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

The positive valence system (PVS) is increasingly recognized as an important target in facilitating recovery from anxiety and depression. Amplification of Positivity (AMP), a cognitive and behavioral intervention, targets the PVS through repeated and intentional activities (e.g., savoring positive experiences, gratitude, and acts of kindness). Initial data demonstrates 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 about 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 focused interventions. Transcripts were analyzed from eleven participants who completed an optional qualitative interview after completing AMP treatment in a randomized controlled trial (NCT04945239). Two superordinate themes with several subthemes emerged. The first theme, , revealed common changes consistent with the core targets of AMP as well as changes less explicitly targeted by AMP. The second theme, , uncovered client's 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. People seeking treatment for anxiety or depression are receptive to amplifying positivity and experience mental and social benefits of doing so. Positive valence centered treatments may therefore be valuable for some clients. Treatment protocols that integrate positive and negative-valence targeted approaches may be preferred by some clients.