What do clients think about amplifying positivity? Client change perspectives following a cognitive and behavioural positive activity intervention for anxiety and depression

Abstract Background The positive valence system (PVS) is increasingly recognised as an important target in facilitating recovery from anxiety and depression. Amplification of positivity (AMP), a cognitive and behavioural intervention, targets the PVS through repeated and intentional activities (e.g. savouring positive experiences, gratitude and acts of kindness). Initial data demonstrate that AMP engages positive valence targets (e.g. positive affect) and outcomes (e.g. social connectedness) in people seeking treatment for anxiety or depression; however, client perspectives on AMP are not well understood. This study aimed to qualitatively explore clients' experiences to better understand post‐treatment client changes and advance the development and effectiveness of AMP and other emerging positive valence‐focussed interventions. Methods Transcripts were analysed from 11 participants who completed an optional qualitative interview after completing AMP treatment in a randomised controlled trial (NCT04945239). Results Two superordinate themes with several subthemes emerged. The first theme, Changes in Self, revealed common changes consistent with the core targets of AMP, as well as changes less explicitly targeted by AMP. The second theme, The Positivity Pivot, uncovered clients' perceptions on the emphasis of positive emotions in treatment. Overall, clients enjoyed and reaped benefits from amplifying positivity; some clients also reported wanting more time and space to discuss negative valence symptoms. Conclusion People seeking treatment for anxiety or depression are receptive to amplifying positivity and experience the mental and social benefits of doing so. Positive valence‐centred treatments may therefore be valuable for some clients. Treatment protocols that integrate positive valence‐ and negative valence‐targeted approaches may be preferred by some clients.