The “helping professions” of the 21st century are increasingly diverse
and in flux. The recent emergence of “positive psychology,” a compelling model focused on development of the human individual’s strengths and assets, underlies some of the most exciting new tools for enhancing human happiness and potential.1 There is a growing body of empirical literature
demonstrating that positive thinking helps to promote mental health and optimal functioning.2

Cognitive therapy, for example, draws on positive psychology to help people rework their thoughts about themselves in a more hopeful and healthy way. It has been shown to be reliably effective for treating people with a host of psychiatric conditions, including anxiety and mood disorders.3 When anxious and depressed people learn to be less self-critical and pessimistic, and choose instead to focus on realistic yet hopeful parts of their lives, they feel and function better in daily life.

Psychologists and other mental health clinicians are the usual providers of cognitive therapy, but novel approaches to delivering cognitive therapy effectively via the Internet have emerged in the last few years.4   These
newer modalities for delivering cognitive therapy and the principles of positive psychology appear to be equally effective, and they have the
advantages of being inexpensive and highly accessible to large populations.5

Positive psychology is an essential counterpoint to the negativistic and pessimistic focus of psychiatry and related mental health disciplines. In the 20th-century Western world, psychoanalysis and psychiatry were the predominant paradigms for helping people manage emotional distress. Both approaches are underpinned by a philosophy of disease
and defect. Their starting point is the biological determination of human
experience and behavior, with a primary focus on diagnosing and treating mental illness.

In psychoanalysis, the human being
from earliest infancy is understood as a bundle of biological drives. When
development of drives is arrested or goes awry, the individual develops a “neurosis”
(e.g., anxiety) that requires psychoanalytic therapy. From the time of Freud until
the rise of biological psychiatry in the latter half of the 20th century,
psychoanalysis was dominant. Treatment in this model usually entailed several clinical
sessions per week, focused on unearthing and “working through” traumatic
experiences of the past.

Biological psychiatry and
psychopharmacology attend to brain chemicals and neurotransmitters, but they share
with psychoanalysis a dark view of the human condition. In this world-view,
people are constrained by their genetics and how their genes express themselves
as “chemical imbalances.” Psychotropic medications can improve neurobiological
functioning, but they do not in themselves help people attain their full potential.
When psychiatrists only prescribe medications to patients (as so many nowadays do),
they limit what they can help patients achieve on a more global and holistic

Many people look to professional
help to achieve more than psychoanalysis, psychiatry, and related mental health
disciplines can provide. They seek help which builds on their personal
strengths and assets to propel them toward greater self-understanding, better
interpersonal relationships, success in work and career, and ultimately peak experience
and performance in all areas of life. Emotionally healthy and stable
individuals also can benefit from professional assistance to improve their
quality of life and overall functioning.

We already have seen that positive
psychology forms the basis for evidence-based cognitive therapy for many psychiatric
disorders. But it also serves as the basis for professions that help healthy,
rational, and successful individuals striving toward their highest potential in
all dimensions of their lives. A prime example of a field being shaped by
positive psychology is professional coaching in its various manifestations,
such as executive coaching, career coaching, and life coaching.

What is the nature of professional
coaching? An effective coach is a careful listener and trusted confidante who forms
a professional relationship with a client who is seeking to change or improve
important elements of his or her life. Toward this end, the coach uses many
conversational strategies with the client. Many coaches use structured assessments
to help clients identify the strengths they can use to enhance their lives. At
all times, the coach maintains a positive psychology orientation by respecting
the client’s individual strengths and ability to think in a healthy, rational

The core coaching conversation is Active Inquiry, in which the coach asks
the client open-ended, thought provoking, and transformative questions. In the
course of reflecting upon and responding to these questions, the client discovers
that he or she has strengths and assets to address the challenge at hand. The
professional coach helps the client develop insight and a hopeful action plan.
An essential tenet of professional coaching is that genuine, lasting success is
more likely to result when a client formulates his or her own positive
solution, rather than being critiqued or told what to do by the coach or
anybody else.

If professional coaching is to flourish
as a bona fide helping profession in the twenty-first century, it will need to
establish a strong theoretical basis, evaluate scientifically the services it
provides, and continually improve the quality of those services. A growing
literature suggests that positive psychology provides a strong theoretical
foundation for the field of coaching6 and a growing body of
empirical data reveal the efficacy of various forms of coaching.7,8

One set of studies has shown that
business teams achieve peak performance, customer satisfaction, and profitability
when they achieve an optimal ratio of positive to negative affect.9,10,11 In one of these studies, strategy sessions of
60 business teams were observed and statements team members made to each other were
coded as either positive (supportive or approving) or as negative (critical or
disapproving). The ratio of positive to negative differentiated high performing
from low performing teams.

