Motivatiedeficit, onmacht of een dubbeltje op zijn...

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Motivatiedeficit, onmacht of een dubbeltje op zijn kant? Herstel en re-integratie bij afhankelijkheid Charlotte Vanovenberghe CM – KULeuven

Transcript of Motivatiedeficit, onmacht of een dubbeltje op zijn...

  • 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.