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Character Strengths and Health: Practical Implications – Part 2

Ryan Niemiec1, Alina Yarova2

1 Education Director, VIA Institute on Character, Cincinnati, Ohio

2 Vice President, Positive Health and Wellness Division, International Positive Psychology Association (IPPA), New York, New York

Corresponding Authors: 

Alina Yarova, Vice President, Positive Health and Wellness Division, International Positive Psychology Association (IPPA), New York, New York, yarova.a@gmail.com

Ryan Niemiec, Education Director, VIA Institute on Character, Cincinnati, Ohio, ryan@viacharacter.org 

Note: This article is a continuation of an article published previously: Character Strengths and Health Research- Part 1.

Character Strengths and Health: Practical Implications – Part 2

In Part 1 of “Character Strengths and Health,” we examined the science of character strengths within the domain of health across four categories of investigation. In this condensed summary, we highlighted that there is exciting pioneering research showing an important role for character strengths and their interventions, however, this research is, in our opinion, in its infancy. Part 2 takes off from there offering practical considerations and future directions for this exciting field.

A. Practical Implications and Future Directions 

It is clear that interventions are finding success in a range of healthcare settings and the potential is substantial. That said, the progress to date has been incremental as the medical model and deficit-based approaches are deeply entrenched. To counterbalance this with a character strengths-based approach, we argue for the advancement of research and development of best practices across the following three areas: the individual, the provider, and the system.

1. The Individual

While we detail several interventions that have been used in group settings in Part 1, the simplest starting point for application is with the individual. When working with individuals on health-related areas, practitioners can directly leverage any of an individual’s 24 character strengths, pursue the individual’s top strengths (called signature strengths), or deploy relevant character strengths concepts such as overuse and underuse of character strengths. We immerse each of these ideas in a handful of examples below. 

Health promotion/lifestyle adjustment: Character strengths can be used to start or maintain a range of healthy lifestyle habits such as boosting exercise, improving sleep hygiene, and building healthy eating (Niemiec, 2019). Patients might tap into the strength of prudence to map out an exercise plan, use their signature strengths of curiosity and love of learning to build in healthier eating habits, and strategize on how to not to underuse their strength of self-regulation when establishing a new routine for their sleep schedule.

  • Psychosocial impact: It is clear from the literature that psychosocial drivers are one of the biggest reasons patients seek medical attention, especially in primary care settings. It is also clear that physicians and nurses are often the main provider of mental health treatment (and in some regions, the only mental health providers). Character strengths offer an opportunity to build upon what is strong within the patient. Patients can be encouraged to set up signature strengths goals that directly target their mental health. This often leaves patients feeling empowered with greater self-efficacy to approach their mental health in a new way. 
  • Physical illness management: As character strengths are human capacities for thinking, feeling, and behaving in healthy and productive ways, they play an important role in counterbalancing the catastrophizing thinking, depression triad, anxiety/fear-response, helplessness, and counterproductive behavior that often accompanies chronic illness. Another reality of chronic illness is chronic stress. Patients can be encouraged to turn to their signature strengths as additional tools within them to approach their illness in a different way. The stories of cancer patients using strengths of bravery, perseverance, perspective, and kindness are legion.  The strengths of love, gratitude, and hope that are born in patients following a successful heart surgery are as frequent as they are inspiring. And, the stories of patients learning to bravely face their chronic pain, discover meaning in a new diagnosis of diabetes, weave in self-regulation to manage arthritis, and paradoxically find hope in the present moment despite a new terminal illness are too high to count. If these patients did not turn to several of their character strengths to reframe, cope with, or transcend their illness, especially turning to their most central signature strengths, what else could they possibly turn to internally? 
  • Adherence: Character strengths certainly play an important role in improving adherence to medications or medical regimens (Berg et al., 2007). Consider the importance of using bravery or perspective when self-administering insulin shots.

These aims can be pursued on one’s own or with the help of a qualified provider or practitioner anywhere on the spectrum from an individual pursuing a wellness goal to a patient managing an illness within the context of a traditional healthcare setting.   

2. The Provider / Practitioner

The healthcare provider, and in particular the medical doctor, is well positioned to disseminate the science and encourage the practice of character strengths. As authority figures, physicians are some of the most respected in our society, and the potential to serve as exemplars and model character strengths is far reaching. Unfortunately, this particular channel of influence is significantly underdeveloped. 