When positive to negative
statements among team members occurred in a 3 to 1 ratio, the business team
performed at its best. Teams demonstrating a lower ratio, or a very high ratio
(above 11 to 1), were less flexible and successful. These data suggest that business
teams should pay careful attention to the ratio of positive to negative statements
among their members. This is an example of how positive psychology research can
obtain empirical data that have real-world implications. Executive coaches can
draw on these data to educate business leaders about positive psychology and
help business teams become more successful by developing strategies to achieve
a favorable positivity ratio. Other coaches can draw on similar research about
positivity ratios to help clients improve their lives and interpersonal

Ongoing research and quality
improvement can help the field of coaching to thrive. A growing number of
organizations, such as the Institute of Coaching, are funding this kind of
research and providing educational services for coaches and the broader public.
Professional coaches can implement the findings of positive psychology to help
a diverse array of clients seeking to improve and optimize their lives at work,
at home, and across all areas of their lives. An essential complement to
psychiatry and other mental health disciplines, positive psychology continues
to establish itself as a bona fide discipline and the foundation of professional
coaching in the 21st century.


1)    Seligman ME, Csikszentmihalyi M. Positive psychology: An introduction.
Am Psychol 2000; Jan;55(1):5-14.
An overview of positive psychology by two of the scientific leaders in the
field. From the abstract: “The authors
outline a framework for a science of positive psychology, point to gaps in our knowledge, and predict
that the next century will see a science and profession that will come to
understand and build the factors that allow individuals, communities, and
societies to flourish.”

2)    Seligman ME, Steen TA, Park N, Peterson C. Positive psychology progress: empirical validation of interventions. Am Psychol 2005; Jul-Aug;60(5):410-21. From the abstract: “In a 6-group, random-assignment, placebo-controlled
Internet study, the authors tested 5 purported happiness interventions and 1
plausible control exercise. They found that 3 of the interventions lastingly
increased happiness and decreased depressive symptoms.”

3)    Hofmann SG, Smits JA. Cognitive-behavioral therapy for adult anxiety disorders: a meta-analysis of
randomized placebo-controlled trials. J Clin Psychiatry. 2008 Apr;69(4):621-32. From the abstract: “Our review of randomized placebo-controlled trials indicates
that CBT is efficacious for adult anxiety disorders.”

4)    Johansson R, Sjöberg E, Sjögren M, Johnsson E, Carlbring P, Andersson T, Rousseau A, Andersson G. Tailored vs. standardized
internet-based cognitive behavior therapy for depression and
comorbid symptoms: a randomized controlled trial. PLoS One 2012;7(5):e36905. doi: 10.1371/journal.pone.0036905. Epub 2012 May 15. From
the abstract: “Major depression can be treated by
means of cognitive behavior therapy,
delivered via the Internet as guided self-help. Individually tailored guided
self-help treatments have shown promising results in the treatment of anxiety
disorders. This randomized controlled trial tested the efficacy of an Internet-based individually tailored guided self-help treatment which
specifically targeted depression with comorbid symptoms…This
study shows that tailored Internet-based treatment for depression is effective and that addressing comorbidity by tailoring may be one way of
making guided self-help treatments more effective than standardized approaches
in the treatment of more severe depression.”

5)    Powell J, Hamborg T, Stallard N, Burls A, McSorley J, Bennett K, Griffiths KM, Christensen H. Effectiveness of a web-based
cognitive-behavioral tool to improve mental well-being in the general
population: randomized controlled trial. J Med Internet Res. 2012
Dec 31;15(1):e2. doi:

6)    Kauffman C. Positive psychology: The science at
the heart of coaching. In: Evidence based coaching handbook: Putting best
practices to work for your clients, eds. DR Stober and AM Grant. Wiley (2006).

7)    Grant AM. The impact of
life coaching on goal attainment, metacognition, and mental health. Social
Behavior and Personality 2003;31(3):253-64. This study has indicated that
solution-focused, cognitive-behavioral life
coaching can facilitate goal attainment, improve mental health and
general life experience.”

8)    Orenstein RL. Measuring executive coaching efficacy? The answer was right here all the
time. Consulting
Psychology Journal: Practice and Research
10/2012; 58(2):106-116.
From the abstract: “This article
demonstrates that executive coaching efficacy can be measured empirically.”

9)    Losada M. The complex
dynamics of high performance teams. Mathematical and Computer Modeling 1999;30(9-10):179-92.

10) Losada M, Heaphy E. The role of positivity and connectivity
in the performance of business teams: A nonlinear dynamics model. American
Behavioral Scientist 2004;47(6):740-65.

11) Frederickson BL, Losada M. Positive affect and the complex dynamics of human
flourishing. American Psychologist 2005;60(7):678-86.


David H. Brendel, MD, PhD is a certified executive coach and Harvard-trained physician in the Boston area. His coaching firm, Leading Minds
Executive Coaching, provides a wide array of personal and executive coaching
services. More information is available at