Exploring the Benefits and Acceptance of Blended Positive Psychotherapy as an Adjunctive Treatment for Clients with Residual Depressive Symptoms: A Mixed-Method Study

Abstract

A proof-of-concept study was conducted to explore the acceptability and potential benefits of a blended positive psychotherapy intervention for clients with residual depressive symptoms. A single-arm pilot study was conducted in 2022 and 2023 with 24 Dutch adults experiencing residual depressive symptoms after treatment. Clients who had recently received an evidence-based treatment for depressive disorder were approached to participate in this study through opportunity sampling. The intervention consisted of nine sessions with a therapist and a six-week self-guided digital positive psychology intervention. Acceptability was examined using semi-structured interviews (n = 15). Participants filled out questionnaires pre- (n = 21), mid- (n = 14) and post-intervention (n = 8). Potential benefits were assessed in terms of changes in mental well-being (MHC-SF), depression (PHQ-9) and personal recovery (QPR). Quantitative data and qualitative data were analysed using linear mixed-effects models and framework analysis, respectively. The analyses were primarily based on Sekhon’s theoretical framework of acceptability. Linear mixed-effects analyses showed changes over time in most mental health indicators, including mental well-being (Hedge’s g = 1.58), depression (g = 1.43) and personal recovery (g = 1.96). Most of the interviewed participants considered blended positive psychotherapy a valuable adjunctive treatment; it connected well with their wish to become more positive in their daily life without ignoring difficult experiences. For some participants, shifting towards a positive treatment approach was difficult, resulting in early dropout. This study’s findings suggest that blended positive psychotherapy is acceptable to most people with residual depressive symptoms after treatment. Its impact is yet to be established in larger samples of studies involving more robust designs.