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PROMIS Research in Progress: Some early findings

Some 7 months ago, following the start of my work as Director of Research, PROMIS agreed to conduct an experimental trial of new interventions based on proven practices that have emerged within the broad framework of the Positive Psychology movement (Peterson, 2007). Our intervention programme has been carefully designed in consultation with the VIA Institute on Character (University of Pennsylvania, and will be introduced shortly when staff training has been completed.

In the meantime we have been gathering the information that will be required to conduct a controlled evaluation of the intervention following its incorporation into the PROMIS Programme. Some interesting findings have already emerged, and I would like briefly to give the flavour of the kind of things we are discovering, in relation to just two small aspects of our ‘benchmark’ studies of clients at PROMIS, prior to implementation of the experimental intervention.

Aspects of Well-being

Working effectively with clients is problematic if they are feeling angry, depressed, anxious or ashamed, or another state indicative of a negative mood. Our ‘benchmark’ findings indicate that although clients do generally arrive in a negative, neutral or only slightly positive mood, this does not persist for long. The mood of the vast majority of clients soon greatly improves, and remains at more or less the same significantly more positive level throughout treatment.

But a positive change in mood, whilst desirable and important, is only the start. It may facilitate progress in treatment, but it may or may not be linked to progress in the long term. We’ll have to wait and see. The evidence we now have, already shows that the pattern of change over time is very different for our measures of psychologically more important states of mind. Let’s take just one example: Satisfaction with Life (SWL) is an important judgement about how satisfied with life one generally is, and is independent of transient moods. We measure it by asking clients to judge in their own way, using their own criteria, how closely their lives are to what ideally they might wish was the case. Our findings so far indicate that SWL, like mood, also improves markedly. Most importantly, this increase in positive judgements increases over the time in treatment, whether that is one week, two, or three weeks. The longer a client stays, the more satisfied they become. Similar findings are emerging with respect to other aspects of positive psychological progress, but to varying degrees. ‘Insight’, for example, seems to be more resistant to change. The overall picture will be clarified in time; the research is still in its early stages.

Posttraumatic Growth

The Positive Psychology movement has embraced the finding that traumatic events may lead not only to post-traumatic stress disorders, but to posttraumatic growth, or what has been termed “Benefit-finding” or “Adversarial growth”. The idea is not new. Major religions and philosophies have pointed to the possibilities of character developing positively as a consequence of overcoming, even welcoming, adversities. Psychological studies have now shown that a large array of crises in people’s lives – e.g physical illnesses like cancer, divorce, bereavement, military combat, rape and sexual assault – lead to perception of positive changes in five different but related areas of personal and social functioning, as follows: 1. relating to others, 2. establishing new opportunities in life, 3. increases in personal strength, 4. spiritual change, and 5. appreciation of being alive. These studies have used standardised questionnaire measures of posttraumatic growth, and at PROMIS we have used one of these inventories to assess how clients feel they have benefited from the crisis in their lives that led them to seek treatment. This work is in its initial stages, and some important questions cannot yet be answered. However we do have data that indicates that clients at PROMIS, after only a comparatively short time in treatment, demonstrate at least the same level of positive changes commonly found in those who have faced the extreme physical and stressful crises listed above. Moreover, these changes show signs of being related to length of time in treatment. If substantiated, this will in time suggest new ways of encouraging the processes of personal growth that coping with traumatic events in themselves naturally facilitate.

The research we are conducting at PROMIS indicates the centre’s commitment to defining priority areas of improvement and to implementing practices that are soundly based in replicable research. The most important results will emerge when the experimental intervention has been implemented and evaluated. In the meantime, the examination of changes occurring prior to the intervention is already of some intrinsic interest, and suggestive of therapeutic potential.

Geoffrey Stephenson
(October 25th 2012)

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