Well-Being Therapy and Adlerian Psychology:

Revisiting the Task of Self

Thor Johansen

Abstract
The author discusses well-being therapy and the dimensional model on which it
is based. The multidimensional model of psychological well-being is compared to
the Adlerian concept of the life tasks, with a special emphasis on the task of self as
issues pertinent to experiencing a sense of purpose and self-acceptance are consid-
ered central to well-being therapy. The author conceptualizes well-being therapy as
a therapeutic technique of encouragement that Adlerians may consider applying in
the final phases of the orientation stage of treatment.
Keywords: Adlerian psychology, task of self, well-being therapy

Well-being therapy (Fava, 2016; Fava, Rafanelli, Cazzaro, Conti, &

Grandi, 1998; Fava, Rafanelli, Grandi, Conti, & Belluardo, 1998; Fava &
Ruini, 2003) is a Cognitive Behavior Therapy technique based on Carol Ryff’s
multidimensional model of psychological well-being. It comprises six di-
mensions: autonomy, personal growth, environmental mastery, purpose in
life, positive relations, and self-acceptance (Ryff, 1989; 2014; Ryff & Keyes,
1995; Ryff & Singer, 1996, 1998, 2000). A product of the positive psychol-
ogy movement (Gillham & Seligman, 1999; Seligman & Csikszentmihalyi,
2000), well-being therapy seeks to improve clients’ level of psychological
well-being along these six dimensions. In this particular model, the absence
of well-being is considered to create conditions of vulnerability to life’s
stressors. Rather than viewing mental health as just the absence of illness,
mental health is thought to encompass positive psychological resources, in-
cluding subjective well-being (life satisfaction, self-acceptance, autonomy,
a sense of purpose, and positive relations). Well-being therapy has been
found to be effective in the treatment of depressive and anxiety disorders, as
well as the development of resilience in the prevention of recurrent depres-
sion (Fava, Rafanelli, Cazzaro, et al., 1998; Fava, Rafanelli, Grandi, et al.,
1998; Fava et al., 2005; Fava & Tomba, 2009; Fava, Tomba, & Grandi, 2007;
Moeenizadeh & Salagame, 2010; Ruini & Fava, 2009).
With the positive psychology movement, there has been a shift in psychol-
ogy from primarily focusing on pathology to focusing on the amplification of
strengths (subjective well-being, positive individual traits, and civic virtues

The Journal of Individual Psychology, Vol. 73, No. 3, Fall 2017

©2017 by the University of Texas Press

Published for the North American Society of Adlerian Psychology.

 Well-Being Therapy and Adlerian Psychology 235

supported by institutions in society) (Seligman & Csikszentmihalyi, 2000).

Adlerians have examined the relationship between Individual Psychology
and positive psychology, particularly emphasizing the Adlerian concept
of social interest (Barlow, Tobin, & Schmidt, 2009; Leak & Leak, 2006).
Carlson, Watts, and Maniacci (2006) argued that many contemporary thera-
peutic perspectives, including positive psychology, are progressing toward a
position that is congruent with Individual Psychology.
The purpose of this article is to examine the parallels of well-being
therapy and Individual Psychology while also emphasizing factors con-
sistent with what Adlerians call the task of self (Adler, 1927; Dreikurs &
Mosak, 1967/1977). Although never specifically identified by Adler him-
self, Dreikurs and Mosak argued that Adler discussed this task in his writ-
ings. They further argued that every person needs to come to a conclusion
about themselves, a process that has a significant impact on functioning in
other tasks of life (Mosak & Maniacci, 1999). The tasks of life are clearly
delineated in Ryff’s multidimensional model of psychological well-being,
and similar to Adlerian therapy, well-being therapy uses it as a guide in
treatment. This article provides an overview of well-being therapy and de-
scribes Ryff’s multidimensional model in the context of the tasks of life. What
Adlerian therapists can learn and how they may incorporate this treatment
technique is also discussed.

