Introduction to the special issue on forgiveness in therapy.
Forgiveness has only recently entered the general consciousness of therapists and researchers. Before the 1990s a few therapists and clinicians were writing about or working on forgiveness with their clients, but the overall sentiment in research and practice appeared to be that forgiveness was not part of the psychological domain. That changed dramatically in the 1990s. Since then over a thousand psychological studies of forgiveness have been published, varying from neuro-imaging of forgiveness to controlled experiments of forgiving responses to efficacy studies of interventions promoting forgiveness (Worthington, 2005). This initial research not only provided an excellent basis for understanding the processes and potential benefits of forgiveness in therapy, it has also inspired continued research into these phenomena. This Special Issue on Forgiveness in Therapy is intended to provide the readers of the Journal of Mental Health Counseling with a sample of recent developments in the research on forgiveness as it applies to therapeutic settings.
One of the first tasks of working toward forgiveness with clients is helping them understand exactly what forgiveness means (Wade & Worthington, 2005). Forgiveness comes with many misconceptions, some of which can be very damaging to clients in unhealthy or hurtful relationships. For example, many people think that forgiveness necessarily includes reconciling with the offending person. Understood this way, encouraging a person to "forgive" a harmful and potentially dangerous partner would be sending them back into an unsafe situation. By properly understanding forgiveness, clients and therapists can work toward a healthy resolution of past hurts that includes the emotional and physical benefits of forgiveness without exposing clients to re-injury or revictimization.
In the first article, Freedman and Chang address the common understandings people have of forgiveness and their experiences with being hurt in personal relationships. The authors report that although many people do see reconciliation as a part of forgiveness, when asked directly about any differences between these two ideas, most people are able to distinguish them. Also, the vast majority of the people interviewed reported that they had experienced a significant hurt in their life and had worked to forgive. Freedman and Chang also reported on the understandings people have about forgiveness and condoning an offense, and the reasons why they have or have not forgiven people who have hurt them.
Understanding the concepts addressed in Freedman and Chang's article is critical for helping clients move toward forgiveness. Without a clear idea of what forgiveness is and the obstacles to it, it is hard for the client to achieve it and for the clinician to facilitate it. Still, even if forgiveness is understood in a "proper" or therapeutic way, and even if clinicians are able to work around the obstacles to forgiving, can psychotherapeutic interventions really help people forgive? This question has been addressed in various ways in past research and the basic answer seems to be, yes, counseling to promote forgiveness does help people achieve forgiveness (Wade, Worthington, & Meyer, 2005). At the same time it can also address psychological problems like depression and anxiety.
However, despite progress in the area of forgiveness interventions, many questions are still unanswered. In the second article, Sandage and Worthington seek to uncover the mechanisms of change that help people achieve forgiveness. One of the earliest answers to this question was the development of empathy for the offending person. For example, McCullough, Worthington, and Rachal (1997) described a set of studies that suggested that when people forgive, it is at least in part due to their developing empathy for (i.e., feeling compassionate about and understanding the perspective of) the person who hurt them.
As a follow-up to the original study, Sandage and Worthington report on an efficacy study that compared an intervention focused on promoting empathy with one that did not. Although the two treatments did not differ in the amount of forgiveness participants achieved over the course of the intervention, follow-up mediational analyses suggested that all participants, regardless of intervention, achieved forgiveness primarily by developing empathy for the person who offended them. They found that participants' tendencies toward guilt and shame (as a general trait) were related to development of forgiveness. These results provide important data for answering the question of what works and why, and for whom it works in interventions designed to promote forgiveness.
The third article reports on a further investigation of questions related to the efficacy of forgiveness interventions. Blocher and Wade address the question of the long-term effect of interventions to promote forgiveness. Up to this point, most forgiveness intervention outcome studies have examined their effects only within at most a six-month time frame. Although these verified that the effects last several months after treatment, no information was available on longer-term effects. Blocher and Wade assessed participants more than two years after their participation in a forgiveness intervention. They report that participants had mostly retained the effects of the intervention in terms of reduced negative reactions and feelings toward the offending person, desires for revenge against the person, and general psychological symptoms. They also examined possible differences between an intervention designed specifically to promote forgiveness and a more general intervention. Here the results were mixed. According to data from outcome measures, there appears to be no difference between the treatments in the amount of forgiveness achieved. However, from the open-response data, participants appeared to receive more benefit from the explicit forgiveness treatment.
