Motivatiedeficit, onmacht of een dubbeltje op zijn kant? Herstel en re-integratie bij afhankelijkheid Charlotte Vanovenberghe CM – KULeuven
Motivatiedeficit, onmacht of een dubbeltje op zijn kant?
Herstel en re-integratie bij afhankelijkheid
Charlotte Vanovenberghe CM – KULeuven
30%
Intrinsiek – extrinsiek
Autonomie
Relationele verbondenheid
Competentie
30%
Zelfdeterminatietheorie
Zelfdeterminatietheorie
Zelfdeterminatietheorie
Extern
Zelfdeterminatietheorie
Introjectie
Zelfdeterminatietheorie
Zelfdeterminatietheorie
Zelfdeterminatietheorie
Autonome motivatie -therapietrouw
Autonome motivatie -
methadonbehandeling
Alcohol
Ryan, R. M., Plant, R. W., & O'Malley, S. (1995). Initial motivations for alcohol treatment: Relations with patient characteristics, treatment involvement, and dropout.
Onderzoek
TherapietrouwGewichtsverlies:
↑ interne ↓ externe M
Alcoholafhankelijkheid: ↑ interne ↑ externe M
Methadon: ↑ interne soms ↑ externe M
MAAR intern steeds voorwaarde
Motivational Interviewing
Motivational Interviewing
“Motiverende Gespreksvoering is een op samenwerking gerichte
gespreksstijl die iemands eigen motivatie en bereidheid tot
verandering versterkt.”
SSRR
DDEE
SSRR
DDEE
Express Empathy
SSRR
DDEEDevelop Discrepancy
Keuzevrijheid
Liang Meng Qingguo Ma
Keuzevrijheid
SSRR
DDEE
Roll with Resistance
SSRR
DDEE
Support Self-efficacy
Change talk
Barnett, e.a. From counselor skill to decreased marijuana use: Does change talk matter?
MI
Lundahl, B., & Burke, B. L. (2009). The effectiveness and applicability of motivational interviewing: A practice‐friendly review of four meta‐analyses.
GMI – middelenafhankelijkheid
Santa Ana et. Al. (2005). Efficacy of group motivational interviewing (GMI) forpsychiatric inpatients with chemical dependence.
MI – intrinsieke motivatie?
ZDT – MI
Take home message
• Cave gedwongen hulpverlening
• Externe motivatie kan succesvol zijn, maar enkel als vergezeld door interne motivatie
• Cave expertrol
• Motiverende gesprekstechnieken interfereren niet met de lopende behandeling
ReferentiesAltman, H., Evenson, R., & Cho, D. (1978). Predicting length of stay by patients hospitalized for alcoholism or drug dependence. Journal of Studies on Alcohol, 39, 197-201.
Burke, B. L., Arkowitz, H., & Menchola, M. (2003). The efficacy of motivational interviewing: a meta-analysis of controlled clinical trials.
Barnett, E., Moyers, T. B., Sussman, S., Smith, C., Rohrbach, L. A., Sun, P., & Spruijt-Metz, D. (2014). From counselor skill to decreasedmarijuana use: Does change talk matter?. Journal of substance abuse treatment, 46(4), 498-505.
Larimer, M. E., & Palmer, R. S. (1999). Relapse prevention: An overview of Marlatt's cognitive-behavioral model. Alcohol research and Health, 23(2), 151-160.
Markland, D., Ryan, R. M., Tobin, V. J., & Rollnick, S. (2005). Motivational interviewing and self–determination theory. Journal of social andclinical psychology, 24(6), 811-831.
Meng, L., & Ma, Q. (2015). Live as we choose: The role of autonomy support in facilitating intrinsic motivation. International Journal of Psychophysiology, 98(3), 441-447.
Miller, W. (1985). Motivation for treatment: A review with special emphasis on alcoholism. Psychological Bulletin, 98, 84-107.
Ryan, R. M. (1995). Psychological needs and the facilitation of integrative processes. Journal of personality, 63(3), 397-427.
Ryan, R. M., Plant, R. W., & O'Malley, S. (1995). Initial motivations for alcohol treatment: Relations with patient characteristics, treatment involvement, and dropout. Addictive behaviors, 20(3), 279-297.
Santa Ana, E. J., Wulfert, E., & Nietert, P. J. (2007). Efficacy of group motivational interviewing (GMI) for psychiatric inpatients with chemical dependence. Journal of Consulting and Clinical Psychology, 75(5), 816.
ReferentiesSheldon, K. M., Joiner, T., & Williams, G. (2003). Motivating health: Applying self-determination theory in the clinic. Yale: Yale University Press
Simoneau, H., & Bergeron, J. (2003). Factors affecting motivation during the first six weeks of treatment. Addictive behaviors, 28(7), 1219-1241.
Stein, L. A. R., & Lebeau-Craven, R. (2002). Motivational interviewing and relapse prevention for DWI: A pilot study. Journal of drug issues, 32(4), 1051-1070.
Vansteenkiste, M., & Sheldon, K. M. (2006). There's nothing more practical than a good theory: Integrating motivational interviewingand self‐determination theory. British journal of clinical psychology, 45(1), 63-82.
Warneken, F., & Tomasello, M. (2009). The roots of human altruism. British Journal of Psychology, 100(3), 455-471.
Wild, T. C., Cunningham, J. A., & Ryan, R. M. (2006). Social pressure, coercion, and client engagement at treatment entry: A self-determination theory perspective. Addictive behaviors, 31(10), 1858-1872.
Williams, G. C., Grow, V. M., Freedman, Z. R., Ryan, R. M., & Deci, E. L. (1996). Motivational predictors of weight loss and weight-loss maintenance. Journal of personality and social psychology, 70(1), 115.
Williams, G. C. (2002). Improving patients’ health through supporting the autonomy of patients and providers. In E. L. Deci & R. M. Ryan (Eds.), Handbook of self-determination research. Rochester: University of Rochester Press.
Zeldman, A., Ryan, R. M., & Fiscella, K. (2004). Motivation, autonomy support, and entity beliefs: Their role in methadone maintenance treatment. Journal of Social and Clinical Psychology, 23(5), 675-696.