Well-Being Therapy

Well-being therapy is a structured, directive, problem-solving, educa-

tional model of treatment that utilizes cognitive and behavioral interven-
tions. It is often applied in treatment as a well-being–enhancing technique to
prevent relapse (Fava & Ruini, 2003). As discussed by Fava and Ruini (2003),
well-being therapy often lasts 10–12 sessions and is generally divided into
three phases. The first phase of treatment focuses on helping clients identify
episodes of well-being, regardless of how short lived they are. Clients are
asked to keep a structured diary to record episodes of well-being and rate
their intensity. They are also asked to record the situation or event in which
they experienced well-being. The goal is to encourage the client to start fo-
cusing on these positive life experiences. The emphasis on self-observation
is central to this therapy.
In the second phase of treatment, once instances of well-being have
been properly identified, clients are encouraged to identify and record
thoughts that interfere with well-being. This tactic is similar to identifying
self-discouraging attitudes and beliefs (i.e., basic mistakes), except the basis
for observation is well-being rather than emotional distress. In this phase of
treatment the client and the therapist work together to identify which areas
236 Thor Johansen

of well-being are unaffected by useless and exaggerated beliefs and which

are heavily influenced by them (Fava & Ruini, 2003). Here, the therapist uses
a variety of cognitive and behavioral interventions to challenge and reorient
the client’s basic mistakes that impede his or her experience of well-being.
Interventions such as evaluating the evidence, guided discovery, skills train-
ing, and exposure are just some of the interventions at the therapist’s disposal
to facilitate this process. The therapist may also reinforce and encourage new
activities that are likely to elicit well-being and optimal experiences (Fava &
Tomba, 2009).
In the third and final phase of treatment, Ryff’s six dimensions of psy­
chological well-being are progressively introduced in the context of the ex-
periences and activities the client is partaking in. For example, if a client
reports a diary entry pertaining to a positive social interaction, the therapist
encourages the experience and broadens the meaning of positive relation-
ships with others to help the client consider what a positive interpersonal
relationship might entail. The therapist continues to work with the client to
monitor established experiences of well-being while promoting and encour-
aging the client toward an optimal level in each of the six dimensions of
psychological well-being outlined by Ryff (1989, 2014; Ryff & Singer, 1996,
1998, 2000).
Well-being therapy is a Cognitive Behavior Therapy focused on problem
solving. Adlerian therapists may view it as a process of guided encourage-
ment. Clients are taught to encourage themselves, expand on encouraging
experiences (e.g., well-being), and effectively manage obstacles that impede
those encouraging experiences.
Clinical and intervention studies suggest that complete recovery involves
both a reduction in emotional distress and improvements in well-being (Ryff,
2014). Some studies have found well-being therapy to have a positive effect
in the treatment of anxiety and depression (Fava, Rafanelli, Cazzaro, et al.,
1998; Fava, Rafanelli, Grandi, et al., 1998; Fava et al., 2005; Fava & Tomba,
2009; Fava et al., 2007; Moeenizadeh & Salagame, 2010; Ruini & Fava,
2009; Ryff, 2014).

Ryff’s Model of Well-Being and the Tasks of Life

The six-dimensional model of well-being that guides the process of

well-being therapy was originally put forth to address challenges in the
scientific formulations of positive human functioning. The six dimensions
include autonomy, environmental mastery, personal growth, positive rela-
tions with others, purpose in life, and self-acceptance. According to Ryff
(2014), these dimensions describe well-being, which she distinguishes from
feelings of happiness or feeling good and satisfying appetites. Well-being
 Well-Being Therapy and Adlerian Psychology 237

has to do with the activities of the soul that are in harmony with our human
qualities—in other words, activities that allow us to strive to achieve the best
within us. These experiences of well-being are in and of themselves experi-
ences of encouragement. At the ideal level as reflected in the six dimensions
of well-being, these experiences both reflect optimal self-regard and social
belonging, and they further encourage the individual. According to Ryff,
the first four dimensions noted above are fundamentally related to how the
person negotiates their way through the challenges of life. As we will see,
they relate to the first three tasks of life (work, love, and social relations)
described by Adler (1927), but also to the task of self. The last two, purpose
and self-acceptance, relate directly to the task of self.
The concept of the tasks of life represents the challenges of social liv-
ing that each individual has to confront. Adler (1927) described the three
main challenges of work, social relations, and love. Dreikurs and Mosak
(1967/1977; Mosak & Dreikurs, 1967/1977) further discussed the self task
and the spiritual task. This concept becomes important in Adlerian psycho-
therapy as it provides the social context in which the client operates. The
therapist first seeks to understand the client’s lifestyle and then examines how
these lifestyle patterns play out within the client’s social context. Individuals
meet the life tasks according to their lifestyles (Adler, 1927). Adler noted
that every lifestyle is adaptable until life presents it with something it is not
adequately prepared for (Adler, 1927). Thus, the various tasks of life have
the potential to become stressors and sometimes cause significant distress.
However, as much as these tasks have the potential to stress the individual,
they are also avenues for optimal experiences or experiences of well-being.
Ryff’s model delineates six specific dimensions of the individual’s subjective
interpretation of how they are faring in the life tasks. Our subjective interpre-
tation along these dimensions has been found to be crucial for psychological
well-being. Thus, subjectively these six dimensions may all be viewed as
aspects of the task of self.
Most discussions about the life tasks in the Adlerian literature have fo-
cused on the tasks of work, social relations, and love. Many discussions have
also focused on the spiritual task, whereas the task of self has to a large extent
been overlooked. The task of self has to do with the individual’s evaluation
and opinion of him or herself. Mosak and Maniacci (1999) noted that every
person has to come to a conclusion about him- or herself. They described
four subtasks: survival, body image, opinion, and evaluation. They wrote
that the survival subtask has to do with biological, psychological, and social
survival. Questions such as, Do I take care of myself? Can I accept who I
am? and Where and how do I fit in? are examples of what each person has
to grapple with. The subtask of body image deals with questions and opin-
ions we have about our bodies (e.g., Am I too thin? Am I muscular enough?).
The subtask of opinion deals with what we think of ourselves (e.g., Do I like
238 Thor Johansen

