Interventions to promote forgiveness in couple and family context: conceptualization, review, and analysis.
Worthington, Everett L., Jr. ; Jennings, David J., II ; DiBlasio, Frederick A. 等
Forgiveness interventions have not been adapted for children,
couples, families, and also specifically with Christians.
Conceptualization and theorizing have lagged empirical studies. We use a
stress-and-coping conceptualization of forgiveness to provide a
framework for understanding forgiveness in family context, especially
with Christians. Although several evidence-based interventions to
promote forgiveness have been developed, few have targeted children,
early adolescents, parents, families, and Christians. However, most will
likely resonate with Christian beliefs and values and can be adapted to
Christian families. More target high school adolescents and couples.
Most are adaptations of (a) Enright's process model of forgiveness,
(b) Worthington's emotional forgiveness through the REACH
Forgiveness program, (c) DiBlasio's Decision-based model, and (d)
Worthington's Forgiveness and Reconciliation through Experiencing
Empathy--FREE--model. Such interventions need to be manualized and
studied empirically to determine their efficacy in family context.
Forgiveness is perhaps the central value to Christianity (Marty,
1998)--and with love is certainly one of the two most central values.
Jesus told his followers to love their enemies (Mt 5:44), and he even
made divine forgiveness contingent on forgiving people who sinned
against them (Mt 6:14-5). However, forgiving is difficult, and
Christians struggle with this central value of their faith (Smedes,
1984). Christians are not the only people who value forgiveness, nor are
they the only ones who struggle with it. Each of the five major
religions also values forgiveness (Rye et al., 2000), though each
understands it differently, and forgiveness was long considered a
religious construct.
Christians seek to forgive for many reasons (Worthington, 2009).
These include because (a) there is Scriptural mandate for forgiving (Mt
6:12, 14-15), (b) it is a way of loving one's enemies (Worthington,
Lerner, Sharp, C., & Sharp, J., 2006), (c) it is consistent with
other Christian values on families, (d) it is part of life in the body
of Christ (Jones, 1995), and (e) it is instrumentally useful to
one's physical, mental, relational, and spiritual health (Smedes,
1984). Yet despite the benefits, little attention has been paid to how
to forgive faster, more deeply, and in more situations. This deficit has
not been evident with adults in groups or in psychotherapy, but has been
evident: within the family.
In this conceptualization and review, we seek to accomplish five
tasks. First, we set the stage with a description of a theoretical
framework that explains forgiveness, its development, and its practice
in the family. The crucial role played by parents is noted. We
especially consider families in which one or more of the adults is a
Christian. Whereas not all interventions have drawn on the
conceptualization we advance, the present conceptualization is one that
can help understand even interventions arising from other assumptions.
Second, we review interventions to promote forgiveness especially within
families. Unfortunately, as we will see, few interventions to promote
forgiveness in the family have been explicitly Tailored to deal
specifically with Christian children, young adolescents, marriages,
parents, or families as a whole. We focus on interventions to promote
forgiveness that are available to the secular public because religious
people--many of whom are Christians--make a substantial proportion of
the general population. Thus, because a high proportion of the public at
least endorses a belief in God, say they pray and worship regularly, and
might even seek religiously or spiritually oriented interventions to
promote forgiveness, we draw upon the secular interventions. Third, we
examine all interventions explicitly tailored to Christians. Fourth, we
review the empirical studies of the efficacy of the interventions.
Fifth, we draw conclusions that advise Christian clinicians and clinical
researchers on the future use and study of forgiveness in Christian
families.
CONCEPTUALIZING FORGIVENESS AND ITS DEVELOPMENT
We use a stress-and-coping model to understand forgiveness
(Worthington, 2006a). Stress-and-coping models begin with stressors.
Transgressions and Their Appraisals
Transgressions are understood to be stressors that provide a demand
to change for the victim. Transgressions violate people's
psychological or physical boundaries. People appraise the transgression
along the dimensions of degree of hurtfulness, injury, severity, and
duration. However, they also make a primary appraisal--is this
potentially harmful? Answering yes to that question provokes the
secondary appraisal--can I cope?
Coping Responses
People can cope with transgressions by seeking to re-establish
justice or redress the injustice. They may do this by enacting revenge
or by appealing to some formal system to reestablish societal
justice--such as through judicial, criminal, political, or social
avenues. They may seek personal justice in the form of pursuing an
apology or restitution. Or they might turn judgment over to a divine
power to bring justice about.
People might also respond to transgressions by trying to control
their emotions. They might forebear their immediate responses to the
transgression. Forbearing is withstanding and perhaps suppressing anger
and hatred while controlling negative emotions. People might also simply
accept the transgressions and the injustice and move on with their life.
Acceptance acknowledges injustice and its ill effects but reduces the
future importance of the event in governing one's behavior. It
releases one from emotion by giving up one's expectations for the
redress of injustice. People might reduce injustice through narrative
approaches by excusing (i.e., recounting mitigating circumstances) or
justifying (i.e., telling how they were in the wrong and the offender
was within his or her rights to offend) transgressions against
themselves. Essentially, they tell a different story about the
transgression.
Forgiveness
Finally, people might deal with injustice by forgiving. There are
two distinct types of forgiving. Emotional forgiveness is the emotional
replacement of negative unforgiving emotions (like bitterness,
resentment, and anger) by positive other-oriented emotions such as
empathy, sympathy, compassion, or love (Worthington, 2003, 2006a). When
people forgive, their negative emotions subside. They are less motivated
to get revenge or avoid the transgressor, and, if forgiving is complete,
they might feel love, compassion, sympathy, or empathy for the
transgressor (DiBlasio, 1998). Some people grant (silently to
themselves) decisional forgiveness, which applies to their behavioral
intentions toward the offender. They decide not to seek revenge, not to
avoid the transgressor (unless continued interaction is potentially
dangerous), and to treat the person as a person of worth even though
they might not have completely forgiven the person emotionally.
Decisional forgiveness is a sincere intention statement about
controlling one's future behavior (Worthington, 2003, 2006a).
Forgiveness may be initiated by-reasoning, simply experiencing positive
other-oriented emotions toward the transgressor, acting kindly toward
the transgressor, or having the transgressor act contritely or in a way
that provokes empathy, sympathy, compassion, or love.
