Building Wellbeing in People With Chronic Conditions: A Qualitative Evaluation of an 8-Week Positive Psychotherapy Intervention for People Living With an Acquired Brain Injury

Abstract

Research indicates that Acquired Brain Injury (ABI) is associated with significant and chronic impairment across multiple areas of functioning including physical, cognitive, emotional and behavioral domains. Whilst impairments associated with ABI can be ameliorated, cure is seldom possible. The emergence of positive psychology reflects a paradigm shift in health and wellbeing research, highlighting the role of character strengths, positive emotions, meaning, and resilience. Positive psychology interventions have been demonstrated to improve wellbeing in a variety of populations, although research investigating the impact of positive psychotherapy for people living with ABI are sparse. Here we characterize the experience of an 8-week positive psychotherapy intervention for 13 people living with ABI including four mentors and nine participants using thematic analysis of transcripts collected during mini-groups and one-to-one interviews. Six main themes were identified including empowerment, social opportunity, coping, cultivation of positive emotion, consolidation of skills and barriers. Results indicated that wellbeing can be promoted and improved in individuals with ABI. Recent theoretical developments in wellbeing science highlight scope to improve the intervention by connecting individuals to their communities and spending time in nature.

The Impact of Psycho-Social Interventions on the Wellbeing of Individuals With Acquired Brain Injury During the COVID-19 Pandemic

“…The barrier ‘recovery stage’ was noted by one participant only, who felt there was one negative consequence of the ‘fun group.’ She felt that as her peers were further along in their recovery than her, she didn’t feel a part of the friendship group and their limitations made her realise that she wouldn’t return to her old self. Previous research has highlighted that psychotherapy groups should consider grouping patients according to their perceived stage in recovery ( Tulip et al, 2020 ). However, as previously noted, being in a mixed group that included service-user mentors was beneficial for most due to upward social comparison ( Festinger, 1954 ), and so grouping interventions according to recovery stage would compromise those benefits.…”

“…ABI patients undergoing rehabilitation during the pandemic were often unable to access face-to-face appointments or groups ( Coetzer and Bichard, 2020 ) as healthcare professionals were deployed to acute COVID-19 services ( Silva et al, 2020 ), increasing psycho-social symptoms of anxiety, isolation and apathy ( Rossi et al, 2020 ). Although brain injury can bring considerable distress and suffering, there are also potential opportunities for psychological growth ( Frankl, 1985 ; Wong, 2011 ; Lyon et al, 2020 ; Tulip et al, 2020 ). Presented here, are the qualitative experiences of ABI patients from a Neurorehabilitation service in South Wales, United Kingdom, who participated in a series of interventions designed to facilitate wellbeing during the COVID-19 pandemic.…”

“…The PERMA model led to the development of positive psychology interventions (PPI), which aim to cultivate positive emotions, behaviours and thoughts and subsequently enhance wellbeing ( Parks and Titova, 2016 ). Positive psychology focuses on creating a context for wellbeing as opposed to symptom reduction, and its potential application to ABI is promising ( Andrewes et al, 2014 ; Cullen et al, 2018 ; Tulip et al, 2020 ). Over emphasising positive affect can be counterproductive, as negative emotions guide us toward positive change ( Wong, 2011 ).…”

Moving Beyond Disciplinary Silos Towards a Transdisciplinary Model of Wellbeing: An Invited Review

“…The word "wellbeing" is not a simile for reduced illbeing, quality of life or happiness (Headey et al, 1985;Ryff et al, 2006;Westerhof and Keyes, 2010;Skevington and Böhnke, 2018). Our own work for example (Fisher et al, 2020;Tulip et al, 2020;Wilkie et al, 2021), has shown that wellbeing may be improved in neurological disorders, and in despite of significant levels of illhealth and distress. These findings reinforce Wong's dual system model of what makes life worth living (Wong, 2012).…”

A novel ACT-based video game to support mental health through embedded learning: a mixed-methods feasibility study protocol

“…17 Biofeedback has also been shown to improve impulse control difficulties, and attentional difficulties in bulimia nervosa and attention deficit hyperactivity disorder, 15 16 18 as well as symptoms of stress, anxiety and anger. 19 The focus on physiological data in the psychotherapeutic context is gaining traction [20][21][22] and has strong theoretical underpinnings. [23][24][25] Within PM, there are three mini-games: 'The face of Cronos'; 'Treasures of the sea' and 'Sign of the Magupta'.…”