An Exploratory Examination of Client Perspectives on a Positive Memory Technique for PTSD

Couns and Psychother Res

Caldas

Dolan

et al. 2019

Self Cite

Despite the role of positive memories in the aetiology and maintenance of post-traumatic stress disorder (PTSD), most PTSD interventions primarily focus on traumatic memories. To aid the development of a PTSD-specific technique focused on processing positive memories, we gathered formative input from practicing clinicians on the content, format, feasibility and acceptability of this proposed intervention technique. We recruited licensed clinicians (n = 46) through professional networks and psychology organisation Listservs, provided a description of a positive memory processing technique, and administered a questionnaire querying perspectives on the proposed technique. Most clinicians reported using positive memories in PTSD therapy (67.39%) and interest in addressing them in depth/frequently (71.74%).They reported that (a) positive memory processing could increase positive thoughts (82.50%), feelings (80%) and memory specificity (75%); (b) optimal intervention components included defining a positive memory as a peak experience (characterised by strong positive affect, a positive and impactful change on one's life, and overwhelming joy/happiness; 57.50%), identifying 1-3 memories (25.64%-33.33%), discussing them in session to elicit positive elements (68.57%-82.86%), tracking affect intensity/valence (57.14%), and using this technique to augment trauma-focused interventions (57.14%); and (c) feasibility indicators included perceived acceptability to clients (80.65%) and clinicians (66.67%), practicality (51.61%), successful implementation considering resources/time (63.33%), ease of learning (51.61%) and positive impact on therapy satisfaction/tolerability (54.84%-58.06%). Taken together, our study provides parameters for the development and investigation of a PTSD-specific positive memory processing technique. K E Y W O R D S clinician perspectives, feasibility, intervention development, positive memories, posttraumatic stress disorder | 93 CONTRACTOR eT Al. programme of research examines heterogeneity/diversity in post-traumatic stress disorder (PTSD) symptoms; heterogeneity (pattern and types) of traumatic experiences; transdiagnostic constructs/mechanisms driving PTSD's relationship with depression and reckless behaviours (including positive memory processes and emotional dysregulation); and the intersection between cultural factors and PTSD symptoms. She has published 70 peer-reviewed articles, is an associate editor for Europe's Journal of Psychology, and an editorial board member for three trauma journals.

Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Exploratory examination of clinician perspectives on positive memories and post‐traumatic stress disorder interventions

Couns and Psychother Res

Caldas

Dolan

et al. 2019

Self Cite

“…Still, other clinicians may never assess for or address positive internal experiences in PTSD treatment; perhaps, clinicians conceptually link trauma with negative internal experiences and do not consider the influence of processing positive internal experiences on distress (Lyubomirsky et al, 2006). Recent research indicates that trauma-exposed clients (Caldas et al, 2020) and trauma clinicians (Contractor, Caldas, et al, 2019) are willing and interested in discussing more positive internal experiences (positive memories in particular) during treatment, which provides an impetus for future research to explore ways in which positive internal experiences are actually addressed in practice (e.g., by reviewing audio transcripts of PTSD sessions provided by clinicians in the community).…”

Section: Discussionmentioning

confidence: 99%

Positive Internal Experiences in PTSD Interventions: A Critical Review

Trauma, Violence, & Abuse

Weiss

Keegan

2020

Self Cite

Evidence suggests that individuals with post-traumatic stress disorder (PTSD) symptoms exhibit deficits in positive internal experiences. This study critically reviewed empirically validated PTSD interventions to determine (1) whether positive memories, cognitions, and emotions were explicitly addressed and (2) the goals of focusing on these positive internal experiences. We selected 11 empirically validated PTSD interventions listed as “recommended/strongly recommended” in recently published reviews, reviewed existing literature for studies using these interventions ( N = 1,070), short-listed randomized controlled trial studies meeting predetermined inclusion criteria for the selected interventions (in English, developed for adults, individual therapy modality, in-person administration, tailored to PTSD; N = 47), and emailed authors ( N = 41) to obtain the unique intervention manuals. Hereby, we reviewed 13 unique empirically validated PTSD intervention manuals. Findings indicated 53.85%, 69.23%, and 69.23% of reviewed manuals explicitly discussed positive memories, emotions, and cognitions, respectively. Primarily, positive memories were integral to mechanisms underlying PTSD, a precursor to targeting negative experiences, an indicator of treatment progress, or a way to identify client problems; positive emotions were discussed when providing psychoeducation on PTSD/trauma reactions; and positive cognitions were addressed in reference to coping with negative experiences or as targets to enhance self-concept. This review demonstrates that comparatively, positive memories are infrequently elicited in the reviewed interventions; positive emotions and cognitions are explicitly referenced in two-thirds of the reviewed interventions but are included as a primary focus for therapeutic processing only in a few interventions; and eye movement desensitization and reprocessing has the most comprehensive focus on positive internal experiences.

“…Current study findings have important clinical implications. Prior research indicates that trauma‐exposed clients (Caldas, Jin, Dolan, Dranger, & Contractor, 2020) and trauma clinicians (Contractor, Caldas, Dolan, Banducci, & Jin, 2020) are willing and wish to therapeutically address positive memories in PTSD treatment. Consistent with this trend, a recent review indicated that positive memories and positive emotions are addressed as clinical targets and mechanisms in a few PTSD interventions (Contractor, Weiss, Forkus, & Keegan, in press).…”

Section: Discussionmentioning

confidence: 99%

Moderating effects of dysregulation and fear of positive emotions on the relationship between posttraumatic stress disorder symptoms and positive memory count

Weiss

2020

J Clin Psychol

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Objectives We examined moderating effects of positive emotion dysregulation and fear of positive emotions in the relation between posttraumatic stress disorder (PTSD) severity and positive memory count. Method Participants were 205 trauma‐exposed community individuals (Mage = 35.44; 61.50% female). Results Moderation analyses indicated interaction effects of PTSD severity with nonacceptance of positive emotions (b = −0.01, p = .002) and difficulties with goal‐directed behaviors when experiencing positive emotions (b = −0.01, p = .006) on positive memory count. Conclusions Greater PTSD severity was associated with more specific positive memories when individuals reported less nonacceptance of positive emotions and fewer difficulties engaging in goal‐directed behaviors in the context of positive emotions. Greater PTSD severity was associated with fewer specific positive memories when individuals reported greater nonacceptance of positive emotions and greater difficulties engaging in goal‐directed behaviors in the context of positive emotions. Results support addressing positive emotion dysregulation in memory‐focused interventions for PTSD.