Presentation by Jen Unwin at the SFCT research conference Orienting Solutions 2013, University of Hertfordshire. For more resources like this, go to http://herts.ac.uk/hesian.

1. SF: The Hope Therapy
Dr Jen Unwin
BSc, MSc, PsyD, CPsychol, AFBPsS
Southport & Ormskirk NHS Trust
j.unwin@nhs.net

2. “HOPE is what makes us
strong. It is why we are here.
It is what we fight with when
all else is lost.”
- Pandora

3. Overview
• The importance of hope
• The placebo effect = hope
• Can we define and measure hope?
• What kinds of hope make a difference?
• Solution focused brief therapy and hope
• What next?

4. The Importance being Hopeful
 Positive Psychology: Hope as a major component of
wellbeing and adjustment to adversity-Seligman
 Wellbeing: High hope individuals have higher wellbeing
and self reported ‘health’ (synonymous?)
 Morbidity: High hope individuals are less likely to get ill and
more likely to cope well if they do-Snyder 2002
 Mortality: High hope people live longer-happy nun Study
 A million anecdotes-’The Anatomy of Hope: how people
prevail in the face of Illness’ Dr J Groopman 2009

5. Unwin, Kacperek & Clarke (2009)
 A prospective study of positive adjustment in
N= 99 lower limb amputation patients over 6 months
 Including variables previously suggested to relate to
outcome in cross sectional studies (type and cause of
amputation, age, gender, disability, social support, coping
style)
 Hope at the start of rehabilitation was the only variable to
explain significant variance in positive mood outcomes 6
months after lower limb amputation

6. The Placebo Effect
Latin: placēbō, "I shall please"
Levine et al (1981)
The percentage of post-op patients who reported pain relief
following
Placebo (39%)
4 mg morphine (36%)
Kahn et al (2008)
79% of placebo responders in anti-depressant trials do not
relapse
Kaptchuk et al (2013)
Open label placebos work for IBS patients-no deception
needed!

7. Dr Frank developed his understanding that all psychotherapies make
effective use of certain common principles, including a healing rationale,
hope, mastery, and a caring therapeutic relationship

8. Can we define Hope?
 Frank (1975)
The perception that one can reach desired goals
 Snyder (2002)
The belief that one can find pathways to desired goals
and the agency (motivation) to use those pathways
 Scioli (2009)
Four Linked Sub-networks : mastery, attachment,
survival, spirituality

9. Unwin & Dickson (2010)
Goal focused hope, spiritual hope and wellbeing
 On line cross sectional questionnaire study of N=207
university staff and students
 Measures of goal focused hope, spiritual hope, satisfaction
with life and positive affect
 Goal focused hope and spiritual hope are not correlated.
 Goal focused hope is an independent predictor of
wellbeing but spiritual hope is not.
 Spiritual hope has a buffering effect when goal focused
hope is low.

10. Hope SF
Desired Goals
Agency thinking
Pathways thinking
Iterative
SF & Hope

11. Can an SF intervention increase
Hope?
 The Living Well Project
A co-constructed wellbeing course for patients with
long-term health conditions, facilitated by patient tutors
Five sessions based on SF principles
Uncovering each person’s:
Desired wellbeing goals
Strengths and resources (agency)
Weekly small steps (pathways)

12. Living Well pilot data
N Mean Sig
Hope 1 30 28.17 >.01
Hope 2 30 33.75
Positive mood 1 27 33.37 >.01
Positive mood 2 27 35.15
Subjective
Wellbeing 1
28 4.83 >.01
Subjective
Wellbeing 2
28 6.73

13. Conclusions
 Hope is central to human flourishing
 Hope is about a confidence that one can reach one’s
desired future
 Solution focused therapy concentrates on enhancing the
research-identified key cognitive components of hope
 Much more research to be done-which therapies are best
at enhancing hope, does wellbeing improvement mirror
rising hope? How can we maximise hope enhancement in
our work?
 Should we re-name SFBT ‘Hope Therapy’?

14. References and Resources
 Billington, Simpson, Unwin, Bray, & Giles (2008). Does hope
predict adjustment to end-stage renal failure and consequent
dialysis? British Journal of Health Psychology, 13, 4, 683-700.
 Frank & Frank (1993). Persuasion & Healing. JHU Press.
 Scioli & Biller (2009). Hope in the Age of Anxiety. OUP.
 Snyder (2002). Hope Theory: Rainbows in the mind. Psychological
Inquiry 13(4): 249-275.
 Unwin & Dickson (2010). Goal focused hope, spiritual hope and
well-being. Social Scientific Study of Religion, 21, 161-174.
 Unwin, Kacperek, & Clark (2009). A prospective study of
positive adjustment to lower limb amputation. Clinical
Rehabilitation, 23, 1044-1050.