Most treatments for depression and anxiety focus on one main goal: reducing negative feelings like sadness, fear, and worry. But what if there’s a missing piece?

A 2026 clinical trial published in JAMA Network Open found that a therapy designed to build positive emotions produced better results than standard therapy for people struggling with depression, anxiety, and a common but often overlooked symptom called anhedonia.

Anhedonia is the reduced ability to feel pleasure or interest in things you used to enjoy. It’s a common symptom of depression and anxiety. Anhedonia is a significant barrier to recovery, yet many standard therapies don’t directly address it. That’s part of what makes this new research so noteworthy.

What the Study Found

The study enrolled 98 adults experiencing anhedonia along with moderate-to-severe depression or anxiety. Participants were randomly assigned to receive one of two therapies, delivered in 15 weekly one-on-one telehealth sessions:

Positive Affect Treatment (PAT): A structured therapy specifically designed to help people experience more reward and pleasure in their daily lives.

Negative Affect Treatment (NAT): A more standard comparison therapy focused on reducing negative emotions.

The study found that people in the PAT group showed significantly greater improvement in their overall mental health, and those gains held up a month after treatment ended. People in the PAT group also saw larger reductions in both depression and anxiety compared to those in the NAT group.

A female client in a therapy session

How Does Positive Affect Treatment Work?

PAT is built around a concept called reward processing, i.e. the brain’s ability to anticipate, experience, and learn from positive events. PAT directly targets three key stages:

  1. Connecting actions to feelings (Reward Learning): This phase helps people build stronger mental connections between engaging in positive activities and feeling good as a result.If you struggle with impulse buying you might recognize some of the common thoughts below:
  2. Looking forward to good things (Reward Anticipation): This involves planning enjoyable activities and practicing imagining positive future experiences.
  3. Savoring the moment (Reward Consumption): This includes techniques like mindfulness, gratitude, and loving-kindness. The goal is to help people be more present with the good moments in their lives.

Dr. Judith Beck on What This Research Means for CBT

Beck Institute President Dr. Judith Beck shared her perspective on the study’s significance and its connection to her own clinical work.

“This research is exciting and very important for our field,” said Dr. Beck. “It provides support for helping clients experience positive emotions both in and out of session—something we do at Beck Institute as part of CBT.”

Dr. Beck continued: “Our clinicians actively create opportunities for clients to experience and reflect on positive activities. We help clients learn skills that make positive experiences more accessible and rewarding.”

If you’re dealing with depression or anxiety, especially if you’ve lost the ability to feel joy or excitement, it may not be enough to just work on reducing negative thoughts and feelings. Working to increase positive experiences matters, too. Consider talking to a licensed mental health professional about ways to increase positive emotions.

Reference:

Meuret, A. E., Rosenfield, D., Wang, E., Hough, C. M., Ritz, T., & Craske, M. G. (2026). Positive affect treatment for depression, anxiety, and low positive affect: a randomized clinical trial. JAMA Network Open, 9(4), e267403.

To find a CBT-trained therapist near you, visit the Beck Institute Clinician Directory.