INTRODUCTION
Depression is a condition
when the mood decreases and the reluctance to do activities or apathy can
affect the thoughts, feelings, behavior, and well-being of individuals (N, 2017). This condition can cause
individuals to commit suicide or premature death. The annual prevalence of
major depression is 6.6% and the lifetime prevalence of depression is 16.2% (Miller, Dell�Osso, & Ketter, 2014). Worldwide, 804,000 people committed
suicide in 2012, making depression the second leading cause of death for young
adults (15-29 years) after traffic accidents (Organization, 2016).
Individuals with major depression have a 40% greater chance of dying earlier
than individuals in general (Organization, 2016). In
Indonesia, according to Riskesdas 2018 data, it is estimated that more than 12
million Indonesians aged over 15 years have experienced depression (Kemenkes, 2020).
Several studies have been
conducted to reduce depression levels such as cognitive behavioral therapy,
self-help mindfulness-based cognitive therapy, regular exercise, qigong, and
electroacupuncture (Jing-Ping Zhang, Yu-Fang Guo, Xia Zhang, Hui Li &
Hung, n.d.). Most traditional therapies
focus on depressive symptoms rather than individual strengths and weaknesses.
There are still few interventions that focus on improving individual attitudes
and conditions (Jing-Ping Zhang, Yu-Fang Guo, Xia Zhang, Hui Li &
Hung, n.d.).
Positive psychotherapy (PPT)
developed by Seligman, Rasyid & Parks helps individuals to regulate
emotions and improve self-evaluation in various contexts by teaching
individuals to be able to use both positive and negative sides (Rashid, 2015). PPT
has been shown to be effective for improving individual psychological health (Jing-Ping Zhang, Yu-Fang Guo, Xia Zhang, Hui Li &
Hung, n.d.). Research conducted by (Seligman, Rashid, & Parks, 2006),
showed that PPT can reduce levels of depression. Similarly, research conducted
by (Khanjani, 2017),
states that positive psychotherapy is effective for reducing anxiety, stress,
and depression. In addition, research conducted by (Firoozy & Ramezani Piyani, 2018),
shows that positive psychotherapy significantly reduces depression and anxiety.
Psychotherapy not only solves
the problem of clinical symptoms, but can also increase the positive
psychological component of each individual. Teaching positive psychological
techniques and skills can strengthen and enhance positive relationships with
oneself, others, and the world (Mahmoudi & Khoshakhlagh, 2018).
Psychotherapy guides individuals to focus on positive things in themselves and
others and causes individuals to be able to take responsibility despite their
own weaknesses and become more aware of themselves.
In the process of giving
positive psychotherapy to individuals who are depressed, the positive things
that are in them are emphasized while trying to focus on eliminating the
negative emotions they feel (Mahmoudi & Khoshakhlagh, 2018).
Individuals try to identify abilities, capacities, and positive dimensions that
exist in themselves and others that ultimately make individuals improve
attitudes towards other people such as family members and friends of the individual.
This approach emphasizes abilities and talents, optimism on happiness, focuses
more on positive things and emotions, and prevents negative emotions from
entering oneself. This will increase the positive relationship which is one of
the basics of a positive approach so that it has an effect on the mental health
of a more positive individual (Mahmoudi & Khoshakhlagh, 2018).
Based on the results of the
study, the researcher wanted to try to test the effectiveness of this
intervention. The aim of this research is to increase statistical power.
METHOD
1. Meta-Analysis
Meta analysis is a
quantitative technique that uses a specific measure (eg effect size) to show
the strength of the relationship between a study's variables that are included
in the analysis. This technique emphasizes the results of multiple studies as
opposed to the results of a single study (Shelby & Vaske, 2008).
2. Statistical
Procedure
This study will look at the
effectiveness of giving positive psychotherapy to reduce the level of
depression through post-treatment results in the experimental group (EC) and
control group (KK). Effect size is seen from the mean (M) and Standard
Deviation (SD) and sample size (N) on the post-treatment results. The
heterogeneity of the research is obtained from the value of I2 with the greater
the value produced, the greater the diversity of results, and vice versa.
Statistical analysis in this
study looked at the value of effect size (Cohen d). The result is said to have
a large effect size value when the result is above 0.8 (large effect size). If
the effect size value obtained is above 0.5, it is said to be medium (medium
effect size). Finally, the effect size result is said to have a small value
when the result is below 0.2 (small effect size) (Sullivan & Feinn, 2012).
This study was analyzed using the Stat Direct Trial Version. This paper refers
to the meta-analysis guidelines for PRISMA 2009 and MARS 2012.