Talking about Transgressions
Neither decisional nor emotional forgiveness is necessarily
involved if one says aloud that one forgives a person. Talking about
forgiveness is clearly different than either the intrapersonal
experience of making a decision to forgive or of experiencing emotional
forgiveness (Worthington, 2006a). For instance, one might say one
forgives because one is trying to disarm the offender so that revenge
can he exacted. Or alternatively, one could easily forgive--the
decisionally and emotionally--and yet not tell the other person that one
forgives because one might know that guilt will elicit from the offender
many guilt-motivated benefits to the victim.
Most Childhood "Forgiveness" Is Likely Talking about
Forgiveness, Not Actually Forgiving Internally
A child can be induced to say that he or she grants decisional
forgiveness at very early ages (Worthington, 2006b). Parents can model
apologizing, asking for forgiveness, and saying, "I forgive
you." They can instruct children to foreswear avoidance and revenge
and to treat the other person as if the other person were a person of
great worth (i.e., decisional forgiveness). If the child complies, the
child's behavior is consistent with an internal decision to
forgive. Yet the internal world of the child might not have been
accessed. Mischel (1973) showed that children imitate their
parents' behavior. For example, if a parent says, "I forgive
you" but acts vengefully, the child will likely do likewise. By
controlling his or her negative behavior toward an offender, the child
might even experience changed negative emotions and motivations, thus
come to emotionally forgive as an internal experience. The child, if
cognitively developed enough, might actually make a decision
internally--but that requires cognitive development to where internal
speech is governing the child's behavior. But importantly, the
child also might not experience emotional forgiveness in tandem with
decisional forgiveness, and neither is a necessary link to the
child's saying that he or she forgives.
Reasoning about Forgiveness
Enright and his colleagues (see Enright & Fitzgibbons, 2000,
for a review) have conducted substantial research on the development of
reasoning about forgiveness. They identified six stages of development
of reasoning capacity in children. Enright's stages, which
emphasize mercy, parallel Kohlberg's (1984) six stages of reasoning
about justice. The time-tables of development of reasoning about justice
and mercy are also parallel.
In Enright's model, very young children think that forgiveness
will help them avoid punishment (stage 1) or get rewards (stage 2). As
children progress into middle childhood and early adolescence, they
become capable of reasoning that considers social disapproval and
approval for their responses to transgressions. They thus might say they
forgive, depending on the contingencies, when they do not feel forgiving
at all. Only in adolescence are children thought to be capable of
reasoning abstractly about forgiveness.
In some ways, the consideration of how children develop the
capacity to reason about forgiveness is less important than whether
children actually experience forgiveness after a transgression.
One's capacity to forgive (for instance) at stage 5 (in the
Kohlbergian and Enright schemes) does not imply that one will ever
actually forgive. We all know brilliant adults with highly developed
reasoning capabilities who are spiteful, bitter, unforgiving, and
vindictive.
Presumably, most parents and other authority figures (like
teachers, religious leaders, and day care personnel) want children to
develop into forgiving adults. This is especially true in Christian
families due to the Christian mandate to forgive. Presumably, they also
will not merely wait until children develop mature reasoning capacity to
forgive, but they will intervene early and often to promote forgiving in
their children.
We believe that interventions by patents and by mental health
professionals and other adult educators can help children develop
age-appropriate forgiveness even when the children are very young.
Usually they will help the parents; (a) become more forgiving as a
couple, (b) learn how to coach their children to make decisions to
forgive, experience emotional forgiveness, and (c) communicate
forgiveness as congruently as they can.
Clearly, children's or adolescents' capacity to reason in
such a way that they conclude they should forgive can be important to
whether they emotionally forgive or make an internal decision to
forgive. To reason that one should forgive for reasons more socially and
spiritually motivated than motivated by rewards and punishments will
also affect how children and adolescents think about and try to
experience forgiving. So, development of reasoning capacities is not
unimportant to actually forgiving.
However, by understanding emotional forgiveness as an emotional
replacement of negative with positive emotions, we are led to understand
the development of forgiveness as being more complex than mere obedience
("Tell your sister that you forgive her, Johnny. She won't
flush any more of your pet goldfish down the toilet") or as being
primarily a function of cognitive development (although clearly some
minimal level of cognitive development is necessary).
Other developmental considerations besides level of cognitive
reasoning that are important to forgiving. Other developmental
considerations that are in line with the child's emotional
development are important to understanding whether children actually
forgive and at which ages (Denham et al., 2005). First, temperament is
important. Babies often develop easy, difficult, slow-to-warm-up, or
mixed temperaments by-three months (Gottman et al., 1996). Temperament
is important to the development of forgiveness, but it is of little
importance to intervention. Second, childhood attachment to parental
love objects should be expected to influence the degree to which
children experience emotional forgiveness. Because childhood attachment
styles are difficult to change, assessing attachment difficulties helps
clinicians understand why some children might have difficulties
forgiving, but they are not usually the target of clinicians who are
intervening to promote forgiveness.
Third, from the early months of a child's life, emotion
regulation occurs (for an excellent review, see Denham et al., 2005).
Even babies at the youngest ages learn to emotionally down-regulate
negative emotions by self-soothing, calming, and distracting themselves
from their frustrations. As children age, their repertoire of
emotion-regulation strategies becomes more varied and sophisticated.
Those strategies can be targeted for age-appropriate interventions. Even
in preschool years, an early sense of empathy, sympathy, compassion and
unselfish love for others can be built.
Fourth, coaching from their parents can help children broaden and
deepen their emotion-regulation strategies (Gottman et al., 1996).
Through emotion coaching, parents convey their meta-emotional philosophy
to children. They directly and indirectly tell and show children what
emotions are acceptable to experience and to express. They train
children in how to deal with emotion-provoking experiences--notably (for
our purposes) transgressions.
Fifth, people encounter stress throughout their lives. Stressors
make demands for change. Children appraise the stressors and respond to
their appraisals with stress reactions, or they respond to physical
stressors, sometimes without appraisal. They try to cope with both
situations and their own reactions. Clinicians can apply the
stress-and-coping model of forgiveness with children, just as with
adults. However, the coping strategies will differ. The development of a
repertoire of emotion-focused coping strategies will facilitate or
hamper forgiving depending on what types of coping strategies the child
practices.
