Gratitude interventions don’t help with depression, anxiety

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A study by researchers at The Ohio State University analysed results from 27 separate studies that examined the effectiveness of gratitude interventions on reducing symptoms of anxiety and depression. The results showed that such interventions had limited benefits at best.

“For years now, we have heard in the media and elsewhere about how finding ways to increase gratitude can help make us happier and healthier in so many ways,” said David Cregg, lead author of the study and a doctoral student in psychology at Ohio State. “But when it comes to one supposed benefit of these interventions – helping with symptoms of anxiety and depression — they really seem to have limited value.”

Cregg conducted the study with Jennifer Cheavens, associate professor of psychology at Ohio State.

There are two commonly recommended gratitude interventions, Cheavens said. One is the “Three Good Things” exercise: At the end of the day, a person thinks of three things that went well for them that day, then writes them down and reflects on them.

Another is a “gratitude visit,” when a person writes a letter thanking someone who has made a difference in their life and then reads the letter to that person.

The 27 studies involved in this analysis often had participants do one of these exercises or something similar. The studies included 3,675 participants.

In many studies, participants who did the gratitude interventions were compared with people who performed a similar activity that was unrelated to gratitude. For example, instead of writing about what they were grateful about, a college student sample might write about their class schedule.

The gratitude intervention was not much better at relieving anxiety and depression than the seemingly unrelated activity.

“There was a difference, but it was a small difference,” Cheavens said. “It would not be something you would recommend as a treatment.” As an alternative, Cheavens and Cregg recommend people pursue treatments that have been shown to be effective with anxiety and depression, such as cognitive behavioural therapy.

The results suggest that it isn’t helpful to tell people with symptoms of depression or anxiety to simply be more grateful for the good things they have, Cheavens said. “Based on our results, telling people who are feeling depressed and anxious to be more grateful likely won’t result in the kind of reductions in depression and anxiety we would want to see,” she said.

“It might be that these sort of interventions, on their own, aren’t powerful enough or that people have difficulty enacting them fully when they are feeling depressed and anxious.”

The results don’t mean that there are no benefits to being grateful or to using gratitude interventions, the researchers said. In fact, some studies show that such interventions are effective at improving relationships.

“It is good to be more grateful – it has intrinsic virtue and there’s evidence that people who have gratitude as a general trait have a lower incidence of mental health problems and better relationships,” Cregg said.

“The problem is when we try to turn gratefulness into a self-help tool. Gratitude can’t fix everything.”

Abstract
Research suggests gratitude interventions—designed to increase appreciation of positive qualities, situations, and people in one’s life—may improve psychological well-being (Seligman et al. in Am Psychol 60:410–421, 2005. https://doi.org/10.1037/0003-066X.60.5.410). Accordingly, mental health practitioners have promoted gratitude interventions as a means of self-help. However, results from previous reviews suggest that well-being improvements associated with gratitude interventions may be attributable to placebo effects (Davis et al. in J Couns Psychol 63:20–31, 2016. https://doi.org/10.1037/cou0000107; Wood et al. in Clin Psychol Rev 30:890–905, 2010, https://doi.org/10.1016/j.cpr.2010.03.005). With this meta-analysis, we examined the efficacy of gratitude interventions (k = 27, N = 3675) in reducing symptoms of depression and anxiety at post-test and follow-up periods. Gratitude interventions had a small effect on symptoms of depression and anxiety at both post-test (g = − 0.29, SE = 0.06, p < .01) and follow-up (g = − 0.23, SE = 0.06, p < .01). Correcting for attenuation from unreliability did not change results. Moderation analyses indicated effect sizes were larger for studies using waitlist, rather than active, control conditions at post-test and follow-up. We did not find consistent evidence for effects of other moderator variables (e.g., risk of bias, depressive symptom severity, or type of intervention used). Our results suggest the effects of gratitude interventions on symptoms of depression and anxiety are relatively modest. Therefore, we recommend individuals seeking to reduce symptoms of depression and anxiety engage in interventions with stronger evidence of efficacy for these symptoms.

Authors
David R Cregg, Jennifer S Cheaven

The Ohio State University material

Journal of Happiness Studies abstract

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