Gratitude and Appreciation Practices: Evidence

What these practices are

Gratitude practices ask you to notice and name things you appreciate. Common forms are writing a short list each day, writing a thank-you letter, and a short gratitude meditation, where you bring to mind a person or moment and rest your attention on appreciation. They are related to, but different from, loving-kindness and compassion meditation, which directs good wishes toward people. For the wider map of practices, see types of meditation.

In health research these practices are usually tested as brief exercises, so the findings below tell you about those exercises only.

What the research shows

Labels follow the strength of the sources. Most trials rely on self-reported mood questionnaires and cannot hide the exercise from participants.

1. Well-being across cultures

   Promising but limited (small effect)

   A 2025 meta-analysis of 145 papers and 24,804 participants from 28 countries found a small average increase in well-being (Hedges' g 0.19). Effects were larger when positive affect was the outcome and when several gratitude exercises were combined. [1]

2. Compared with a comparison activity

   Mixed

   A 2016 meta-analysis found gratitude exercises beat a measurement-only control on well-being, but performed as well as, not better than, a psychologically active comparison. Anxiety was not clearly reduced. [2]

3. Anxiety and depression

   Promising but limited

   A 2023 review of 64 randomized trials reported fewer anxiety and depression symptoms and a more positive mood. [3]

4. People already in therapy

   Promising but limited (one trial)

   In a trial of 293 adults seeking university psychotherapy, those who added gratitude letters reported better mental health at 4 and 12 weeks than those who added expressive writing or did therapy alone. [4]

5. Physical health and sleep

   Insufficient evidence

   A review of 19 trials found subjective sleep quality improved in 5 of 8 studies; blood pressure, blood sugar and asthma control had one study each; other outcomes were mixed, and most studies had some risk of bias. [5]

6. Brain imaging of gratitude meditation

   Preclinical / physiological finding only

   One small imaging study compared gratitude and resentment exercises and reported differences in brain connectivity and heart rate during the exercise. [6]

Neuroimaging findings describe what happens during a task. They do not show that the practice improves health.

Making a simple practice

This is general information, not a prescription. The exercises tested in these trials were mostly simple writing tasks, such as thank-you letters [4] or a short daily diary. [8] If you try one, keep it brief and light, and skip it on days it feels like a chore. Gratitude exercises should sit beside, not instead of, care for depression or anxiety; see meditation and mindfulness for depression and well-being in healthy adults.