myself? Do I hate myself? Can I live with myself?). As Mosak and Maniacci
(1999) point out, the opinions we form of ourselves are a foundation for
feelings of self-esteem, inferiority, superiority, and security. Finally, questions
arise in terms of how we evaluate ourselves and our actions: Did I make the
right decision? Was that selfish of me? Why did I do that? Our answers to
these and similar questions have a tremendous impact on how we get along
with ourselves as well as others.
The autonomy dimension, according to Ryff (1989), ranges from be-
ing concerned about the expectations of others and relying on the opinions
of others to make decisions, to being self-determining and independent.
Having a sense of autonomy is accompanied by being able to resist social
pressures and to regulate behaviors from within. This dimension relates to
what Mosak and Maniacci (1999) described as the social survival subtask
but is also related to the social task (Can I make my own decisions? What do
I do to fit in? What will others think of me? If I make my own decisions, will
they accept me or reject me?).
The environmental mastery and personal growth dimensions can be
viewed as features of the work task and the self task. Personal growth has
been found to correlate strongly with career commitments (Ryff, 2014).
Environmental mastery ranges from feeling unable to change or improve
surrounding contexts and a general lack of sense of control to feelings of
being in control of various areas of life’s activities and having a sense of
competence in managing the environment. The personal growth dimension
is closely related, ranging from a sense of personal stagnation and feeling
bored and uninterested with life to viewing oneself as growing, expanding,
and being open to new experiences.
Positive relations with others is a dimension that ranges from feeling
distant and having few close and trusting relationships to experiencing
warm, satisfying, and trusting relationships with other people. This dimen-
sion relates directly to the social task, the social survival subtask and the
task of love.
Finally, the dimensions of purpose in life and self-acceptance are
reflected in the challenges many Adlerians consider the task of self. The di-
mension purpose in life ranges from a lack of meaning, having few goals,
and a poor sense of direction in life to having a strong sense of directed-
ness and a feeling of purpose and meaning to the present and past. Some
Adlerians consider issues pertaining to purpose and meaning as part of the
spiritual task. However, in Ryff’s model the dimension of purpose in life
does not describe issues pertaining to religion, relationship with God, or
our place in the cosmos. Thus, this dimension is perhaps better construed
as an aspect of the task of self. Mosak and Dreikurs (1967/1977) discussed
the self task in the context of life purpose and self-acceptance. They noted
that a person’s fighting with him- or herself results from feelings of inferiority.
 Well-Being Therapy and Adlerian Psychology 239

