Different Perspectives of Clinicians and Patients with Severe Mental Illness on Motivation for Treatment

Abstract

Clinicians show poor to moderate capability in estimating how patients perceive their motivation for engaging in treatment, especially so when the patient's motives revolve around feelings of shame and guilt. Clinicians generally give higher motivation ratings for patients where they experience a higher quality therapeutic relationships with, whereas-depending on the scale that is used to measure motivation-they give lower ratings to patients who respond in socially desirable ways and to ethnic minority patients. As 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 assess motivation), this implies 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 effects of motivation feedback in patients with severe mental illness: a cluster randomized controlled trial

“…This suggests that clinicians noticed a reduction in relatively external motivation for engaging in treatment in their patients in response to MF, signifying that their perception of the patient’s motivation has changed in response to the intervention. We have previously found that introjected motivation for treatment was especially difficult for clinicians to estimate in the current patient sample, 40 and it is therefore reasonable to assume that the repeated conversations with patients regarding their motives has led to a change in the clinician’s perception of the motivation such that it became more closely aligned with the patient’s perspective. As such, the intervention may have enhanced the clinician’s ability to estimate the patient’s perspective on motivation.…”

“…Numerous studies suggest that evaluation of the patient’s motivation may help understand how a patient may best be engaged in treatment, 1 – 5 while other studies have found that clinicians have difficulties in estimating their patient’s motivation for treatment, 40 suggesting that the plausibility of the rationale for the current study was high. However, it should be noted that in the Netherlands, the accessibility and quality of mental health care for patients with SMI are currently at a relatively high level.…”

Randomized controlled trial of cognitive-motivational therapy program (PIPE) for the initial phase of schizophrenia: Maintenance of efficacy at 5-year follow up✰

“…None of the members of the sample were lost during the treatment and follow-up phases of the research, setting this study apart from others in which the sample attrition rate at five years exceeded 60% (Turkington et al, 2008).Refusal to participate in studies and abandonment during the course of a study are very common phenomena among the population examined here (Villeneuvea, Potvinc, Lesageb, & Nicolec, 2010), as patients often display a lack of motivation to undertake treatment (Jochems et al, 2015)and experience great difficulties in sustaining it.…”

“…For example, some researchers have looked at combining CBT with compassionate mind training therapy (CMT) (Beaumont, Galpin, & Jenkins, 2012), while others have examined the use of motivational interventions in cognitive therapy programs to treat psychosis Wai, Mui, Cheung, & Gray, 2015). In fact, patents' degree of motivation to start and maintain the therapy process has been found to play a critical role in determining the prognosis of a disorder (Jochems, van Dam, Duivenvoorden, Scheffer, van der Feltz-Cornelis & Niels, 2015).…”

Exploring Counselor‐Client Agreement on Clients’ Work Capacity in Established and Consultative Dyads

“…Investigations into counselor‐client agreement have been conducted in the context of diverse relationships that counselors have with their clients with serious mental illnesses, such as treatment, counseling, vocational rehabilitation, and supportive services. Counselor‐client agreement has been investigated in the areas of (a) perceived needs for treatment (Lasalvia et al, 2000; Miyamoto et al, 2015), (b) vocational goals (Knaeps et al, 2015), (c) quality of life (Crocker et al, 2015), and (d) motivation for mental health treatment (Jochems et al, 2016). The cumulative results of these studies have suggested that counselors often report differing levels of functioning and needs than do their clients (Fitzpatrick et al, 2005; Holmqvist et al, 2016; Marfeo, Ni, Haley, Bogusz, et al, 2013; Tryon et al, 2007).…”