... a central task of psychotherapy is to support the client to autonomously explore, identify, initiate, and sustain a process of change
... when more autonomously engaged in the therapeutic process — that is, when they have a more internal perceived locus of causality for treatment — people will be more likely to integrate learning & behavior change, resulting in more positive outcomes.
(Listed below are the) varied types of motives that bring people to therapy, along with their correlates & consequences. These motives, with corresponding regulatory processes, vary along a continuum of relative autonomy, and people typically have varied degrees of each type of motive.
• First, persons can be pressured or coerced by external factors, a process referred to as external regulation. This is especially apparent in the treatment of children, & in therapies connected with the legal system such as substance abuse.
• Second, introjection is evident when people initiate treatment because of 'shoulds,' guilt, or seeking social approval & thus pressure themselves to change.
• Third, clients may have the more autonomous experience of identifying with the goals of therapy & volitionally pursuing change.
• This volitional identification will be transformed into integrated regulation when it is brought into congruence with all of the person’s values & perceptions.
• Finally, clients may even come to treatment with considerable intrinsic motivation, reflected in an open curiosity and interest in what can occur.
... the less autonomous the motive the more SDT predicts poor engagement in therapy & lowered long-term, or maintained, success.
Testing ... the degree to which individuals enter treatment for more controlled (i.e., external or introjected motivation) or autonomous reasons (i.e., identified, integrated, or intrinsic motivation) ... revealed that the more autonomous individuals were in their motivation for therapy, the more important they believed the therapy to be, the less distracted they were during therapy, the less tension they experienced about therapy, the more satisfied they were with the therapy, the greater their intention to persist, the higher their self-esteem, the lower their level of depressive symptoms, and the greater their life satisfaction. People’s controlled motivation, in contrast, positively predicted tension, and negatively predicted the importance of therapy, the intention to persist, and self-esteem."
Ryan RM, Deci EL. "A Self-Determination Theory Approach to Psychotherapy: The Motivational Basis for Effective Change."
Canadian Psychology 2008; 49(3): 186–193.
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