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

Abstract

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.

Positive Internal Experiences in PTSD Interventions: A Critical Review

“…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).…”

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

“…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).…”

Processing of positive memories technique (PPMT) for posttraumatic stress disorder: A primer.

“…In doing so, PPMT may address diverse client needs, goals, and symptom profiles with flexibility. Lastly, clinicians endorse practicality, ease of learning, and positive impact on therapy satisfaction/tolerability of positive memory processing (Contractor et al, in press), and clients endorse willingness to participate in positive memory-oriented sessions, perceive feasibility and acceptability of incorporating positive memory strategies into treatment, and anticipate increased satisfaction/tolerability of trauma-focused therapy with an integrated positive memory component (Caldas et al, 2020).…”