Table 1 Session-by-session summary of 8-week-positive psychotherapy course for people living with acquired brain injurya
Session no. and name | Summary of session content |
|---|---|
Session 1: Living with difficult emotions | • Difficult emotions are understandable following brain injury • A series of exercises encourage participants to accept such emotions • Participants learn coping skills, e.g., a ‘defusion exercise’ • Also includes focus on mindful breathing exercises and self-compassion • Difficult emotions motivate reflection and/or need for helpful changes • ‘Snakes and ladders’ adaptation helps to make content memorable |
Session 2: Identifying and using character strengths | • Discussion of the nature of character strengths • Participants discuss results from a character strengths questionnaire • Discussion of how participants might use their strengths • Positive impacts of character strengths use are emphasised • Positive self-statements are created on which a positive introduction is built • ‘Snakes and ladders’ framework used to reinforce relevant concepts |
Session 3: Building positive emotion | • Positive emotions have psychological and health benefits • They also help to cope with stress and adversity • Participants complete a ‘Getting to Know Your Lemon’ mindfulness exercise • Discussion of psychological flow, learned optimism and existential gratitude • Activities include mindful eating exercise and the ‘three good things’ activity • Participants complete meaning and values clarification exercise • Snakes and ladders’ framework is again used to reinforce relevant concepts |
Session 4: Connection between body and mind | • Participants learn about the mechanisms of the mind–body connection • Focus on positive health behaviours, e.g., healthy diet, sleep, exercise • Regulatory role of the vagus nerve, indexed by heart rate variability (HRV) • Other techniques, e.g., singing, meditation, cold showers improve HRV • Participants explore acute impacts of different activities on own HRV • Highlights need for self-care, contextualised by healthy mind–body connection |
Session 5: Connection to others and the natural environment | • Focuses on connecting to others and nature, and links to health and wellbeing • Science behind these connections, and how to improve wellbeing • Responding to good news and events, e.g., active-constructive responding • Variety of gratitude exercises, loving kindness meditation, volunteering • Nature-based activities good for wellbeing (e.g., gardening) • Also good for the environment (e.g., pro-environmental behaviours) • Participants complete a ‘photo-journalist exercise’ |
Session 6: Meaning and purpose | • Meaning and purpose give us a sense of direction and motivation in life • May be enhanced and facilitated by focus on the self, collective and planet • Discussion of photos representing areas of meaning for participants • Areas of meaning linked to personal values as per exercise in Session 3 • Behaviour-intention gaps constrain the translation of values into action • Reflection on how those gaps might be overcome |
Session 7: Translating values into action | • Recap on participant's strengths, values and important areas of meaning • Explore extent to which participants are living a values-based life • Participants identify and share areas where they are acting out their values • Areas where they could better connect with their values are explored • Participants set goals that support them to reconnect with some of their values • Thoughts and feelings serve as barriers / facilitators to acting out values • Return to the metaphor of ‘snakes and ladders’ |
Session 8: Behaviour change and managing the ups and the downs | • Focus on sustainable behaviour change • Participants refine goals identified in Session 7 • Challenges encountered when moving toward wellbeing are revisited • Recap on strategies to manage those challenges • Techniques and strategies that can be practised to support wellbeing reviewed • Game of ‘snakes and ladders’ played to reinforce challenges and opportunities • Variety of resources provided to help practice different techniques |