Eline C Jochems1,2, Arno van Dam3,4, Hugo J Duivenvoorden5, Sylvia C M Scheffer6, Christina M van der Feltz-Cornelis7,8,4, Niels L Mulder7,9. 1. Department of Psychiatry, Epidemiological and Social Psychiatric Research Institute, Erasmus MC University Medical Center, Rotterdam, The Netherlands. e.c.jochems@gmail.com. 2. Topclinical Center for Body, Mind and Health, GGz Breburg, Tilburg, The Netherlands. e.c.jochems@gmail.com. 3. Western North Brabant Mental Health Center (GGZ Westelijk Noord Brabant), Bergen op Zoom, The Netherlands. 4. Department of Tranzo, Faculty of Social Sciences, Tilburg University, Tilburg, The Netherlands. 5. Erasmus MC University Medical Center, Rotterdam, The Netherlands. 6. Viersprong Institute for Studies on Personality Disorders, Halsteren, The Netherlands. 7. Department of Psychiatry, Epidemiological and Social Psychiatric Research Institute, Erasmus MC University Medical Center, Rotterdam, The Netherlands. 8. Topclinical Center for Body, Mind and Health, GGz Breburg, Tilburg, The Netherlands. 9. Parnassia Bavo Groep, Rotterdam, The Netherlands.
Abstract
The present study assessed motivation for engaging in treatment as rated by clinicians (n = 57) and patients with severe mental illness (SMI, n = 294) using measures based on three different motivation theories. Questionnaires were derived from self-determination theory, the transtheoretical model and the integral model of treatment motivation. It was investigated to which extent clinicians of patients with SMI were able to estimate their patient's perspective on motivation for engaging in treatment, to which extent they agreed on the patient's motivation and which factors were associated with estimation and agreement on treatment motivation. It was found that clinicians were poorly to moderately capable of estimating their patient's type of motivation and readiness for change. Further, agreement on the level of motivation between patients and clinicians was moderate. These findings were consistent across diagnostic groups (psychotic and personality disorders). A higher quality therapeutic relationship was generally associated with higher clinician-rated motivation. The patient's ethnicity and socially desirable responding were factors that differentiated between scales of different motivation theories. It is concluded that patients with SMI and their clinicians have different perceptions on the patient's motivation for engaging in psychiatric treatment, regardless of the theoretical framework that is used to measure motivation. The findings imply that a negotiated approach is needed where both perceptions of clinicians and patients on motivation for treatment are considered to ensure effective mental health interventions.
The present study assessed motivation for engaging in treatment as rated by clinicians (n = 57) and patients with severe mental illness (SMI, n = 294) using measures based on three different motivation theories. Questionnaires were derived from self-determination theory, the transtheoretical model and the integral model of treatment motivation. It was investigated to which extent clinicians of patients with SMI were able to estimate their patient's perspective on motivation for engaging in treatment, to which extent they agreed on the patient's motivation and which factors were associated with estimation and agreement on treatment motivation. It was found that clinicians were poorly to moderately capable of estimating their patient's type of motivation and readiness for change. Further, agreement on the level of motivation between patients and clinicians was moderate. These findings were consistent across diagnostic groups (psychotic and personality disorders). A higher quality therapeutic relationship was generally associated with higher clinician-rated motivation. The patient's ethnicity and socially desirable responding were factors that differentiated between scales of different motivation theories. It is concluded that patients with SMI and their clinicians have different perceptions on the patient's motivation for engaging in psychiatric treatment, regardless of the theoretical framework that is used to measure motivation. The findings imply that a negotiated approach is needed where both perceptions of clinicians and patients on motivation for treatment are considered to ensure effective mental health interventions.
Authors: Eline C Jochems; Christina M van der Feltz-Cornelis; Arno van Dam; Hugo J Duivenvoorden; Cornelis L Mulder Journal: Neuropsychiatr Dis Treat Date: 2015-12-11 Impact factor: 2.570