According to Mosak and Dreikurs, people can learn to accept themselves

only when they learn to accept all their imperfections and realize that they
do not exist to prove themselves but to be useful.
Self-acceptance, according to Ryff, ranges from feeling dissatisfied with
self, feeling disappointed with one’s past life, and wishing to be something
or someone different to possessing a positive attitude toward oneself, and
acknowledging and accepting multiple aspects of self, including good and
bad qualities (e.g., courage to be imperfect).
The notion of the life tasks is a useful guide throughout Adlerian psycho­
therapy (Manaster & Corsini, 1993). Similarly, well-being therapy uses Ryff’s
dimensions of well-being as its guide. It can be helpful to both the therapist
and the client to monitor progress as well as evaluate problems in various ar-
eas of functioning. Moreover, the life tasks are the points of contact between
the person and the world (Mosak & Maniacci, 1999). In treatment, Adlerians
seek to look across the personality and show how pervasive it is across the
life tasks. In other words, they help clients recognize that the same behavior
or approach to life has different effects in different situations. In well-being
therapy, this is accomplished toward the final sessions of treatment as Ryff’s
six dimensions of psychological well-being are progressively introduced.
However, it is achieved in the process of focusing on moments of well-­being
rather than moments of psychological distress. Thus, well-­being therapy
looks for areas in the life tasks, particularly the task of self, in which the
individual experiences optimal experiences.
There are certainly multiple avenues for approaching or addressing
problems within the self task in therapy. Many times, issues related to the
client’s opinions of him- or herself come up when the focus is on other life
tasks. What well-being therapy attempts to do is be intentional about look-
ing at issues pertinent to this task.

Conclusion

Well-being therapy is not a comprehensive system of personality and

treatment, and it diverges from Individual Psychology on many levels.
However, as with many contemporary approaches to treatment, particularly
positive psychology approaches, there are several aspects that run parallel
to the principles of Individual Psychology. Thus, there are some valuable
takeaways from studying the model.
Well-being therapy should perhaps at best be considered a therapeu-
tic technique, as opposed to strategy, that Adlerian therapists can utilize to
achieve therapeutic goals consistent with Adlerian theory (e.g., encourage-
ment, increasing social interest, and learning to live with oneself despite
one’s imperfections).
240 Thor Johansen

The technique is consistent with Adlerian psychotherapy in that it is

structured, short term, and directive. It also emphasizes treatment as a pro-
cess of learning and it utilizes cognitive and behavioral tactics throughout.
Within Adlerian psychotherapy, well-being therapy can be utilized as in-
tended: toward the end of therapy in the reorientation stage, to promote
enduring recovery and relapse prevention.
Another takeaway is the exclusive focus on positive experiences through-
out the treatment process. Well-being therapy focuses on acceptance by en-
gendering the positive rather than exclusively focusing on alleviating the
negative. Basic mistakes and faulty assumptions can be identified, chal-
lenged, and changed while the therapeutic focus remains on improving en-
couraging experiences, rather than emphasizing discouraging experiences.
This does not suggest, however, that one should ignore the acute condition
of the client, but it does constitute a technique for use in psychotherapy that,
when appropriately used, focuses primarily on encouraging experiences.
This brings us to another important point. The process of encouragement
is central to Adlerian psychotherapy. Encouragement involves communicat-
ing respect as well as confidence in clients. It also involves emphasizing
strengths and helping clients to notice and take responsibility for their efforts
and their progress. As a positive psychology approach, well-being therapy
can be thought of as a process of guided encouragement. Experiences of
well-being as described in Ryff’s model are in and of themselves experiences
of encouragement. These experiences both reflect optimal self-regard and
social belonging and further encourage the individual. It is the therapist’s
role to help the client recognize these moments, expand upon them, and
remove obstacles that impede experiences of well-being.
Finally, the model of well-being put forth by Ryff reminds the Adlerian
therapist of the importance of focusing on all the life tasks, including the
task of self. Many times clients and their therapists get stuck on the life task
related to the acute problem. However, by looking broadly at the client’s so-
cial context, including their relationship with themselves, and examining the
lifestyle’s interactions with all the life tasks, the therapist can assess how the
problem affects other areas of life and help address problems accordingly.
To summarize, well-being therapy is a Cognitive Behavior Therapy
treatment technique based on Carol Ryff’s multidimensional model of psy-
chological well-being, which, similar to the life tasks, serves as a guide in
treatment. However, the dimensions of well-being also provide avenues
for experiences of well-being. Well-being therapy provides the Adlerian
therapist a model for an encouragement technique he or she may consider
utilizing in the reorientation stage of therapy to achieve therapeutic goals
consistent with Adlerian theory.
 Well-Being Therapy and Adlerian Psychology 241

