Although gratitude may seem straightforward, it is a complex construct comprised of cognitive, emotional and behavioral elements. Gratitude has been presented as a positive psychological character trait, coping response, attitude, moral virtue, emotion, and habit (Emmons, McCullough, & Tsang, 2003), and significant overlap exists among these definitional presentations (Lambert, Graham, & Fincham, 2009). Despite definitional limitations, promising evidence indicates that gratitude can help survivors positively process and cope with trauma and contribute to the post-trauma recovery experience (Kashdan, Uswatte, & Julian, 2006; Vernon, Dillon, & Steiner, 2009). Yet, there is a lack of research examining how gratitude is expressed in psychotherapy with those who have experienced trauma. The purpose of the current study was to qualitatively explore expressions of gratitude by psychotherapy clients who were trauma survivors. A deductive coding system was used, based on existing gratitude literature that allows researchers to comprehensively examine different types of gratitude. This study also compared gratitude expressions that took place during trauma and non-trauma discussions, which is an area of research that had not been examined. In contrast to existing assessment and research, the findings from this study revealed that clients tended to express gratitude infrequently, in a Narrow manner or in a manner that was Not Otherwise Specified. Findings revealed that client expressions of gratitude were captured by four of the nine proposed coding categories: personal gratitude, gratitude for specific benefits received from a higher power, gratitude expressions that are not otherwise specified, and generalized gratitude as an attitude, in order of frequency. It is hoped that the current study will contribute to the definition, understanding and measurement of gratitude in therapy. By demonstrating the extent that gratitude is utilized in psychotherapy with clients who have experienced trauma, the results of this study can be used as a baseline from which to compare results of future studies that evaluate the effects of training therapists in gratitude interventions. This study may also help therapists develop a deeper understanding of a gratitude that emerges as a result of trauma, which can potentially inform their use of gratitude in future assessment and treatment.

Library of Congress Subject Headings

Dissertations (PsyD) -- Psychology; Gratitude -- Psychological aspects; Psychic trauma -- Treatment

Date of Award


School Affiliation

Graduate School of Education and Psychology



Degree Type


Degree Name


Faculty Advisor

Hall, Susan;