For example, a child who sees God as a hostile authority figure
might be less likely to respond with forgiveness to someone who had
offended him or her (especially to a parent, caregiver, or other
authority figure) than would a child who perceives God to be nurturing
and collaborative. Pargament (1997) has identified numerous religious
and spiritual coping strategies. These religious and spiritual coping
strategies--such as praying, meditating, and making positive
attributions to God--can affect the capacity of the child to forgive.
Prayer as a coping strategy might be more available to older children
than to younger children, which demonstrates development as well.
Sixth, the religions and spiritual environment in the home will
likely also affect the child's development of the experience of
emotional forgiveness. Forgiveness, (decisional or emotional) in
response to a transgression, is valued by every' major religion
(Rye et al., 2000). It is the centerpiece of Christianity. Some
religions (e.g., Judaism, Islam, and Christianity) firmly advocate
decisional forgiveness and emphasize controlling one's negative
behavior. Christianity also advocates emotional forgiveness in addition
to decisional forgiveness. Buddhism and Hinduism also promote
forgiveness (Rye et al., 2000). Religion has been found to be correlated
with forgiveness in adults (for a meta-analysis, see Davis, Worthington,
&C Hook, 2010). Membership in a religious denomination, which
involves a belief system that values forgiveness more or less strongly,
will determine what parents teach their children.
The crucial importance of parents. Altogether then, we can see that
children probably learn to grant forgiveness largely depending on the
parents' belief system, their practice of encouraging and rewarding
the child's expression of decisional forgiveness after being
transgressed against, and their modeling of decisional forgiveness.
However, the development of the experiencing of emotional forgiveness
(in contrast to granting decisional forgiveness) is substantially less
due to external demands from parents. Instead, it is highly related to
the emotional climate within the parent-child relationship, which
affects the child's temperament, emotion-regulation capability,
parental meta-emotional philosophy, the child's cognitive
development of the ability to reason about justice and forgiveness, the
repertoire of ways of coping with stress that has been built through
being intentionally and unintentionally rewarded, and the religious and
spiritual environment in the home and church.
We suggest that the couple, co-, and single-parenting relationships
are crucial for developing forgiveness. Parents can provide both an
environment that nurtures forgiveness and structures that stimulate,
encourage, and reward (or punish) a child for forgiving. Through the
emotional climate and environmental contingencies and structures,
children develop prototypes of forgiving, and those prototypes are honed
into personality dispositions as the children move beyond the home and
deal with peers and other adults more frequently in their grade school,
middle school, and high school years.
It is thus important to examine how psychotherapists, couple
therapists, and family therapists have attempted to promote forgiveness
in their work with families and individuals. Our theoretical
considerations have suggested that five elements are crucial: promoting
(1) decisions to forgive; (2) emotional forgiveness; (3) good couple
relationships that provide a warm environment that invites restoring
after a transgression; (4) facilitative talk about transgressions; and
(5) a climate where Christian beliefs and values are apparent and
appreciated. We reviewed the literature investigating intervention in
family context. This involved school aged, middle school, and high
school children, couple counseling, and parent training (see Tables 1
and 2).
TABLE 1
Empirical Research on Interventions with Children, Middle School
Adolescents, and High School Adolescents
Study Source Participants Intervention
Children
Hepp-Dax (1996) Dissertation 23 fifth-grade An 8-session,
students ages 4-week group based
10-12 years on the process
model of
forgiveness
(Enright &
Fitzgibbons, 2000)
Adolescents (Middle School)
Freedman & Knupp Journal Article 10 adolescents 8 weekly
(2003) in junior high educational group
school who had sessions based on
experienced the process model
parental divorce of forgiveness
ages 12-14 (Enright &
years Fitzgibbons, 2000)
Gambaro (2002) Dissertation 12 middle school Educational
students ages program conducted
12-14 years 2x per week for 12
weeks based on the
process model of
forgiveness
(Enright &
Fitzgibbons, 2000)
Hui & Chau Journal Article 56 Chinese 8 educational
(2009) children in forgiveness
grade six who sessions were
had judged conducted over a
themselves to be 2-month period
hurt and chose based on the
not to forgive Enright Process
their offenders model of
forgiveness
(Enright &
Fitzgibbons, 2000)
Adolescents (High School)
Beck (2005) Dissertation 76 adolescents A 6-session
from private and workshop based on
alternative the REACH model of
schools ages forgiveness
14-18 years (Worthington,
2003) conducted
over a six-week
period
Gassin (1995) Dissertation 19 juniors and An 8-session
seniors in high psychological
school who had curriculum that
been injured by did not explicitly
a romantic discuss
partner forgiveness, but
challenged
participants to
apply
psychological
ideas to a hurtful
situation
Hui & Ho (2004) Journal Article 63 male Chinese 8 educational
students in Hong forgiveness
Kong; mean age sessions were
16 years conducted over a
4-week period based
on the Enright
Process model of
forgiveness
(Enright &
Fitzgibbons, 2000)
Klatt (2008) Dissertation 12 adolescent 12-week forgiveness
males in a intervention added
juvenile to the usual
correctional treatment plan
facility ages based on the
12-17 years Strengthening
Families
curriculum
Park (2003) Dissertation 48 Korean 12-week program
adolescent based on the
females who had Enright
been victims of Forgiveness
aggression ages process model
12-21 years (Enright &
Fitzgibbons, 2000)
Perez (2007) Dissertation 7 adolescent 15-week group
males in a intervention based
residential on the Enright
treatment process model of
program ages forgiveness
14-17 years (Enright &
Fitzgibbons, 2000)
Sim (2003) Dissertation 20 adolescents 15 sessions
in a residential loosely structured
treatment on the Enright
facility ages Forgiveness
16-18 years Process model
(Enright &
Fitzgibbons, 2000)
Williams, Journal Article 106 youth with 9-week modularized
Johnson, & Bott prior aggression program based on
(2008) in the school The Peaceful
setting ages Alternatives to
5-18 years Tough Situations
(PATTS).
