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Gratitude and Social Support: When We Share, We Grow

Increasing social support has been a shortcoming in self-help apps. With ever increasing telehealth options available, this important piece to overall wellbeing must not be overlooked. To discover whether interventions that increase social support can be easily integrated into existing application structure, this study examined how the sharing of a gratitude journal can increase feelings of social support more than journaling alone. The results were that when participants shared their journal they felt more connected to their social circle. This research may now be applied to improved self-help application development.

What is the purpose?

To explore techniques for increasing feelings of social support and overall mental wellness while decreasing feelings of stress within a digital therapeutic setting.

Hypothesis

I hypothesized that a gratitude practice in addition to a stress journal will have a significant positive effect on mood, and sharing this gratitude exercise will have an effect of increased feelings of social connection.
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What is the method?

The study consists of a questionnaire about stress, social support, overall mental wellness, and gratitude, as well as journal exercises focusing on stress, gratitude, and social support.

Study Design

A 2 (time) x 2 (journal group) Mixed design ANOVA was conducted to assess whether the type of journaling of the participant would affect levels of stress, gratitude, mental wellness, and social support.
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What are the results?

By completing the study, participants reported a reduction of stress and an increase in overall mental wellness and gratitude. Additionally, the group that shared their gratitude exercise reported an increase in feelings of social support.

Application

The implications of findings from this study are that as digital therapy continues to be an exploding field, including simple mechanisms for social interaction may have a significant impact on wellbeing.
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Introduction

Therapeutic treatment has enjoyed a lessening of stigma over the last decade. During the 2019 COVID pandemic crisis, mental health concerns have been especially highlighted, and an increased effort has been made to address how individuals cope with negative emotions and build resilience (Li, et al. 2021). Many self-help apps have become popularized, and focus on techniques such as stress journaling, mood journaling, gratitude practices, meditation, and telehealth counseling (Harvard Health 2015).

Many of these apps focus on positive psychology techniques as opposed to treatment for psychological abnormalities. Positive psychology is the identification and study of positive human emotions, virtues, and character strengths (Seligman, 2005). Peterson and Seligman (2005) defined human strengths into six virtues: wisdom and knowledge, which includes cognitive strengths such as creativity; courage, including emotional strengths such as persistence; humanity, encompassing interpersonal strengths such as altruism; justice, comprising of civic strengths such as leadership; temperance, including strengths of self-regulation such as modesty; and transcendence, involving strengths of spirituality such as mindfulness. Seligman (2005) found that interventions where participants engaged in activities that emphasized one of the aforementioned virtues were significantly happier and experienced decreased depression symptoms over a period of six months. But how can these virtues be easily accessed? Seligman (2005) also examined the use of internet-based interventions as a method for delivering positive psychology techniques and practices.

Seligman (2005) established internet-based interventions as a legitimate method of delivery and found that participants benefited greatly from them. Even when the numbers of interventions increased it appeared that participants rose to the challenge. Torniainen-Holm (2016) verified that participants did not become overwhelmed by multiple internet-based interventions but tended to complete more interventions as the number sent increased (Torniainen-Holm, 2016). In addition to overall happiness, Crookston found that the use of self-help apps increased overall feelings of “motivation, desire to set goals, confidence, control, and intentions to be mentally and emotionally healthy” (Crookston, 2017). Social support was not significantly affected by the use of self-help in the Crookston study, which is what this paper intends to examine. If self-help apps can have such a strong effect on so many positive psychology virtues, it might be possible to evoke that same effect on feelings of social support if the right intervention is utilized. This is where the practice of gratitude becomes significant.

There is some evidence that gratitude interventions positively influence social behaviors and relationships. Wood (2010) discusses the range of social outcomes and traits associated with gratitude, including self-reported perceived quality of relationships. Additionally, in a study where Chu (2020) examined the application of positive psychology techniques to increase student engagement, Chu showed increased feelings of connectedness to the instructor as well as other students in their group after gratitude practice. In another study on gratitude and how it might affect social support and perceived feelings thereof, O’Connell et al. (2018) discusses how gratitude exercises increase quality of friendships and life satisfaction.