Beyond the role of the physician, a range of other providers and practitioners, within medicine/healthcare as well as the broader wellness spheres can play significant roles. These include nurses, nurse practitioners, physician assistants, nutritionists, dieticians, medical assistants and health coaches. As more traditional care models evolve to team-based, patient-centered approaches, these providers can play a greater role in supporting patient well-being using character strengths. 

 Specific suggestions include:

  • Incorporating character strengths training into a range of medical curriculums: medical school, residency, as well as physician and other provider continuing education. Training should cover core concepts, research, case examples and applications, as well as the “what, why, and how” of character strengths for health. In addition, interventions aimed at supporting physician and other provider well-being (e.g., using character strengths at work, tailored to the healthcare setting) is essential.
  • To both improve their own strengths development and encourage patient education, providers can integrate strengths into their workflow in the following ways: 

a) assess strengths formally and informally

b) display character strengths in sessions

c) lead strength-oriented discussions

d) probe past use of strengths

e) strengths-spot and reinforce strengths

f) offer strengths education in the form of handouts and videos

g) reframe patient problems from a strengths lens

h) offer character strength prescriptions in every patient encounter.

3. The System

Ultimately, the largest impact will come from a systemic approach. Workplace research has shown support for the importance of institutions operating within a strengths-based climate, establishing links between well-being and productivity (van Woerkom & Meyers, 2014). New research shows that the signature strengths of physicians have a positive impact on social-moral climate in the medical setting. In turn, such positive climates have a positive impact on physician’s signature strengths. Opportunities for integrating a strengths-based approach exist at both the health system (e.g., hospital system and provider network) and public health levels (local, regional and national).  

Suggestions include:

  • Health systems can commit to a character strengths-based approach that is systematic and comprehensive, inclusive of the entire staff, and emphasizes the integration of character strengths assessment into electronic medical records (EMRs) and patient interviews while integrating character strengths interventions into patient education and treatment approaches. 
  • Public health governing bodies can incorporate strengths-based approaches into health promotion programs and materials.
  • The VIA Classification language, definitions, and interventions can be posted and made available in health, wellness and community settings. This keeps a “common language” at the top of the healthcare professional’s mind, can serve as a cue for medical staff when interacting with patients, and may prompt discussion through patient’s curiosity and questioning.
  • Healthcare teams can bring strengths-spotting, strengths appreciation, and strengths conversations directly into their meetings and hallway conversations. Some teams may start a meeting with one team member sharing a short story of strengths use that week, share a strengths-based intervention that was impactful for a patient that week, and conclude meetings with one instance of strengths-spotting from the meeting. 

Health and wellness systems can prioritize trainings in the science of well-being and character strengths for physicians, nurses, and other medical staff. Particular attention might be paid to training new staff on character strengths as new research with young physicians shows the importance of building skills around character strengths and fostering thriving workplace characteristics in hospitals (Strecker et al., 2019).

B. Conclusion

Our aim in these two articles has been to synthesize the research and outline a number of future directions for further study, application and dissemination of character strengths in health and healthcare. Though many excellent studies exist, further and more nuanced research establishing additional linkages between use of character strengths and health, examining different populations, and exhibiting greater statistical power are needed. For further application ideas for practitioners and healthcare administrators looking to create a strengths culture or deploy strengths interventions, see Niemiec (2018), while consumers looking to pursue greater health by means of character strengths can see Niemiec (2019). We look to the future of this important area of research and practice with a sense of hope. 

C. References

Berg, C. J., Rapoff, M. A., Snyder, C. R., & Belmont, J. M. (2007). The relationship of      children’s hope to pediatric asthma treatment adherence. Journal of Positive Psychology, 2, 176-184.

Höge, T., Strecker, C., Hausler, M., Huber, A., & Höfer, S. (2019). Perceived socio-moral climate and the applicability of signature character strengths at work: A study among hospital physicians. Applied Research in Quality of Life. 

https://doi.org/10.1007/s11482-018-9697-x 

Niemiec, R. M. (2018). Character strengths interventions: A field-guide for practitioners. Boston, MA: Hogrefe.

Niemiec, R. M. (2019). The strengths-based workbook for stress relief: A character strengths approach to finding calm in the chaos of daily life. Oakland, CA: New Harbinger.

Strecker, C., Huber, A., Höge, T., Hausler, M., & Höfer, S. (2019). Identifying thriving   workplaces in hospitals: Work characteristics and the applicability of character strengths at work. Applied Research in Quality of Life. https://doi.org/10.1007/s11482-018-9693-1

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