Study Source Measurement General Findings
Children
Hepp-Dax (1996) Dissertation Enright Experimental
Forgiveness group showed
Inventory for significant
children, the increase in
Revised Manifest total
Anxiety Scale, the forgiveness
Self-Esteem score at
inventory, & the Posttest 1 but
Social Skills not at Posttest
Inventory (teacher 2.
rated)
Adolescents (Middle School)
Freedman & Knupp Journal Article Enright Experimental
(2003) Forgiveness group experienced
Inventory, State significantly
and Trait Anxiety greater hope and
Inventory, decreased trait
Reynolds anxiety compared
Adolescent to control group.
Depression Scale, No significant
Hope Scale, and difference was
the Coopersmith found between
Self-Esteem Scale groups on
forgiveness,
state anxiety,
depression, or
self-esteem.
Gambaro (2002) Dissertation the Enright Experimental
Forgiveness group showed
Inventory for significant
Children, the reductions of
Behavior Trait anger,
Assessment System angry
for Children, & temperament, and
the State-Trait angry reaction,
Anger Expression and significant
Inventory improvement in
attitudes toward
teachers and
schools and
relationships
with parents and
peers compared
to control.
Hui & Chau Journal Article the Enright Experimental
(2009) Forgiveness group reported
Inventory, the significant
Chinese Beck increase in
Depression forgiveness,
Inventory, the self-esteem, &
Children's Hope hope, and
Scale, the significant
Rosenberg decrease of
Self-Esteem Scale, depression than
& the Chinese control group,
Concepts of but groups did
Forgiveness scale not differ in
behavior, affect
and cognition as
measured by the
EFI. Qualitative
analysis
revealed
experimental
group had a
better
understanding of
forgiveness,
were more aware
of personal and
social benefits
of forgiveness,
and were more
inclined to see
forgiveness as
an unconditional
act of love
Adolescents (High School)
Beck (2005) Dissertation Enright Treatment group
Forgiveness showed
Inventory, significant
Batson's Empathy increases in
Adjectives, forgiveness and
Modified Anger empathy, and a
Scale, and the significant
Aggression decrease of
Questionnaire anger compared
to control
group, but there
was no
difference
between groups
on reported
levels of
aggression
Gassin (1995) Dissertation State Anger scale, Experimental
Enright group showed
Forgiveness significant
Inventory, Life increase in
Change scale, & overall
the Social social-cognitive
Description Task complexity
compared to
control, but no
differences were
found in
depression,
hope, anger, or
forgiveness
Participants who
had moderate to
high increases
in
social-cognitive
complexity
showed greater
forgiveness
responses at
post-test and
follow-up
Hui & Ho (2004) Journal Article Self-Esteem scale, Experimental
the Children's group had no
Hope scale, the significant
Conceptual differences
Forgiveness between pre and
Questions, & the posttest
Enright measures of
Forgiveness self-esteem and
Inventory hope, and they
did not differ
from the control
group on
posttest
measures of
self-esteem and
hope either.
Participants did
not show
significant
differences on
concept of
forgiveness
between pre and
posttest.
Klatt (2008) Dissertation The Aggression Experimental
Questionnaire, the group showed
Enright greater
Forgiveness increases in
Inventory, How I forgiveness and
Think greater
Questionnaire, & reductions in
behavioral self-reported
ratings anger and
aggression than
treatment as
usual group.
Park (2003) Dissertation Enright Experimental
Forgiveness group
Inventory for experienced
Children, State greater
Anger Scale, forgiveness and
Bryant's Empathy empathy, and
Scale, Hostile less
Attribution self-reported
Measure, & Child anger, hostile
Behavior attribution,
Checklist-Youth's delinquency and
Report Form & aggression than
Teacher Report control at
Form posttest and
significant
differences were
maintained at
8-week follow-up
for all
variables except
self-reported
aggression
Perez (2007) Dissertation Enright Participants
Forgiveness experienced
Inventory, the significant
Personality increases in
Inventory for forgiveness and
Youth, & the significant
Devereux Scales of decreases in
Mental Disorder disruptive
behaviors
andexternalizing
behaviors
between pre and
posttest.
Sim (2003) Dissertation Enright Treatment group
Forgiveness showed
Inventory & significantly
Religious higher
Commitment forgiveness
Inventory posttest than
control group
Williams, Journal Article Conflict Tactics PATTS
Johnson, & Bott Scale-Revised, and participants
(2008) a modified version indicated
of the Mauger significant
Forgiveness Scale positive
decreases in
physical
assault,
psychological
aggression, and
vengefulness, as
well as
reduction of
school
suspensions,
principal
referrals, or
new criminal
offenses, and
significant
increase of
forgiveness of
others compared
ton control
group.
TABLE 2
Empirical Research on Interventions with Parents, Couples, and Families
Study Source Participants Intervention
Parents (n = 1)
Kiefer et al. Journal Article 27 parents and Forgiveness and
(2010) caregivers of Reconciliation
children 0-9 through
years old Experiencing
Empathy (FREE)
delivered through a
3-week workshop
totaling 9 hours
Couples (n = 11)
Alvaro (2001) Dissertation 46 married 4 hours of a
couples who had psychoeducational,
experienced interpersonal
hurt in their forgiveness
relationship intervention given
during a one-day
workshop based
provided by
Intimate Life
Ministries.