References

Adler, A. (1927). Understanding human nature. New York, NY: Garden City.
Barlow, P. J., Tobin, D. J., & Schmidt, M. M. (2009). Social interest and posi-
tive psychology: Positively aligned. Journal of Individual Psychology,
65(3), 2–34.
Carlson, J., Watts, R. E., & Maniacci, M. (2006). Adlerian therapy: Theory
and practice. Washington, DC: American Psychological Association.
Dreikurs, R., & Mosak, H. H. (1977). The tasks of life II: The fourth life task.
In H. H. Mosak (Ed.), On purpose: Collected papers (pp. 100–107).
Chicago, IL: Adler School of Professional Psychology. (Original work
published 1967).
Fava, G. A. (2016). Well-being therapy: Treatment manual and clinical ap-
plications. New York, NY: Karger.
Fava, G. A., Rafanelli, C., Cazzaro, M., Conti, S., & Grandi, S. (1998). Well-
being therapy. Psychological Medicine, 28, 475–480.
Fava, G. A., Rafanelli, C., Grandi, S., Conti, S., & Belluardo, P. (1998). Pre-
vention of recurrent depression with cognitive behavioral therapy: Pre-
liminary findings. Archives of General Psychiatry, 55(9), 816–820.
Fava, G. A., & Ruini, C. (2003). Development and characteristics of a well-
being enhancing psychotherapeutic strategy: Well-being therapy. Journal
of Behavior Therapy and Experimental Psychiatry, 34, 45–63.
Fava, G. A., Ruini, C., Rafanelli, C., Finos, L., Salmaso, L., & Mangelli, L.
(2005). Well-being therapy of generalized anxiety disorder. Psycho­
therapy and Psychosomatics, 74(1), 26–30.
Fava, G. A., & Tomba, E. (2009). Increasing psychological well-being and
resilience by psychotherapeutic methods. Journal of Personality, 77(6),
1903–1934.
Fava, G. A., Tomba, E., & Grandi, S. (2007). The road to recovery from de-
pression. Psychotherapy and Psychosomatics, 76, 260–265.
Gillham, J. E., & Seligman, M. E. P. (1999). Footsteps on the road to a positive
psychology. Behaviour Research and Therapy, 37, 5163–5173.
Leak, G. K., & Leak, K. C. (2006). Adlerian social interest and positive psy-
chology: A conceptual and empirical integration. Journal of Individual
Psychology, 62(3), 207–223.
Manaster, G., & Corsini, R. I. (1993). Individual Psychology: Theory and
practice. Chicago, IL: Adler School of Professional Psychology.
Moeenizadeh, M. & Salagame, K. (2010). The impact of well-being therapy
on symptoms of depression. International Journal of Psychological Stud-
ies, 2(2), 223–230.
242 Thor Johansen

Mosak, H. H., & Dreikurs, R. (1977). The life tasks III: The fifth life task.
In H. H. Mosak (Ed.), On purpose: Collected papers (pp. 108–117).
Chicago, IL: Adler School of Professional Psychology. (Original work
published 1967).
Mosak, H. H., & Maniacci, M. (1999). A primer of Adlerian psychology: The
analytic, behavioral, cognitive psychology of Alfred Adler. New York,
NY: Brunner-Routledge.
Ruini, C., & Fava, G. A. (2009). Well-being therapy for generalized anxiety
disorder. Journal of Clinical Psychology, 65(5), 510–519.
Ryff, C. D. (1989). Happiness is everything, or is it? Explorations on the
meaning of psychological well-being. Journal of Personality and Social
Psychology, 6, 1069–1081.
Ryff, C. D. (2014). Psychological well-being revisited: Advances in the sci-
ence and practice of eudaimonia. Psychotherapy and Psychosomatics,
83, 10–28.
Ryff, C. D., & Keyes, L. M. (1995). The structure of psychological well-being
revisited. Journal of Personality and Social Psychology, 69(4), 719–727.
Ryff, C. D., & Singer, B. H. (1996). Psychological well-being: Meaning, mea-
surement, and implications for psychotherapy research. Psychotherapy
and Psychosomatics, 65, 14–23.
Ryff, C. D., & Singer, B. H. (1998). The contours of positive human health.
Psychological Inquiry, 9, 1–28.
Ryff, C. D., & Singer, B. H. (2000). Biopsychosocial challenges of the new
millennium. Psychotherapy and Psychosomatics, 69, 170–177.
Seligman, M. E. P., & Csikszentmihalyi, M. (2000). Positive psychology: An
introduction. American Psychologist, 55(1), 5–14.

Thor Johansen, PsyD, ABPP, is a psychologist with the Northern Arizona VA

Health Care System in Prescott, Arizona. He is a graduate of Adler University
in Chicago.
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