Bringing Gratitude to Aphasia Intervention: A Scoping Review of Gratitude Interventions for Adults with Chronic Health Conditions

Abstract

Aphasia negatively impacts mental health, disrupting social connections and meaningful life activities. Gratitude interventions for healthy adults positively impact well-being, physical health, and mental health. A systematic review of gratitude interventions for people living with chronic health conditions was conducted to identify current practices and existing gaps and to map the literature for incorporating gratitude interventions into aphasia rehabilitation. A scoping review of the literature published prior to March 2023 was conducted using CINAHL, Google Scholar, PubMed, and ERIC to identify gratitude interventions for adults with chronic health conditions. The search identified 414 studies. Five met the inclusion criteria. Interventions targeting chronic health conditions included alcohol use disorder, chronic heart failure, cancer, and asthma. No empirical studies were identified that used gratitude interventions with people who have aphasia or have had a stroke. Four studies used journaling as the intervention and one used gratitude letters. All interventions used written or verbal expressions of gratitude. Gratitude interventions have been used in limited ways with chronic health conditions. As gratitude interventions are language-based and rely on writing, people with aphasia may need modifications to support accessibility to these interventions which can positively impact mental health and well-being.

Keywords

gratitude intervention - chronic health condition - quality of life - depression - aphasia

Authors' Contribution

S.S.C.: conceptualization, investigation, data curation, writing—original draft, writing—review and editing. K.A.S.: conceptualization, investigation, data curation, writing—original draft, writing—review and editing. E.W.: data curation, writing—review and editing.