Burchard, Journal Article 20 newly Forgiveness and
Yarhouse, married Reconciliation
Kilian, couples through
Worthington, Experiencing
Berry, & Canter Empathy (FREE),
(2003) which contains
REACH
Coyle & Enright Journal Article 10 men who Enright's process
(1997) identified as model of
being hurt by forgiveness
the abortion (Enright &
decision of a Fitzgibbons, 2000)
partner
DiBlasio & Benda Journal Article 44 spouses Decision-Based
(2002) Forgiveness
DiBlasio & Benda Journal Article Study 1:44 Decision-based
(2008) married couples forgiveness
Study 2:26 treatment
married intervention
volunteers (DiBlasio, 1999)
Gordon, Baucom, Journal Article 6 married Three-stage
& Snyder (2004) heterosexual forgiveness model
couples
recovering from
an extramarital
affair
Greenberg, Journal Article 46 participants 12-hour
Warwar, & who had psychoeducational
Malcolm (2008) unresolved group administered
interpersonal, over 12weeks that
emotiona injury included content
with a covering aspects of
significant forgiveness such as
other (i.e., what it is and is
parents, not, why one would
ex-partner, be motivated to
sibling or forgive (sources of
child) content
acknowledge, among
others,
Worthington's
theorizing)
Knutson (2003) Dissertation 10 married A 20-session
couples educational program
reporting low based on Enright's
marital process model of
satisfaction forgiveness
(Enright &
Fitzgibbons, 2000)
Ripley & Journal Article 43 married REACH, empathy
Worthington couples centered
(2002) forgiveness-based
marital enrichment
and an early
version of FREE
Sells, Giordano, Journal Article 5 married 8-week marital
& King (2002) couples group curriculum
experiencing using contextual
long-standing family therapy and
frustration a forgiveness model
over recovery based on Hargrave's
from a four-station model
relational of forgiveness
injury
Vaughan (2001) Dissertation 20 newly Forgiveness and
married couples Reconciliation
** through
Experiencing
Empathy (FREE),
which contains
REACH
Study Source Measurement
Parents (n = 1)
Kiefer et al. Journal Article Transgression-related Interpersonal
(2010) Motivations Inventory, Single-Item
Forgiveness, and Batson's Empathy
Adjectives
Couples (n = 11)
Alvaro (2001) Dissertation Enright Forgiveness Inventory, the
Personal Assessment of Intimacy in
Relationships (PAIR), and the
Evaluating & Nurturing Relationship
Issues, Communication, Happiness
(ENRICH) inventory
Burchard, Journal Article The Quality of Life Inventory
Yarhouse,
Kilian,
Worthington,
Berry, & Canter
(2003)
Coyle & Enright Journal Article Enright Forgiveness Inventory,
(1997) State Anger Scale, State Anxiety
Scale, and the Grief Scale
DiBlasio & Benda Journal Article Enright Forgiveness Inventory,
(2002) Index of Marital Satisfaction, and
the Generalized Contentment Scale
DiBlasio & Benda Journal Article Enright Forgiveness Inventory,
(2008) Index of Marital Satisfaction, and
the Generalized Contentment Scale
Gordon, Baucom, Journal Article Beck Depression Inventory,
& Snyder (2004) Post-Traumatic Stress
DisorderSymptom Scale-Self Report,
The Marital Satisfaction
Inventory-Revised, and the
Forgiveness Inventory
Greenberg, Journal Article Enright Forgiveness Inventory,
Warwar, & Forgiveness Measure, Unfinished
Malcolm (2008) Business Empathy and Acceptance
Scale, Unfinished Business Feelings
and Needs Scale, the Letting Go
Measure. Target Complaints
Discomfort and Change Scale, Global
Symptom Index, and the Beck
Depression Inventory
Knutson (2003) Dissertation The Family Strengths Scale, Enrght
Forgiveness Inventory, State-Trait
Anxiety Inventory, Beck Depression
Inventory-II, Coopersmith
Self-Esteem Inventory, and the Hope
Scale
Ripley & Journal Article Dyadic Adjustment Scale, Couples
Worthington Assessment of Relationship
(2002) Elements, The Global Rapid Couples
Interaction Scoring System, the
Relationship Dynamics Scale, and
the Transgression-Related
Interpersonal Motivations
Inventory
Sells, Giordano, Journal Article Interpersonal Relationship
& King (2002) Resolution Scale, the Dyadic
adjustment Scale, the State-Trait
Anger Inventory, and the Symptom
Checklist-Revised 90
Vaughan (2001) Dissertation Kansas Marital Satisfaction Scale
Study Source General Findings
Parents (n = 1)
Kiefer et al. Journal Article Forgiveness of a target offense and
(2010) a measure of general
relationship-aggregated forgiveness
increased and was maintained at a
3-week follow-up.
Couples (n = 11)
Alvaro (2001) Dissertation The experimental group experienced
significant increases in
forgiveness and intimacy measures
compared to the control group.
Burchard, Journal Article The experimental group did not
Yarhouse, statistically increase in quality
Kilian, of life compared to the control
Worthington, group, but the experimental group
Berry, & Canter did increase in quality of life
(2003) from pretest to posttest (p = .07),
while the control group
significantly decreased (p < .05).
Coyle & Enright Journal Article The experimental group experienced
(1997) significant reductions in anxiety,
anger, and grief and significant
increase in forgiveness compared to
control group. Similar significant
findings were found for the control
group after receiving the same
treatment.
DiBlasio & Benda Journal Article Initial data suggests the
(2002) experimental group receiving the
forgiveness intervention
significantly improved in
self-esteem over the control group
(no treatment).
DiBlasio & Benda Journal Article Study 1: The experimental group
(2008) showed a significant increase in
forgiveness from pretest to
posttest, but did not differ
significantly from the control or
the problem-solving group. The
experimental group showed
significant increase in marital
satisfaction and contentment
compared to control group. Study 2:
Experimental group showed
significant increase in
forgiveness, marital satisfaction,
and contentment from pretest to
posttest. No between-group
comparisons were made.
Gordon, Baucom, Journal Article Injured partners experienced
& Snyder (2004) positive gains on dependent
variables as measured by z-scores.
The majority of couples were less
emotionally or martially
distressed, and the injured partner
reported greater forgiveness
post-treatment.
Greenberg, Journal Article The experimental group receiving
Warwar, & emotion-focused therapy showed
Malcolm (2008) significantly more improvement than
the psychoeducational group on
measures of forgiveness, letting
go, global symptoms, and key target
complaints
Knutson (2003) Dissertation No statistical differences were
found between the experimental
group and a CBT-based control group
intervention at posttest; however,
the two groups pooled showed
significant improvements from
pretest to six-week follow-up on
measures of marital satisfaction,
family strengths, forgiveness,
self-esteem, anger, anxiety, and
depression.
Ripley & Journal Article The experimental group
Worthington significantly improved in
(2002) observational measures of
communication compared to control
group, but no significant changes
were produced in self- reported
marital quality, communication, or
forgiveness.
