Hope and discomfort as factors influencing treatment continuance (original) (raw)
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Hope in Psychiatric Patients: An Observational Study in a Psychiatric Rehabilitation Centre
Psychiatria Danubina, 2022
Introduction: the COVID-19 pandemic has led to the re-evaluation of some fundamental aspects for the management of emotions and psychological dynamics. Hope and its lack are important factors that have been especially evaluated in caregivers and HCWs. Instead, our study aimed to explore hopelessness among psychiatric rehabilitation center residents with Primary Psychosis. Methods: we recruited 116 inpatients affected by Primary Psychosis (schizophrenia, bipolar disorder, major depression disorder and personality disorder). Hopelessness was sought through the BHS, during the covid-19 pandemic period. They were compared with data from previous studies on HCWs (HealthCare Workers), in the same period, and in the same centre. Results: the results obtained in this group of patients showed high total scores on the BHS scale (mean total score: 7.28±SD 3.73). These data are significantly higher than those found in HWs in the same pandemic period (mean total score: 3,74±SD 3,62). Among the different disorders the borderline personality disorder patients have presented the highest score (mean total score: 8.00±SD 3.50). Conclusion: understanding resident and HCWs-level variations in hopelessness may be important for targeting interventions to improve the outcome of residential psychiatric patients.
Archives of Psychiatry and Psychotherapy, 2018
Objective: The motives that bring people to psychotherapy vary widely; while some people come on their own volition, others may not care to be in psychotherapy at all, but feel compelled to seek services because of external pressures. A patient's motivation for therapy is believed to influence the likelihood of becoming actively and meaningfully involved in the work of psychotherapy. Methods: We surveyed 343 consecutively admitted psychiatric outpatients from three large, urban psychotherapy clinics about their motives (internal vs. external) for seeking psychotherapy and their expected involvement, or lack of involvement, in the work of therapy. Results: While most patients appear to start therapy on their own volition (76%), a significant proportion also feel compelled to seek services because of external pressures (38%). The more patients were motivated by external forces to seek treatment, the more disinclined they were to become engaged in the work of therapy; greater endorsement of internal motives was associated with reduced unwillingness to work in therapy. Conclusions: Externally motivated patients may be particularly uncertain about the relevance and/or success of therapy and may require preparatory work to help instil in them a sense of hope and investment in the treatment process.
Motivation for therapy: an important ingredient to change?
2012
We analyse the levels of motivation for therapy, as well as explore if there are significant differences between the group of clients who drop-out from therapy and those who continue. Is there a relation between the different dimensions of motivation and the way the client perceive the therapeutic environment? 39 dyads of therapist and clients from Portugal participated. The Client motivation for therapy scale, adapted from Pelletier, Tucson and Haddad (1997) and the modified HCCQ from Williams, McGregor, King, Nelson and Glasgow (2005) were administered to the clients in 1st, 3rd, 5th and 8th session. Significant differences in the intrinsic motivation and amotivation dimension and no significant differences were found, between those who give up/continue psychotherapy (p>.05). Nevertheless it was found a positive significant correlation (rs=.467) between the level of perception of the therapeutic environment and integrated motivation, as well as a negative correlation with amotivation (rs=.521), that is to say, the better the perception of the therapeutic environment, more motivated they are for therapy. Keywords: motivation, psychotherapy, clients, therapeutic environment
Relation between stages of change and motivation in the treatment of psychiatric patients1
Psihologija, 2007
Results have shown that stages of changes are significantly related to inspected motivational variables. Patients in higher stages of readiness express specific motivational profile characterized by the proactive optimism, which means that they rely on their own resources and expect positive outcome of the treatment. Patients in lower stages of readiness express motivational profile characterized by passive resignation receptiveness, by inclination towards demoralization and low trust in their own strength. Results of this research are in conformity with the basic hypothesis of transtheoretical model of change.
Clinical Psychology & Psychotherapy, 2016
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.
Hope for Help-Seeking: A Positive Psychology Perspective of Psychological Help-Seeking Intentions
The Counseling Psychologist, 2017
In the present study, we used multigroup structural equation modeling in a sample of college students ( N = 2,461) to examine ethnic and gender differences in the connections between dispositonal hope and intentions to seek psychological help from formal and informal sources. In a personal-emotional problem scenario, we found a robust positive relationship between hope and intentions to seek help from informal sources, but no association for formal sources. In a suicidal thoughts scenario, hope was positively associated with intentions to seek both informal and formal psychological help. Results of exploratory moderation analyses indicated that the model was invariant across non-Latino White students and Asian American students, as well as across men and women. These findings address critical gaps in the hope and help-seeking literature, and suggest that increasing college students’ dispositional hope may provide a unique positive psychology-focused avenue for increasing help-seekin...
Why People Do Not Always Follow the Doctor's Orders: The Role of Hope and Perceived Control
Journal of Consumer Affairs, 2014
The lack of adherence to medical advice is a widely recognized health care concern with important implications for consumer well-being. This study advances a model for better understanding adherence behaviors by incorporating the positive emotion of hope and consumer perceptions of control. Empirical testing of the model in the context of type 2 diabetes, a lifestyle-changing chronic illness, shows that hope generates more patient adherence. Furthermore, individuals have higher hope when they believe they are capable of performing the actions their treatment requires, and/or that their health outcomes are under their physician's control. The results indicate that health care providers can play an important role in encouraging adherence behaviors by cultivating hope and customizing their interactions with patients. Interventions aimed at increasing patient self-efficacy or promoting patients' beliefs that health outcomes are under their physician's control are two routes to building hope. Health initiatives aimed at increasing diabetes treatment adherence should consider alternatives beyond asking patients to "take control" of their diabetes.