Positive psychiatry is the science and practice of psychiatry seeking to promote overall well-being and understand the “positive” aspects of the patient’s life, such as resilience, social connections, and meaning and values in life. While positive psychiatry research has recently blossomed, the field lacks practical ways to integrate these overarching principles into clinical practice. Life review interventions are commonly used in palliative care, spiritual care, and geriatrics, and involve a healthcare team member interviewing a patient about their life.

Our objective is to describe the implementation of a positive psychiatry-informed life story review initiative into medical education, with the goal of creating a structure for medical trainees to see the larger context of patients’ health, understand how past experiences influence current values, and improve patients’ overall well-being.

First- and third-year students at Alpert Medical School of Brown University are required to participate in at least one strengths-based life review with a patient in the community or inpatient setting, transcribe the story, and integrate the story into the electronic health record.

Preliminary results demonstrate high acceptability and perceived development of patient-centered competencies, such as understanding patients as more complete human beings. While this is a low cost and sustainable intervention, barriers include buy-in from medical educators, hospital administrators, and trainees.

To our knowledge, this is one of the first positive psychiatry-informed interventions to be implemented into the required medical curricula. Life story reviews may allow providers to understand the “positive” aspects of patients’ lives and understand their patients better as people.

Positive psychiatry offers an unique approach to promote brain health and well-being in aging populations. Minimal interventions through behavioral activation to promote wellness are increasingly available using self-guided apps, yet little is known about the effectiveness of app technology or the difference between clinician-supported behavioral activation versus self-guided app methodologies.

Investigate the difference in users and outcomes between two methods of the Fountain of Health (FoH) positive psychiatry intervention for behavioral activation to promote brain health and well-being: (1) clinician-assisted and (2) independent app use for behavioral self-management.

As part of a larger knowledge translation intervention in positive psychiatry, two specific methods of a behavioral activation intervention were retrospectively compared.

Two subsets of patients were compared; 254 clinician-assisted patients; 333 independent app users.

A minimal positive psychiatry intervention in frontline care using the FoH health and behavior change clinical tools

Main outcomes were changes in psychological (health and resilience, well-being scores) and behavioral indices (goal attainment, items of goal SMART-ness). User profiles (age, sex and completion rates) were also compared.

Clinician-assisted patients were more likely to be male, older, and have lower health and resilience scores at baseline. Clinician-assisted patients had notably higher completion rates (99.2% vs. 10.8%). Psychological outcomes (improved health and resilience, and well-being) were similar regardless of intervention method for those who completed the intervention. Behavioral outcomes revealed clinician-assisted patients set goals that better adhered to key goal-setting items.

Clinician–patient relationships appear to be an important factor for intervention completion and behavioral outcomes, while further exploration of best practices for intervention completion using health apps in clinical practice is needed. A preliminary goal-setting methodology for effective behavioral activation, to promote brain health and wellness, is given.

The Fountain of Health (FoH) initiative is a knowledge transfer (KT) project on the science of brain health and resilience promotion, in alignment with positive psychiatry.

Assess the effectiveness of FoH KT delivered in individual and group-based formats.

Pre- and post-intervention quality assurance survey of FoH KT.

Interventions occurred in Nova Scotia, Canada.

Adults over age 50 years without pre-existing dementia were targeted. A total of 92 participants received FoH KT in individualized (n = 41) and group-based (n = 51) formats.

FoH KT (e.g. sharing evidence, lifestyle coaching, and goal setting) using a range of KT supports (e.g. FoH website, paper materials) was delivered to (1) individual patients by primary care clinicians and (2) community-based groups by lay leaders.

The main outcome measure was participant pre- and post-quality assurance self-reports.

Improvements were found in participant awareness of FoH, knowledge of evidence-based mental health promotion initiatives, and in application of this information in daily life in both individual and group-based settings. Improvements in participant knowledge about epigenetic factors that impact health and confidence with health behavior goal setting were reported in both contexts. Changes in self-perceptions of aging scores reached significance in the group intervention.

FoH KT produced short-term positive self-reported changes in participants in both individual and group formats. Larger control studies with long-term follow up are needed to better assess effects of both individual and group formats of FoH KT and longer term impacts on health behaviors and outcomes.

The use of the pharmacopsychometric triangle to enhance patient-reported well-being as the ultimate goal of treatment has most intensively been studied in patients with a major depressive episode.

The review is structured on the pharmacopsychometric triangle in which the desired clinical effect of an antidepressive medication is balanced against the undesired side effects induced by this medication in terms of restored well-being. As a biological treatment, the antidepressive medication is compared clinically with both electroconvulsive therapy and psychological treatment.

In the process of this review, evidence from a dose–response study in patients suffering from a major depressive episode with an adequate duration and symptom severity has demonstrated that the dose–response relationship emerged when using the patient-reported well-being outcome rather than the symptomatic reduction as outcome.

The pharmacopsychometric triangle is in patients with major depressive episodes providing important information within positive psychiatry.