Sells, Giordano, Journal Article Couples experienced significant
& King (2002) improvement in forgiveness skills
at posttest and follow-up. The
exhibition of forgiveness skills
was positively correlated with
higher levels of marital
satisfaction, reduced presence of
psychological symptoms, and reduced
anger.
Vaughan (2001) Dissertation Marital satisfaction declined
slightly in the forgiveness
treatment group.
Families (n = 0)
* The same sample used by Burchard et al. (2003)
FREQUENTLY USED INTERVENTION MODELS TO PROMOTE FORGIVENESS
Many models have been advanced to promote forgiveness (see Tables 1
and 2). Two models have been tested multiple times and meet the criteria
for designation as empirically supported. Both Enright's process
model and Worthington's REACH model seek to promote both decisions
to forgive and emotional forgiveness--two of the five foci discerned to
be important in family context based on our theoretical deliberations.
Enright's Process Model
Enright has proposed a process model of forgiving (Enright &c
Fitzgibbons, 2000). The model has 20 units, which are arrayed into four
phases. Enright is a developmental psychologist at the University of
Wisconsin, and he has developed a model that is useful throughout the
developmental spectrum. This has been a popular model for adaptation
with children and adolescents. Enright also has developed a substantial
number of applications to mental health disorders such as incest
survivors, substance abuse and dependence, and men whose partners had
experienced an abortion as well as physical health disorders such as
cancer survivors and cardiovascular disorders. Freedman, Enright, and
Knutson (2005) summarized research in a qualitative review and Baskin
and Enright (2004) conducted a meta-analysis of research on the process
model.
The first eight units comprise the uncovering phase. During
uncovering, the person gets in touch with his or her pain. Units 9 to 11
involve the decision phase. Forgiveness is defined, and people consider
what is involved before committing to forgive. Units 12 to 15 comprise
the work phase. In the work phase, people try to understand the offender
and the context of the transgression, then accept and absorb the pain.
In the outcome phase, units 16-20, the person gives a gift of forgiving
to the offender and develops a sense of healing. The process model
encourages people to make decisions and emotional forgiveness explicit.
Worthington's REACH Forgiveness Model
Worthington (2006a) has developed a psychoeducational model to lead
people in small groups to make a decision to forgive and then experience
five steps to REACH emotional forgiveness. Leaders cue group
members' memory of the five steps by the acrostic REACH. R is
Recall of the Hurt. The offender recalls the event in a way different
from the usual ruminative recall. Namely the person recalls without
blaming the offender or self-pitying. After a conscious attempt to
decide to forgive, an attempt at E (Empathize to Emotionally Replace) is
made during the longest portion of the method. Emotional replacement can
substitute empathy, sympathy, compassion, or love for the unforgiving
emotions of resentment, bitterness, hostility, hatred, anger and fear. A
is an Altruistic Gift of Forgiving in which, through humility and
empathy, the person decides and emotionally experiences forgiveness. C
stands for Commit to the Forgiveness Experienced. The person makes a
public commitment (which could be to others or just a letter or note to
oneself) to solidify the experience of deciding to forgive and
emotionally forgiving. The commitment is intended to help the person H,
Hold onto Forgiveness.
Whereas Enright's model is exceptionally strong with children
and adolescents and also with mental health problems, Worthington's
model has been applied and tested most frequently in the following
settings: Christians in church settings (Worthington et al., 2010),
Christian colleges (Lampton et al., 2005; Stratton et al., 2008),
couples (eg., Ripley & Worthington, 2002; for a review, see
Worthington, 2006a), parents (e.g., Kiefer et al., 2010), and secular
college students (for a review, see Worthington, 2006a). Manuals are
publicly available at www.people.vcu.edu/~eworth. Research has been
subjected to reviews (Wade & Worthington, 2005) and meta-analysis
(Wade, Worthington, & Meyer, 2005) and shown to be efficacious with
Christians, college students (Christian and secular), and couples and
parents.
Two Models That Seek to Change Talk about Transgressions
DiBlasio's decision-based model with couples and families.
Whereas both the process model and REACH forgiveness model aim at
producing emotional and decisional forgiveness as internal experiences,
some intervention models are more focused on promoting both the
experience of forgiveness and healthy talk about transgressions and
forgiveness, which can lead to better relationships. DiBlasio has
described (DiBlasio, 1998) and tested a decision-based model with
couples (DiBlasio & Benda, 2002, 2008). Originating from his
clinical practice (as first reported in Worthington & DiBlasio,
1990), DiBlasio focused on decisional forgiveness as an internal
experience and communicating that decision to forgive between partners,
which then leads to emotional and behavioral forgiveness. DiBlasio and
Benda (2008) reported two studies of the model showing efficacy with
Christian couples and also with secular couples. Couples achieved
improvements in cognitive, emotional and behavioral forgiveness (for
clinical application of this work for Christian couples, see Cheong
&c DiBlasio, 2007; DiBlasio, in press).
Worthington's Forgiveness and Reconciliation through
Experiencing Empathy (FREE) model. Worthington has developed methods of
working with couples that promote both internal experiences of forgiving
(i.e., emotional and decisional forgiveness) and discussions about
transgressions leading to reconciliation (Burchard et al., 2003; Ripley
& Worthington, 2002). A manual for marriage enrichment may be found
at www.people.vcu.edu/~eworth.
Religiously or Spiritually Tailored Interventions
Our theorizing suggested five elements needed for family
application of forgiveness--decisions, emotional change, a warm climate,
instruction in talk about transgressions, and a religious environment.
Thus far, we have discussed the first four. We now assess the status of
the research on religiously or spiritually tailored psychotherapies.
Most of the studies on interventions to promote forgiveness are with
secular clients. The present article is most immediately concerned with
religiously tailored treatments or treatments that are likely to be
effective and evidence-based for use with religiously and spiritually
oriented clients. We must ask, then, whether research using secular
treatments (i.e., those aimed at general populations containing both
religious/spiritual clients and those who do not claim a
religious/spiritual orientation) with secular (i.e., mixtures of
religious/spiritual and those who are not) clients are effective with
religiously and spiritually oriented clients.