Publication History

Article published online:
28 October 2024

• References

• Arksey, H., & O'Malley, L. (2005). Scoping studies: towards a methodological framework. International Journal of Social Research Methodology 8(1), 19–32
• Avant, N. (2023). Think You'll Be Happy: Moving through Grief with Grit, Grace, and Gratitude. Harper One
• Azios, J. H., Strong, K. A., Archer, B., Douglas, N. F., Simmons-Mackie, N., & Worrall, L. (2021). Friendship matters: a research agenda for aphasia. Aphasiology, 36(3), 317–336
• Baker, C., Worrall, L., Rose, M., Hudson, K., Ryan, B., & O'Byrne, L. (2018). A systematic review of rehabilitation interventions to prevent and treat depression in post-stroke aphasia. Disability and Rehabilitation, 40(16), 1870–1892
• Biel, M., Enclade, H., Richardson, A., Guerrero, A., & Patterson, J. (2022). Motivation theory and practice in aphasia rehabilitation: a scoping review. American Journal of Speech-Language Pathology, 31(5S), 2421–2443
• Boggiss, A. L., Consedine, N. S., Brenton-Peters, J. M., Hofman, P. L., & Serlachius, A. S. (2020). A systematic review of gratitude interventions: effects on physical health and health behaviors. Journal of Psychosomatic Research, 135, 110165
• Bright, F. A. S., McCann, C. M., & Kayes, N. M. (2020). Recalibrating hope: a longitudinal study of the experiences of people with aphasia after stroke. Scandinavian Journal of Caring Sciences, 34(2), 428–435
• Brown, J., & Thiessen, A. (2018). Using images with individuals with aphasia: current research and clinical trends. American Journal of Speech-Language Pathology, 27(1S), 504–515
• Brown, J., & Wong, J. (2017, June 6). How gratitude changes you and your brain: New research is starting to explore how gratitude works to improve our mental health. Greater Good Magazine. Accessed September 15, 2024 at: https://greatergood.berkeley.edu/article/item/how_gratitude_changes_you_and_yourbrain
• Brown, K., Worrall, L., Davidson, B., & Howe, T. (2010). Snapshots of success: an insider perspective on living successfully with aphasia. Aphasiology, 24(10), 1267–1295
• Bullier, B., Cassoudesalle, H., Villain, M., Cogné, M., Mollo, C., De Gabory, I., Dehail, P., Joseph, P. A., Sibon, I., & Glize, B. (2020). New factors that affect quality of life in patients with aphasia. Annals of Physical and Rehabilitation Medicine, 63, 33–37
• Centers for Medicare and Medicaid Services. (n.d.). Specific chronic conditions. Accessed September 15, 2024 at: https://data.cms.gov/medicare-chronic-conditions/specific-chronic-conditions
• Chapey, R., Duchan, J. F., Elman, R. J., Garcia, L. J., Kagan, A., Lyon, J. G., & Simmons-Mackie, N. (2000). Life participation approach to aphasia: a statement of values for the future. ASHA Leader, 5, 4–6
• Cook, K. A., Woessner, K. M., & White, A. A. (2018). Happy asthma: improved asthma control with a gratitude journal. The Journal of Allergy and Clinical Immunology. In Practice, 6(6), 2154–2156
• Cousin, L., Redwine, L., Bricker, C., Kip, K., & Buck, H. (2021). Effect of gratitude on cardiovascular health outcomes: a state-of-the-science review. The Journal of Positive Psychology, 16(3), 348–355
• Cregg, D. R., & Cheavens, J. S. (2021). Gratitude interventions: Effective self-help? A meta-analysis of the impact on symptoms of depression and anxiety. Journal of Happiness Studies, 22, 413–445
• Crouch, T. A., Verdi, E. K., & Erickson, T. M. (2020). Gratitude is positively associated with quality of life in multiple sclerosis. Rehabilitation Psychology, 65(3), 231–238
• Davidson, B., Howe, T., Worrall, L., Hickson, L., & Togher, L. (2008). Social participation for older people with aphasia: the impact of communication disability on friendships. Topics in Stroke Rehabilitation, 15(4), 325–340
• Davis, D. E., Choe, E., Meyers, J., Wade, N., Varjas, K., Gifford, A., Quinn, A., Hook, J. N., Van Tongeren, D. R., Griffin, B. J., & Worthington, E. L. (2016). Thankful for the little things: a meta-analysis of gratitude interventions. Journal of Counseling Psychology, 63(1), 20–31
• Dickens, L. R. (2017). Using gratitude to promote positive change: a series of meta-analyses investigating the effectiveness of gratitude interventions. Basic and Applied Social Psychology, 39(4), 193–208
• Dietz, A., Ball, A., & Griffith, J. (2011). Reading and writing with aphasia in the 21st century: technological applications of supported reading comprehension and written expression. Topics in Stroke Rehabilitation, 18(6), 758–769
• Emmons, R. A., & McCullough, M. E. (2003). Counting blessings versus burdens: an experimental investigation of gratitude and subjective well-being in daily life. Journal of Personality and Social Psychology, 84(2), 377–389
• Emmons, R. A., & Mishra, A. (2011). Why gratitude enhances well-being: What we know, what we need to know. In: K. M. Sheldon, T. B. Kashdan, & M. F. Steger (Eds.), Designing Positive Psychology: Taking Stock and Moving Forward (pp. 248–262). Oxford University Press
• Emmons, R. A., & Shelton, C. M. (2002). Gratitude and the science of positive psychology. Handbook of Positive Psychology, 18, 459–471
