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Article Excerpt
A new and sometimes controversial topic, forgiveness, has emerged from the psychological literature in counseling and psychotherapy. Many have claimed that forgiveness is a reasonable and worthwhile goal when attempting to help people deal with difficult experiences (e.g., Enright & Fitzgibbons, 2000; Ferch, 1998). These clinicians and researchers state that helping clients to forgive, rather than just cope with, the consequences of hurts can be useful for ameliorating multiple difficulties and promoting general well-being. Fitzgibbons (1986), for example, theorized that forgiveness can help clients to escape the control that past events have exerted over them and to limit the tendency to project the effects of past hurts into future relationships. Based on the theory that explicitly promoting forgiveness can be especially useful for some clients, interventions have been developed to help clients achieve forgiveness and have proven effective in clinical trials (Wade, Worthington, & Meyer, 2005). However, many of these interventions have not been directly compared with standard psychotherapeutic treatments, and so the question of whether explicit forgiveness treatments are more effective than current methods of treatment is still unanswered.
* Definitions of Forgiveness
There appears to be consensus in the psychological literature that forgiving is not condoning, pardoning, reconciling, excusing, justifying, forbearing, or just moving on with one's life (Wade & Worthington, 2005). But what is forgiveness? On this topic, researchers and clinicians often disagree. Worthington (2005) has suggested that greater consensus exists when one considers two basic types of relationships in which forgiveness can occur. In the case of a transgression by a stranger, forgiveness is defined as reducing one's grudge and giving up negative thoughts, emotions, and motivations. Hence, when dealing with strangers with whom the victim has not had nor desires to have an ongoing relationship, forgiveness is synonymous with the reduction in unforgiveness (defined as a complex of negative emotions, such as bitterness, that develops after ruminating on an offense; Worthington & Wade, 1999).
In contrast, in ongoing valued relationships, forgiveness is understood to include both the reduction of vengeful, avoidant, and bitter feelings, thoughts, and behaviors (i.e., unforgiveness) and the increase or promotion of more positive feelings, thoughts, and behaviors. Theoretically, this occurs through replacing negative emotions with more positive, other-oriented emotions such as pity, sympathy, compassion, or even love (Worthington & Wade, 1999). Moreover, forgiveness is distinct from reconciliation (e.g., one may forgive and still decide to end a relationship). Victims who experience forgiveness defined in this way can still hold an offender accountable for the consequences of the offense and can think carefully about whether trust can be restored and the relationship renewed.
* Outcome Research on Specific Forgiveness Interventions
The first outcome study of an intervention designed explicitly to promote forgiveness was published in 1993 by Hebl and Enright, based on Enright's (Enright & the Human Development Study Group, 1991) process model of forgiveness. Since that time, numerous intervention studies have been conducted, primarily from two research laboratories, Enright's and Worthington's, although others have made significant contributions as well (in particular, Rye & Pargament, 2002; Rye et al., 2005). Most of the outcome research has been conducted in a group, psycho-educational format (for a review, see Wade & Worthington, 2005). However, several studies have been conducted to examine the efficacy of forgiveness interventions in individual counseling (e.g., Freedman & Enright, 1996) and groups of couples (e.g., Ripley & Worthington, 2002). The body of forgiveness intervention research has grown large enough that several meta-analyses have been published summarizing the results.
In one meta-analysis of nine published studies, Baskin and Enright (2004) explored the effect of type of forgiveness treatment on outcome by categorizing the interventions as either process-oriented or decision-oriented. Process-oriented interventions are based on theories that understand forgiveness as a process on which a victim works. Decision-oriented interventions are based on theory that views forgiveness as a decision that a victim makes. This meta-analysis made a new contribution by reviewing not only the promotion of forgiveness as an outcome but also other psychological symptoms (e.g., anxiety and depression). Baskin and Enright's results indicated that only the process-oriented interventions (both individual and group formats) effectively promoted forgiveness (average effect sizes 0.83 and 1.66, respectively) and psychological well-being (average effect sizes 0.59 and 1.42, respectively). The decision-oriented interventions did not significantly promote forgiveness (average effect size = -0.04) or psychological well-being (average effect size = 0.16). However, in their analyses, Baskin and Enright did not control for the duration of the treatments, even though they stated that "an important consideration is the confound between the type of intervention and the duration of the intervention" (p. 88). On average, the process-oriented group interventions (average time = 7 hours) lasted almost twice as long as the decision-oriented group interventions (average time = 4 hours). Furthermore, the process-oriented individual interventions lasted the longest by far (average time = 36 hours). Therefore, because treatment duration was confounded with type of treatment, it is impossible to determine differences between process- and decision-oriented models of forgiveness.
In the most recent meta-analysis of forgiveness treatments, Wade et al. (2005) analyzed 49 group interventions reported in 27 studies (including dissertations and other unpublished materials). Unlike Baskin and Enright (2004), the metaanalysis by Wade et al. (2005) included only group--not individual--studies and attempted to control for the variable of duration of the treatments. Rather than comparing different interventions based on theoretical orientations (because these were confounded with time), Wade et al. (2005) coded each intervention group as a forgiveness treatment (theoretically based treatment focused on promoting forgiveness), forgiveness comparison treatment (comparison treatment focused on promoting forgiveness), attention control groups (groups not focused on forgiveness), or no treatment (often, wait-list control groups). With these categories, they conducted multiple regression analyses that accounted for the duration of each treatment (which was significantly related to outcome). Their analyses indicated that group interventions aimed explicitly at promoting forgiveness (average effect size = 0.56) were significantly more effective than no treatment (average effect size = 0.10) and placebo treatments (average effect size = 0.26), even when controlling for the duration of the interventions. This supports the specific efficacy of forgiveness interventions over no treatment and attention-control conditions, even when accounting for the often longer duration of full forgiveness treatments.
Based on reviews of forgiveness outcome research, it is apparent that interventions specifically designed to promote forgiveness consistently outperform no-treatment, wait-list control, and placebo treatment groups (Baskin & Enright, 2004; Wade et al., 2005). Framed in the larger body of psychotherapy outcome research, this is no surprise. Bona fide attempts to help people deal with myriad psychological concerns (from phobias to relationship problems) have consistently outperformed no treatment and nontherapeutic attention-control treatment (for a review, see...
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