the two.…”

“…Some studies have reported that gratitude exercises were associated with increases in trait gratitude (R. Emmons & McCullough, 2003; Froh, Sefick, & Emmons, 2008; Rao & Kemper, 2017; Redwine et al, 2016) while other studies have reported no change in trait gratitude as the result of gratitude practices (Harbaugh & Vasey, 2014; Killen & Macaskill, 2015; Krentzman et al, 2015; Toepfer, Cichy, & Peters, 2012). Could trait gratitude increase with the onset of addiction recovery, in the absence of gratitude exercises?…”

“…Thus far, one pilot study supports this hypothesis. A randomized controlled pilot tested the effects of a 14-day gratitude exercise among individuals in treatment for alcohol use disorders and found that the practice was associated with a decrease in negative affect (e.g., feeling angry, irritated, upset) and an increase in unactivated positive affect (e.g., feeling calm, at ease, relaxed) (Krentzman et al, 2015). The second theory of gratitude’s support for recovery is a cognitive theory of the effect of gratitude on outlook.…”

“…Thus, gratitude can arise because active addiction has ceased and gratitude can arise because good things are happening in recovery. In a pilot study, participants recovering from alcohol use disorders were asked to write about three good things that happened each day and why they happened (Krentzman et al, 2015). Participants repeatedly stated that good things happened in their lives because they were sober.…”

Randomized controlled trial of a positive affect intervention for people newly diagnosed with HIV.

“…Researchers have begun to demonstrate the efficacy of interventions that specifically target positive affect for people living with chronic physical and mental health conditions (Boutin-Foster et al, 2016; Caponigro et al, 2013; Carrico et al, 2015; Cohn et al, 2014; Huffman et al, 2015; Huffman et al, 2011; Krentzman et al, 2015; Ogedegbe et al, 2012; Peterson et al, 2012; Seligman et al, 2005). Although most of these studies have been small pilot feasibility and preliminary efficacy studies, Charlson and colleagues have conducted larger-scale randomized trials of a positive affect intervention in samples of people with chronic illness and hypothesized that the intervention would have beneficial effects on health behaviors (Mancuso et al, 2012; Ogedegbe et al, 2012; Peterson et al, 2012).…”