• Hilari, K., & Northcott, S. (2017). Struggling to stay connected: Comparing the social relationships of healthy older people and people with stroke and aphasia. Aphasiology, 31(6), 674–687
• Holland, A. (2007a). Counseling in Communication Disorders: A Wellness Perspective. Plural Publishing Incorporated
• Holland, A. (2007b). Counseling families and adults with speech and language disorders: the view from a wellness perspective. In: M. J. Ball and J. S. Damico (Eds.) Clinical Aphasiology Future Directions: A Festschrift for Chris Code. Psychology Press
• Holland, A. (2007c). Counseling/coaching in chronic aphasia: getting on with life. Topics in Language Disorders, 27(4), 339–350
• Holland, A. (2013). Counseling in Communication Disorders: A Wellness Perspective (2nd ed.). Plural Publishing Incorporated
• Holland, A. L., & Nelson, R. L. (2020). Counseling in Communication Disorders: A Wellness Perspective (3rd ed.). Plural Publishing
• Hunting Pompon, R., Amtmann, D., Bombardier, C., & Kendall, D. (2018). Modifying and validating a measure of chronic stress for people with aphasia. Journal of Speech-Language-Hearing Research, 61(12), 2934–2949
• Hunting Pompon, R., & Mach, H. (2022). Characterizations of resilience in poststroke aphasia. Topics in Language Disorders, 42(3), 236–251
• Jans-Beken, L., Jacobs, N., Janssens, M., Peeters, S., Reijnders, J., Lechner, L., & Lataster, J. (2020). Gratitude and health: an updated review. The Journal of Positive Psychology, 15(6), 743–782
• Kagan, A. (1998). Supported conversation for adults with aphasia: methods and resources for training conversation partners. Aphasiology, 12(9), 816–838.
• Kauhanen, M. L., Korpelainen, J. T., Hiltunen, P., Määttä, R., Mononen, H., Brusin, E., Sotaniemi, K. A., & Myllylä, V. V. (2000). Aphasia, depression, and non-verbal cognitive impairment in ischaemic stroke. Cerebrovascular Diseases (Basel, Switzerland), 10(6), 455–461
• Kirca, A. M., Malouff, J., & Meynadier, J. (2023). The effect of expressed gratitude interventions on psychological wellbeing: a meta-analysis of randomised controlled studies. International Journal of Applied Positive Psychology, 8, 63–86
• Komase, Y., Watanabe, K., Hori, D., Nozawa, K., Hidaka, Y., Iida, M., Imamura, K., & Kawakami, N. (2021). Effects of gratitude intervention on mental health and well-being among workers: a systematic review. Journal of Occupational Health, 63(1), e12290
• Krentzman, A. R., Mannella, K. A., Hassett, A. L., Barnett, N. P., Cranford, J. A., Brower, K. J., Higgins, M. M., & Meyer, P. S. (2015). Feasibility, acceptability, and impact of a web-based gratitude exercise among individuals in outpatient treatment for alcohol use disorder. The Journal of Positive Psychology, 10(6), 477–488
• Kwon, S. C., Tandon, S. D., Islam, N., Riley, L., & Trinh-Shevrin, C. (2018). Applying a community-based participatory research framework to patient and family engagement in the development of patient-centered outcomes research and practice. Translational Behavioral Medicine, 8(5), 683–691
• Laures-Gore, J. S., Dotson, V. M., & Belagaje, S. (2020). Depression in poststroke aphasia. American Journal of Speech-Language Pathology, 29(4), 1798–1810
• Levin, T., Scott, B. M., Borders, B., Hart, K., Lee, J., & Decanini, A. (2007). Aphasia Talks: Photography as a means of communication, self-expression, and empowerment in persons with aphasia. Topics in Stroke Rehabilitation, 14(1), 72–84
• Luobomirsky, S., Dickerhoof, R., Boehm, J. K., & Sheldon, K. M. (2011). Becoming happier takes both a will and a proper way: an experimental longitudinal intervention to boost well-being. Emotion (Washington, D.C.), 11(2), 391–402
• McCullough, M. E., Emmons, R. A., & Tsang, J. A. (2002). The grateful disposition: a conceptual and empirical topography. Journal of Personality and Social Psychology, 82(1), 112–127
• Moss, B., Behn, N., Northcott, S., Monnelly, K., Marshall, J., Simpson, A., Thomas, S., McVicker, S., Goldsmith, K., Flood, C., & Hilari, K. (2022). “Loneliness can also kill:” a qualitative exploration of outcomes and experiences of the SUPERB peer-befriending scheme for people with aphasia and their significant others. Disability and Rehabilitation, 44(18), 5015–5024
• Otto, A. K., Szczesny, E. C., Soriano, E. C., Laurenceau, J.-P., & Siegel, S. D. (2016). Effects of a randomized gratitude intervention on death-related fear of recurrence in breast cancer survivors. Health Psychology, 35(12), 1320–1328
• Pearson, M., Clarke, C., & Wolverson, E. (2022). The meaning and experience of gratitude for people living with dementia. Dementia (London), 21(1), 335–352
• Peters, M. D., Godfrey, C. M., Khalil, H., McInerney, P., Parker, D., & Soares, C. B. (2015). Guidance for conducting systematic scoping reviews. International Journal of Evidence-Based Healthcare, 13(3), 141–146
• Pollock, D., Tricco, A. C., Peters, M. D. J., Mclnerney, P. A., Khalil, H., Godfrey, C. M., Alexander, L. A., & Munn, Z. (2022). Methodological quality, guidance, and tools in scoping reviews: a scoping review protocol. JBI Evidence Synthesis, 20(4), 1098–1105