3. Sources
and Information Searching Past Research
The database sources used in
the search for previous studies are Research Gate, NCBI and Springer Link. The
keywords used are as follows: "Positive Psychotherapy",
"Positive Psychotherapy for Depression" and "Positive
Psychotherapy to Decrease Depression". The language used in writing the
keywords is English and the selection of journals is limited to international
journals that have been published. Furthermore, 14 main journals were collected
that will be used. The process of searching for journals in this study is
listed in the following image.
1. Meta-Analysis
Results
The results obtained from the
effectiveness of positive psychotherapy to reduce the level of depression based
on the effect size of 0.10 (95% CI = -0.691597 to 0.89557, P = 0.08) and I2
(inconsistency) of 93.8% (95 % CI = 91.6% to 95.1%). This means that giving
positive psychotherapy has a small and insignificant effect on reducing
depression levels and there is publication bias.
2. Discussion
Positive psychotherapy is a
psychotherapy approach to build individual strengths and positive emotions,
increase meaning from life to reduce individual psychopathology, and foster
happiness (Magyar-Moe, Owens, & Conoley, 2015).
Based on the results of the meta-analysis, the effect size value is small
(small effect size) which is 0.10 (≤ 0.2). This means that positive
psychotherapy has a small and insignificant effect on reducing depression
levels. A study conducted by (Khanjani, 2017),
stated that when PPT was combined with the Pennsylvania Resilience Program it
would produce more effective results for reducing stress, anxiety, depression
and increasing life satisfaction, optimistic attitude, and psychological well-being
(Khanjani, 2017).
There are differences in the
measuring instruments used to measure depression, the type of depression,
gender, and age may affect the results of this study. This is one of the
weaknesses in this study. Therefore, in future meta-analytical studies with
similar topics, it is hoped that this intervention will review and provide more
specific limitations regarding the age, measuring instrument used, gender, and
type of depression of each participant.
CONCLUSION
Previous studies have revealed that positive psychotherapy
has a positive effectiveness for reducing depression. However, based on the
results of the meta-analysis conducted by the researcher, it was found that the
effect size is relatively small (small effect size) which is 0.10 (≤
0.2). It is different with the results of the meta-analysis conducted by Kazdin
and Bass (1989), showing a medium effect size. The inconsistency of these
results can be due to several factors, first, positive psychotherapy will be
much more effective when combined with other intervention techniques and
medications. In addition, there is doubt that the positive effects of
psychotherapy are specific for individuals with depression. Increased positive
emotions, engagement, and meaningful life is the basis for avoiding or fighting
from the problems and tribulations experienced in life. There are differences
in the measuring instruments used to measure depression, the type of
depression, gender, and age may affect the results of this study. This is one
of the weaknesses in this study. Therefore, in future meta-analytical studies
with similar topics, it is hoped that this intervention will review and provide
more specific limitations regarding the age, measuring instrument used, gender,
and type of depression of each participant.
REFERENCES
Amini,
Sahar, Namdari, Kourosh, & Kooshki, Hossinali Mehrabi. (2016). The
effectiveness of positive psychotherapy on happiness and gratitude of female
students. International Journal of Educational and Psychological Researches,
2(3), 163. Google
Scholar
Asl, S T S, Sadeghi, K., Bakhtiari, M.,
Khazaie, H., Rezaei, M., & Ahmadi, S. M. (2014). The effectiveness of group
positive psychotherapy on improving the depression and increasing the happiness
of the infertile women: Clinical trial. European Journal of Experimental
Biology, 4(3), 269�275. Google
Scholar
Asl, Seyed Teymur Seyedi, Sadeghi, Kheirollah,
Bakhtiari, Mitra, Ahmadi, Seyed Mojtaba, Anamagh, Alireza Nazari, &
Khayatan, Tayebeh. (2016). Effect of group positive psychotherapy on
improvement of life satisfaction and the quality of life in infertile woman. International
Journal of Fertility & Sterility, 10(1), 105. Google
Scholar
Dowlatabadi, Mohammad Mehdi, Ahmadi, Seyed
Mojtaba, Sorbi, Mohammad Hossein, Beiki, Omid, Razavi, Tayebeh Khademeh, &
Bidaki, Reza. (2016). The effectiveness of group positive psychotherapy on
depression and happiness in breast cancer patients: A randomized controlled
trial. Electronic Physician, 8(3), 2175. Google
Scholar
Falakaflaki, Sima, & Malekitabar, Mahmoud.