Worthington, Hook, Davis, and McDaniel (in press) reviewed
religious and spiritual treatments. (Spiritual treatments were
relatively fewer, so we will talk only of religious treatments). They
meta-analyzed 51 samples from 46 studies. They found that religious
treatments had clear positive gains from pre-test to post-test, and the
gains were maintained at follow-up. However, when the studies involving
a control group were analyzed, religious treatments were more effective
than those with any control group for improving psychological symptoms.
Religious treatments were not better than controls when compared to an
active alternative treatment on psychological symptoms, but they were
better at instigating changes in spiritual measures (however, at
follow-up those spiritual changes were not maintained). At the most
restrictive level of comparison of a secular treatment and a religious
treatment that is the same in all ways except for being tailored
religiously or spiritually, the secular and religious treatments--though
both efficacious--were not different. This might suggest that (1) it
does not matter whether treatments are tailored to religious clients or
(2) that religious clients might look for the religious even within
secular treatments and benefit from secular treatments.
We hypothesize, then, that for forgiveness interventions, research
on secular treatments will be equally efficacious as will religiously
tailored interventions. We suggest this might be the case for several
reasons. First, all religions seem to value forgiveness (Rye et al.,
2000) and will thus be likely to "read into" the secular
interventions a valuing of forgiveness, to which they will likely
respond positively. Second, therefore, it is likely that religious
people will find the secular interventions that have been tested on
secular samples to be value-congruent with their religious beliefs.
Third, it is likely that religious people exposed to secular
interventions could interpret them as religious. For example, a
Christian who holds a cognitive causal worldview (e.g., "As a man
thinketh in his heart, so is he"; Prov 23:7; KJV), would find a
cognitive approach to promoting forgiveness to be "Christian."
For an alternative view that emphasizes that a Christian forgiveness
intervention for Christian clients is more effective than secular
intervention, see DiBlasio (in press) and DiBlasio and Benda (2008).
As a consequence, in the review below, we have reviewed the
literature on all studies investigating the efficacy of interventions to
promote forgiveness in children, adolescents, and families. Furthermore,
finding few explicitly Christian articles directly with children,
adolescents, and families (and because we wanted to address the fifth
concern--the explicitly religious tailoring of interventions), we
reviewed all available explicitly Christian interventions (most of which
were with college students).
REVIEW OF STUDIES OF THE EFFICACY OF FORGIVENESS INTERVENTIONS
Method of the Review
We accessed PsychINFO on March 12, 2010, using the words forgiv *
and interven *, crossed with child *, adolescent *, parent *, couple *,
and family. After excluding theoretical papers and case studies, we
located 1 intervention study with children, three with middle school
students, and eight with high school students, which we summarized in
Table 1. We also located one with parents specifically, and 11 with
couples, but none with families as a whole. We summarized those in Table
2. Finally, we found nine explicitly with Christians.
Interventions with Children
Having reviewed the most common general models of intervening to
promote forgiveness (and discussions about transgressions), we now
examine the research studies that have been applied with school-aged
children (see Table 1). In the present section, and in subsequent
sections, due to space limitations for the present article, we do not
include case studies or descriptions of interventions. Rather, we focus
on controlled outcome efficacy research. Our strategy is to include the
details of studies in two tables, and in the present narrative summaries
merely to note some general points.
Only one intervention study was conducted with fifth grade students
(Hepp-Dax, 1996). Results were not strong. Gains by the end of treatment
were not maintained. Enright's process model was used. The project
was an unpublished dissertation.
Interventions with Adolescents
In Table 1 we also describe the studies done to help middle school
students (n = 3; one dissertation and two articles) and high school
students (n = 8; two articles and six dissertations). All three projects
with middle school students used the Enright process model. The article
(Hui 8c Chau, 2009) found few quantitative changes, but quite a few
qualitative changes were noted for the middle school students after the
intervention. The dissertation regarding middle school students (i.e.,
Gambato, 2002) reported modest changes as well--mostly in self-reported
traits and attitudes. Freedman and Knupp (2003) in a journal article
used an educational version of the process model with five early
adolescents (12 to 14 years old) who had experienced divorce of their
parents. They experienced greater hope and decreased trait anxiety
compared to control group.
A substantial number of studies investigated high school students.
In a dissertation, Beck (2005) studied 76 students using the REACH
model. Beck found predicted differences in anger, empathy, and
forgiveness, but not in aggression.
Hui and Ho (2004) used the process model with 63 male Hong Kong
students. They found virtually no differences in comparison to a control
condition. Several dissertations were less effective than were the
reports in published papers. In a dissertation, Park (2003) studied the
process model with 48 Korean students. Park found that the experimental
condition experienced greater forgiveness and empathy, and less
self-reported anger, hostile attribution, delinquency and aggression
than control at posttest and significant differences were maintained at
8-week follow-up for all variables except self-reported aggression.
Perez (2007), in a dissertation, studied seven adolescent males in a
residential treatment setting. Participants experienced increases in
forgiveness and decreases in disruptive and externalizing behaviors
between pre and posttest. Likewise, Sim (2003) studied 20 adolescents in
a similar setting using the process model. The treatment condition
showed higher forgiveness posttest than control group.
Several other programs indicated some promise. Williams, Johnson,
and Bott (2008) found that a program called Peaceful Alternatives to
Tough Situations (PATTS), when applied to 106 youth with a history of
aggression in the schools, resulted in decreases in physical assault,
psychological aggression, vengefulness, school suspensions, principal
referrals, and new criminal offenses, and increase of forgiveness of
others compared to a control condition. Gassin (1995) and Klatt (2008)
in dissertations of N = 19 and N = 12, respectively, found some evidence
for effective programs.
Overall, it appears that forgiveness gains with adolescents were
modest. They seemed to affect attitudes and ratings of forgiving, and
sometimes behavior.
Interventions with Parents
In Table 2, we describe the single journal article study that has
been done to help teach parents how to forgive and how to promote
forgiveness in children (Kiefer et al., 2010). Parents were trained to
forgive their children for disappointments and also to forgive their
co-parenting partners for misunderstandings over parenting.
"Worthington's Forgiveness and Reconciliation through
Experiencing Empathy (FREE) model was taught. That model contained as
one step of four instructions on internal forgiveness using the REACH
model. Forgiveness of a target offense, and forgiveness in general were
both increased during 9 hours of treatment and were maintained at a
three-week follow-up.