With evidence that gratitude strongly influences social feelings and behaviors, gratitude practice in addition to a stress journal will have a significant positive effect on mood as opposed to just journaling alone. Additionally, sharing this gratitude exercise with a trusted relation will have an effect of increased feelings of social connection. This means that there will be a significant main effect of increased feelings of gratitude and overall mental wellness, as well as a decrease of feelings of stress. Additionally, the sharing gratitude group will differ from the journal and gratitude only groups by having significantly higher increased feelings of social support.

Methods

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Participants, who were Winona State University students as well as the general public, were recruited through classroom announcements, postings on social media platforms, word-of-mouth, and via email. WSU psychology students received extra credit for participation. Participants received an email link to Qualtrics, a campus-based surveying system; the survey was anonymous. Prior to participating in the study, participants completed an informed consent form. Participants were then randomized within the Qualtrics survey into one of three groups. This study was approved by the WSU IRB.

In the survey, participants were asked four different questionnaires regarding their levels of stress, social support, overall mental wellness, and gratitude. Then, they completed one of three journaling exercises, depending on experimental group. The first group completed a journal about a stressful event they experienced in the past week, and what they did to overcome the stress. The second group completed the stress journal in addition to a gratitude exercise. The third group completed both the stress journal and gratitude exercise, and then were asked to share the gratitude exercise with a trusted friend. Once the exercise(s) were complete, the participants were then assessed a second time using the same scales from the beginning of the questionnaire, measuring stress, social support, overall mental wellness, and gratitude.

Data Analysis & Results

A 2 (time) x 2 (journal group) Mixed design ANOVA was conducted to assess whether the type of journaling of the participant would affect levels of stress, gratitude, mental wellness, and social support. Follow-up tests were also analyzed as necessary.

TIME Reports

There was a significant main effect between the first and second time the survey was completed and the reported level of STRESS, F (1,79) = 4.73, p = .03. Participants reported a significantly lower STRESS scores on the second survey than on the first survey. There was not a significant main effect between the first and second time the survey was completed and the reported level of SOCIAL SUPPORT, F (1,91) = .89, p = 0.35. There was a significant main effect between the first and second time the survey was completed and the reported level of overall MENTAL WELLNESS, F (1,78) = 14.596, p < .001. Participants did report a significantly higher MENTAL WELLNESS score on the second survey than on the first survey. There was not a significant main effect between the first and second time the survey was completed and the reported level of GRATITUDE, F (1,90) = .960, p = .33. Variable means and standard deviations may be found in Table 1.

GROUP Reports

There was no significant difference among the three groups (Journal (J), Journal + Gratitude (JG), and Journal + Gratitude + SS (JGSS)) of participants for stress (F(1,79) = .20, p = .82), social support (STATS), mental wellness (STATS), or gratitude, STATS. See Table 2 for means and standard errors.

Interaction Effects

There was a significant interaction effect for perceived social support, (2, 91) = 3.46, p = .04. This means that the effect of perceived social support depends on whether the participant engaged in a stress journal only, a stress and gratitude journal, or a stress and gratitude journal shared with a friend.  Follow-up tests sing Bonferroni corrections to control for Type I error were conducted. Neither group J nor group JG changed in social support from time 1 to time 2, Group J: t(91) = .92,  =.36; Group JG: t(91) = .13, =.86). However, group JGSS significantly increased in social support from time 1 to time 2, t(91) = -2.62, =.01.

There were no differences in perceived social support among groups before (F(2,91) = 1.03, p = .36) or after (F(2,91) = 0.6, p = .94) the intervention.

There was no interaction effect on the scores for STRESS, (2, 79) = .63, = .53, MENTAL WELLNESS, (2,78) = .61, = .54, or GRATITUDE, (2, 90) = .22, = .80

Discussion & Application

Positive psychology techniques have been shown to greatly improve mental wellness and partnered with technology they are a powerful tool for promoting mental health. Simply engaging in the act of a stress journal or gratitude practice can increase overall mental wellness. The current model of self-help can be improved, however, by including others in our journey. Results from the current study suggest that when individuals shared the exercises provided with a trusted friend, it had the added effect of increasing feelings of social support.