(2016). Group Positive Psychotherapy Effect on Increasing the Happiness of
Mothers of Children with Cochlear Implant. Google
Scholar
Firoozy, M., & Ramezani Piyani, M. (2018).
Effect of positive psychotherapy based on virtual social networks on anxiety
and depression reduction in veterans with spinal cord injury. Iranian
Journal of War and Public Health, 10(1), 21�26. Google
Scholar
Heydari, Mahbobe Ghavidel, Shirazi, Mahmoud,
& Sanagouyemoharer, Gholam Reza. (2018). The effect of positive
psychotherapy in test anxiety among Zahedan students with hemophilia. Research
in Psychotherapy: Psychopathology, Process, and Outcome, 21(1). Google
Scholar
Jing-Ping Zhang, Yu-Fang Guo, Xia Zhang, Hui
Li, Yi ZhenYin, & Hung, Fei Fei and Man Ye. (n.d.). Effects of Positive
Psychotherapy on Depression and Self-efficacy in Undergraduate Nursing Students
Positive Psychotherapy. RRJNHS, 1(3), 12-18. Journal of Nursing & Health
Sciences, 2015. Google
Scholar
Kemenkes. (2020). Kesiapsiagaan Remaja Dalam
Menghadapi Wabah Covid-19. Kemenkes. Google
Scholar
Khanjani, Mahdi. (2017). The Impact of
Positive Psychotherapy on Decreasing the College Students� Stress, Anxiety,
Depression and Increasing their Well-being. مطالعات
روان شناسی بالینی,
7(28), 97�110. Google Scholar
Khayatan, Tayebeh, Azkhosh, Manouchehr,
Bahmani, Bahman, Azimian, Mojtaba, & Dolatshahi, Behrooz. (2014). Group
positive psychotherapy and depression of females affected by multiple
sclerosis. Iranian Rehabilitation Journal, 12(4), 49�53. Google
Scholar
L�, Wei, Wang, Zhenhong, & Liu, Ya.
(2013). A pilot study on changes of cardiac vagal tone in individuals with low
trait positive affect: The effect of positive psychotherapy. International
Journal of Psychophysiology, 88(2), 213�217. Google
Scholar
Magyar-Moe, Jeana L., Owens, Rhea L., &
Conoley, Collie W. (2015). Positive psychological interventions in counseling:
What every counseling psychologist should know. The Counseling Psychologist,
43(4), 508�557. Google
Scholar
Mahmoudi, Hamidreza, & Khoshakhlagh,
Hasan. (2018). The effectiveness of positive psychotherapy on psychological
well-being and self-esteem among adolescents with depression disorder. Social
Behavior Research & Health, 2(1), 153�163. Google
Scholar
Miller, Shefali, Dell�Osso, Bernardo, &
Ketter, Terence A. (2014). The prevalence and burden of bipolar depression. Journal
of Affective Disorders, 169, S3�S11. Google
Scholar
N, Al Qahtani A. &. Al Qahtani. (2017).
Prevention of Depression: A Review of Literature. Journal of Depression and
Anxiety, 6(4). Google
Scholar
Organization, World Health. (2016). World
health statistics 2016: monitoring health for the SDGs sustainable development
goals. World Health Organization. Google
Scholar
Rashid, Tayyab. (2015). Positive
psychotherapy: A strength-based approach. The Journal of Positive Psychology,
10(1), 25�40. Google
Scholar
Seligman, Martin E. P., Rashid, Tayyab, &
Parks, Acacia C. (2006). Positive psychotherapy. American Psychologist, 61(8),
774. Google Scholar
Shelby, Lori B., & Vaske, Jerry J. (2008).
Understanding meta-analysis: A review of the methodological literature. Leisure
Sciences, 30(2), 96�110. Google
Scholar
Sorbi, Mohammad Hossein, Rahmanian, Masoud,
& Azizi, Reyhaneh. (2019). The Effectiveness of Positive Psychotherapy on
the Well-Being and Glycemic Control of Patients with Type 2 Diabetes: A
Randomized Controlled Trial. Thrita, 8(1). Google
Scholar
Sullivan, Gail M., & Feinn, Richard.
(2012). Using effect size�or why the P value is not enough. Journal of
Graduate Medical Education, 4(3), 279�282. Google
Scholar
Zeykani, Marziye, & Nikmanesh, Zahra.
(2018). The effect of positive psychotherapy on perceived competence and
quality of life among children with thalassemia. Jundishapur Journal of
Chronic Disease Care, 7(1). Google
Scholar
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