Interventions with Couples
In Table 2, we describe the studies done to help couples forgive.
In contrast to research on adolescents, which has mostly been
non-referred dissertations, with only three published studies, the
literature on couples boasts 8 of 11 projects from referred journal
articles, and only three dissertations. FREE (and REACH) has been
investigated three times (two articles and one dissertation).
DiBlasio's decision-based forgiveness model was investigated twice
(both articles). Enright's process model has been investigated
twice (one article and one dissertation). Other established programs
have also been investigated, such as one for couples dealing with
affairs (Gordon, Baucom, & Snyder, 2004). Although this was the only
empirical investigation of the model, the authors have written
extensively about the clinical aspects of it. In addition, one article
used the empty chair method (Greenberg, Warwar, &c Malcolm, 2008)
from Gestalt therapy. That approach acknowledged the REACH model, which
uses the empty chair model as one method (acknowledging Malcolm and
Greenberg, 2000, as source). The interventions to help couples have been
found to be consistently effective.
Interventions with Families
In Table 2, we sought studies done to help families promote
forgiveness in their children. No studies involving family therapy for
forgiveness were found.
Interventions with Christians
Because this article is aimed at what forgiveness interventions
might be efficacious with religious or spiritual clients and because
none of the interventions thus far except DiBlasio and Benda (2002,
2008) were used explicitly with religious people (i.e., Christians), we
examined other forgiveness interventions that targeted forgiveness with
religious or spiritual clients among adults. Few religiously or
spiritually oriented interventions to promote forgiveness have been
investigated among the multitude of interventions with adults. Rye and
Pargament (2002) studied women who sought to forgive an ex-partner in a
broken romantic relationship, and Rye, Pargament, Pan, Yingling,
Shogren, and Ito (2005) studied women who sought to forgive a divorced
partner. In both, the intervention was similar to the REACH model,
though it was not an exact version of it. Lampton et al. (2005; with
Christian college students), Stratton et al. (2008; with Christian
college students), and "Worthington et al. (2010; with Filipino
church members) used religiously adapted versions of REACH. Jackson
(1999), in a dissertation using an empathy-based treatment, like the
REACH model but not precisely adapted from it, found effective
forgiveness in Christians. Hart and Shapiro (2002) studied
Enright's process model and found it equivalent to or not quite as
effective as a 12-step approach for people with drug and alcohol
addiction.
CONCLUSIONS
We have provided a conceptualization of forgiveness and its
development that can be used to develop and analyze interventions to
promote forgiveness with youth, couples, and families, especially those
who are Christians. We examined the four major interventions, and we
summarized empirical research on the efficacy of all of the
interventions that might he appropriate for Christian couples and
parents and direct treatment of children and adolescents. Enright's
process model has the widest support across the range of treatments, but
it has not been adapted to religious populations. It is the primary
intervention for working with adolescents. It is an empirically
supported approach, having been used in a variety of labs and found to
have some efficacy, but its adaptation for children is based on a single
study with non-definitive outcomes.
For couples, a variety of models have been tried. The REACH model
has been tested in several labs with couples and twice in studies
directly with parents; it meets the criteria for empirically supported
treatment. DiBlasio's decision-based model (which has been used
with secular and explicitly Christian couples), Enright's process
model, and Rye's model (i.e., loosely similar to REACH, but
tailored to relationship dissolution) have less empirical support for
Christian couples at this point; all three have two studies supporting
them, but in each case, the studies come from the same lab, thus not
meeting one of the criteria for empirically supported status. Only
DiBlasio's (DiBlasio & Benda, 2002, 2008), and Jackson's
(1999) studies were directly with Christians.
We conclude that the evidence is stronger that forgiveness can be
taught more effectively to adults than to adolescents. Basic research on
development of forgiveness is needed. Longitudinal research is
preferred. That would allow a firmer base on which to tailor
interventions to treatment with children, parents, and families. More
research is also needed on Christians. That would inform adaption of
existing interventions that have been investigated mostly in secular
context and would permit modification of the few interventions that have
been specifically tailored to Christians. Clinicians and clinical
researchers are encouraged to adapt interventions--preferably
evidence-based interventions--for Christian families, aimed at children,
middle and high school adolescents, and Christian couples, parents, and
whole families. Then, clinicians and clinical researchers must test the
interventions in order to establish more empirically supported
interventions with these populations.
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* Empirical article summarized in Table 1
** Empirical article summarized in Table 2
*** Empirical article summarized in the text
AUTHORS
WORTHINGTON, EVERETT L., JR. Address: Dept. of Psychology Virgina
Commonwealth University, (VCU), Richmond, VA. Title: Professor of
Psychology. Degrees. Ph.D., Counseling Psychology, University of
Missouri-Columbia. Specializations: Forgiveness and marital and family
interventions, basic research and religion, spirituality.
JENNINGS, DAVID J. II. Address: Virginia Communwealth University,
Richmond, VA. Title: Doctoral student at VCU. Degrees: M.S., M.S.,
Richmont Institute (Clinical Psychology, Atlanta) and VCU (Counseling
Psychology). Specializations: Inspiration, forgiveness and interpersonal
processees around transgressions, especially in couple and family
relationships, religion and spirituality.
DIBLASIO, FREDERICK A. Address: University of Maryland at
Baltimore. Title: Professor of Social Work. Degrees: Ph.D.(Social Work)
from VCU. Specializations: Interventions to promote forgiveness in
families and couples, clinical social work, psychotherapy.
EVERETT L. WORTHINGTON, JR. AND DAVID J. JENNINGS, II
Virginia Commonwealth University
FREDERICK A. DIBLASIO
University of Maryland
This research was partially supported by gram 2266 (Forgiveness and
Relational Spirituality) from the Fetzer Institute to Everett
Worthington (Principal Investigator) and Steven Sandage and Michael
McCullough (Co-Investigators) and by grant 2512.04 (Forgiveness in
Christian Colleges) also from the Fetzer Institute. Please address
correspondence to Everett L. Worthington, Jr., PhD., Department of
Psychology. Virginia Commonwealth University, Richmond, VA.