These results match other ambiguous findings about which interventions are best for promoting forgiveness. In past research, explicit forgiveness interventions have been shown to be more effective than no treatment and than alternative treatments (Wade, Worthington, & Meyer, 2005). However, many of the alternative treatments are not actual psychotherapeutic interventions; they are "placebo" treatments, such as discussion groups. When these are compared with true psychological interventions, the results are much less clear. In these comparisons, some studies support explicit forgiveness interventions as the most effective treatments (Lin, Mack, Enright, Krahn, & Baskin, 2004; Reed & Enright, 2006) and some suggest that there are no real differences between different types of treatments (e.g., Wade & Meyer, 2009; Wade, Worthington, & Haake, 2009). Exactly what works best is still unknown. However, Blocher and Wade's study shows that explicit forgiveness interventions are at least as effective as more traditional therapies and that the effects last even beyond two years.
In the last article of this special issue, Worthington and his colleagues address a unique cross-cultural application of forgiveness interventions. They report the results of group interventions to promote forgiveness conducted in the Philippines that were adapted to Filipino culture and Christian religious language and symbolism. Understanding the effectiveness of adapting established interventions to different cultural and religious settings is crucial. Important work within cross-cultural and multicultural psychology has shown the fallacy of believing that one concept, one theory, or one intervention fits all people at all times. Taking this critique seriously, Worthington et al. tested the effectiveness of an adaptation of an explicit forgiveness intervention. They found that in various settings in the Philippines, individuals reported significant reductions in motivation to seek revenge against and avoid the offending person. Significant gains in forgiveness were also reported over the course of the intervention.
This series of articles shows the maturing of research on forgiveness, particularly in the application of forgiveness in clinical settings. Although much is still unknown about intervening with clients to promote forgiveness, there is enough evidence to provide a solid foundation for continued research and clinical work in this area. From this special issue alone, we can see that although some misperceptions exist, people can tell that there is a difference between forgiveness and reconciliation (Freedman & Chang), that empathy seems to be a key determinant in the process of forgiveness following intervention (Sandage & Worthington), that changes resulting from interventions to promote forgiveness can last over the long term (Blocher & Wade), and that forgiveness interventions can be effectively adapted for other cultures (Worthington et al.). The research reported here and the growing research on forgiveness and therapy provide useful guidance for understanding and implementing interventions to help clients overcome past hurts and achieve peace and resolution.
Lin, W.F., Mack, D., Enright, R.D., Krahn, D.. & Baskin, T.W. (2004). Effects of forgiveness therapy on anger, mood, and vulnerability to substance use among inpatient substance-dependent clients. Journal of Consulting and Clinical Psychology 72. I 114-1121.
McCullough, M.E., Worthington, E. L., Jr., & Rachal, K.C. (1997). Interpersonal forgiving in close relationships. Journal of Personality and Social Psychology, 73. 321-336.
Reed, G.L., & Enright, R.D. (2006). The effects of forgiveness therapy on depression, anxiety, and posttraumatic stress for women after spousal emotional abuse. Journal of Consulting and Clinical Psychology, 74, 920-929.
Wade, N.G., & Meyer, J.E. (2009). Comparison of brief group interventions to promote forgive- ness: A pilot outcome study, International Journal of Group Psychotherapy 59, 199-220.
Wade, N.G., & Worthington, E.L., Jr. (2005). In search of a common core: Content analysis of interventions to promote forgiveness. Psychotherapy: Theoo; Research, Practice, Training, 42, 160-177.
Wade, N.G., Worthington, E.L., Jr., & Haake, S. (2009). Comparison of explicit forgiveness interventions with an alternative treatment: A randomized clinical trial. Journal of Counseling and Development, 87, 143-151.
Wade, N.G., Worthington, E.L., Jr., & Meyer, J. (2005). But do they really work? Meta-analysis of group interventions to promote forgiveness. In Everett L. Worthington, Jr. (Ed.), Handbook of forgiveness (pp. 423440). New York: Brunner-Routledge.
Worthington, E. L., Jr. (Ed.). (2005). Handbook forgiveness. New York: Brunner-Routledge.
Nathaniel G. Wade is affiliated with Iowa State University. Correspondence concerning this article should be addressed to [TK]. E-mail: firstname.lastname@example.org.
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|Title Annotation:||SPECIAL ISSUE ON FORGIVENESS IN THERAPY|
|Author:||Wade, Nathaniel G.|
|Publication:||Journal of Mental Health Counseling|
|Date:||Jan 1, 2010|
|Next Article:||An analysis of a sample of the general population's understanding of forgiveness: implications for mental health counselors.|