Participation in the journaling activities that were provided was enough to significantly reduce stress, increase gratitude, and increase overall mental wellness across all three groups. Those individuals who participated in the sharing of the gratitude exercise with a trusted friend, however, were the only ones to experience an increase in feelings of social support. This is in line with previous research on social interaction and gratitude, such as self-reported perceived quality of relationships (Wood, 2010), feelings of connectedness (Chu, Tsz Lun [Alan], 2020), and increased quality of friendships (O’Connell, B. et al, 2018).

Overall, the findings support the current research on gratitude, positive psychology, and social support (Chu, Tsz Lun [Alan], 2020; Crookston, 2017;  O’Connell, et al, 2018; Seligman, 2005; Wood, 2010) These results also add to this body of research that the trusted friend need not be physically present to maintain a positive effect, and therefore this strategy can more easily be implemented across a variety of therapeutic applications. This is especially important as current research has shown that existing self-help applications are lacking in tools for increasing social support (Crookston, 2017).

The implications of findings from the current study are that as digital therapy continues to be an exploding field, including simple mechanisms for social interaction may have a significant impact on wellbeing. These techniques are easily integrated into existing app structures, as sharing has become a central part of individual social media presence. The difference with this type of intervention is that it is targeted to inspire introspection and spark dialogue as opposed to simply updating a status.

This study was not without its limitations, however. Firstly, our original intention was to test gratitude, social support, overall mental wellness, and stress levels at a third time point, but we were unable to collect sufficient data from the follow-up questionnaire within the allotted data collection period. Additionally, our participants were mostly WSU psychology students, and not a very diverse population. In future research, a focus on diversifying subjects’ age, gender, and ethnicity, as well as increasing incentives to complete follow-up surveys across a wider timeframe would be beneficial for the generalization of results.

Chu, Tsz Lun (Alan). (2020) Applying positive psychology to foster student engagement and classroom community amid the COVID-19 pandemic and beyond. Scholarship of Teaching and Learning in Psychology. https://doi.org/10.1037/stl0000238

Crookston, W. (2017). Mental and Emotional Self-Help Technology Apps: Cross-Sectional Study of Theory, Technology, and Mental Health Behaviors. JMIR Mental Health4(4), e45–e45. https://doi.org/10.2196/mental.7262

Li, F., Luo, S., Mu, W. et al. (2021). Effects of sources of social support and resilience on the mental health of different age groups during the COVID-19 pandemic. BMC Psychiatry 21, 16 (2021). https://doi.org/10.1186/s12888-020-03012-1

O’Connell, B., O’Connell, B., O’Shea, D., O’Shea, D., Gallagher, S., & Gallagher, S. (2018). Examining Psychosocial Pathways Underlying Gratitude Interventions: A Randomized Controlled Trial. Journal of Happiness Studies, 19(8), 2421–2444. https://doi.org/10.1007/s10902-017-9931-5

Schueller, P. (2012). Disseminating self-help: positive psychology exercises in an online trial. Journal of Medical Internet Research, 14(3), e63–e63. https://doi.org/10.2196/jmir.1850

Seligman, S. (2005). Positive Psychology Progress: Empirical Validation of Interventions. The American Psychologist60(5), 410–421.­­ https://doi.org/10.1037/0003-066X.60.5.410

Torniainen-Holm, P. (2016). The effectiveness of email-based exercises in promoting psychological wellbeing and healthy lifestyle: a two-year follow-up study. BMC Psychology, 4(1), 21–21. https://doi.org/10.1186/s40359-016-0125-4

Wood, F. (2010). Gratitude and well-being: A review and theoretical integration. Clinical Psychology Review, 30(7), 890–905. https://doi.org/10.1016/j.cpr.2010.03.005