• Pickering, J., van Leer, E., & Hudock, D. (2024). Special topics and disorders across the lifespan. In J. K. Hoepner (Ed.). Counseling and motivational interviewing in speech-language pathology (pp. 153–157). Slack Incorporated
• Redwine, L. S., Henry, B. L., Pung, M. A., Wilson, K., Chinh, K., Knight, B., Jain, S., Rutledge, T., Greenberg, B., Maisel, A., & Mills, P. J. (2016). Pilot randomized study of a gratitude journaling intervention on heart rate variability and inflammatory biomarkers in patients with Stage B heart failure. Psychosomatic Medicine, 78(6), 667–676
• Rose, M. L., Raymer, A. M., Lanyon, L. E., & Attard, M. C. (2013). A systematic review of gesture treatments for post-stroke aphasia. Aphasiology, 27(9), 1090–1127
• Rose, T. A., Worrall, L. E., Hickson, L. M., & Hoffmann, T. C. (2011). Aphasia friendly written health information: content and design characteristics. International Journal of Speech-Language Pathology, 13(4), 335–347
• Rosenberg, E. L. (1998). Levels of analysis and the organization of affect. Review of General Psychology, 2, 247–270
• Ryan, B., Worrall, L., Sekhon, J., Baker, C., Carragher, M., Bohan, J., Power, E., Rose, M., Simmons-Mackie, N., Togher, L., & Kneebone, I. (2020). Time to step up: A call for the speech pathology profession to utilize stepped psychological care for people with aphasia post stroke. In: K. H. Meredith & G. N. Yeates (eds.), Psychotherapy and Aphasia: Interventions for Emotional Wellbeing and Relationships (pp. 1–16). Taylor & Francis Group
• Seligman, M. E., Steen, T. A., Park, N., & Peterson, C. (2005). Positive psychology progress: empirical validation of interventions. The American Psychologist, 60, 410–421
• Seligman, M. (2011). Flourish. Free Press
• Sirois, F. M., & Wood, A. M. (2017). Gratitude uniquely predicts lower depression in chronic illness populations: a longitudinal study of inflammatory bowel disease and arthritis. Health Psychology, 36(2), 122–132
• Stans, S. E. A., Dalemans, R. J. P., de Witte, L. P., & Beurskens, J. J. H. M. (2019). Using Talking Mats to support conversations with communication vulnerable people: a scoping review. Technology and Disability, 30(4), 153–179
• Strong, K. A. (Host) (2017, September 6). Insights and “aha!” moments about aphasia care Guest: Dr. Audrey Holland (No. 9) [Audio podcast episode]. In: Aphasia Access Conversations. Accessed September 15, 2024 at: https://aphasiaaccess.libsyn.com/insights-and-aha-moments-about-aphasia-care-with-audrey-holland
• Strong, K. A., & Sather, T. W. (2023). “It's not often that people want to hear me talk about my life”: Storytelling experiences of people with aphasia in an interdisciplinary songwriting project. International Journal of Speech-Language Pathology, 1–13
• Stroke Association. (2012). Accessible information guidelines: Making information accessible for people with aphasia. Stroke Association. Accessed September 15, 2024 at: www.stroke.org.uk
• Tan, T. T., Tan, M. P., Lam, C. L., Loh, E. C., Capelle, D. P., Zainuddin, S. I., Ang, B. T., Lim, M. A., Lai, N. Z., Tung, Y. Z., Yee, H. A., Ng, C. G., Ho, G. F., See, M. H., Teh, M. S., Lai, L. L., Pritam Singh, R. K., Chai, C. S., Ng, D. L. C., & Tan, S. B. (2021). Mindful gratitude journaling: psychological distress, quality of life and suffering in advanced cancer: a randomised controlled trial. BMJ Supportive & Palliative Care. 10.1136/bmjspcare-2021-003068
• Tricco, A. C., Lillie, E., Zarin, W., O'Brien, K. K., Colquhoun, H., Levac, D., Moher, D., Peters, M. D. J., Horsley, T., Weeks, L., Hempel, S., Akl, E. A., Chang, C., McGowan, J., Stewart, L., Hartling, L., Aldcroft, A., Wilson, M. G., Garritty, C., . . . Straus, S. E. (2018). PRISMA Extension for Scoping Reviews (PRISMA-ScR): checklist and explanation. Annals of Internal Medicine, 169(7), 467–473
• Thomas, C. (2019). Effectiveness of gratitude intervention on selected mental health indicators: a systematic review and meta-analysis. International Journal of Multidisciplinary Educational Research, 8(12). Accessed September 15, 2024 at: https://www.researchgate.net/publication/348742456
• Valikhani, A., Ahmadnia, F., Karimi, A., & Mills, P. (2019). The relationship between dispositional gratitude and quality of life: The mediating role of perceived stress and mental health. Personality and Individual Differences, 141, 40–46
• Watkins, P. C., Woodward, K., Stone, T., & Kolts, R. L. (2003). Gratitude and happiness: development of a measure of gratitude and relationships with subjective well-being. Social Behavior and Personality, 31(5), 431–452
• Weatherill, M., Tibus, E., & Rodriguez, A. D. (2022). Motivation as a predictor of aphasia treatment outcomes: a scoping review. Topics in Language Disorders, 43(3), 252–265
• Witvliet, C. V. O., Richie, F. J., Root Luna, L. M., & Van Tongeren, D. R. (2018). Gratitude predicts hope and happiness: a two-study assessment of traits and states. The Journal of Positive Psychology, 14(3), 271–282
• Wood, A. M., Maltby, J., Gillett, R., Linley, P. A., & Joseph, S. (2008). The role of gratitude in the development of social support, stress, and depression: two longitudinal studies. Journal of Research in Personality, 42, 854–871