A mixed-methods investigation into impact of motivation type on adherence and effect in iCBT for binge eating disorder
Introduction Motivation is an important factor in therapy and potentially even more so in an online setting. Earlier research shows that more autonomously motivated patients have better outcomes and completion rates than more controlled motivated patients´. However, little is known about how motiva...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Cambridge University Press
2023-03-01
|
| Series: | European Psychiatry |
| Online Access: | https://www.cambridge.org/core/product/identifier/S0924933823009896/type/journal_article |
| _version_ | 1827753451054956544 |
|---|---|
| author | T. T. Holmberg M. Sainte-Marie E. K. Jensen E. Runge J. Linnet M. B. Lichtenstein K. Tarp |
| author_facet | T. T. Holmberg M. Sainte-Marie E. K. Jensen E. Runge J. Linnet M. B. Lichtenstein K. Tarp |
| author_sort | T. T. Holmberg |
| collection | DOAJ |
| description |
Introduction
Motivation is an important factor in therapy and potentially even more so in an online setting. Earlier research shows that more autonomously motivated patients have better outcomes and completion rates than more controlled motivated patients´. However, little is known about how motivation type influences treatment effect in an online setting and in patients with binge eating disorder specifically.
Objectives
This study set out to investigate how motivation type as per the Self-Determination Theory would affect treatment adherence and effect in a sample of 148 patients, undergoing an Internet-based Cognitive Behavioral Therapy (iCBT) for BED.
Methods
The study was mixed-methods. A sample of 148 patients gave two written qualitative statements regarding their motivation for seeking treatment and reasons for choosing online therapy
The statements were transformed into quantitative units via the condensation method. The themes were categorized according to the model by Ryan and Deci based on level of autonomy and perceived locus of causality.
This was compared with completion rate and outcomes on eating disorder symptomatology. Completion was designated into three groups. Low adherers - less than six sessions (n=54), high adherers – between 7 and 10 sessions (n =56) and full adherers - 10 session plus follow up (n=37).
The effect of the treatment was measured via the Eating Disorder Examination Questionnaire (EDEQ) and Binge Eating Disorder Questionnaire (BEDQ).
Results
Table 1
shows the distribution of patients’ motivational types regarding therapy aims
Controlled
→
Autonomous
Motivational type:
Introjection
Introjection
Identification
Integration
Patient motivation:
Shame
Weight loss
Psychological
stress
Insight
In all
In all
25
25
50
48
148
Table 2
shows the distribution of patients´motivational types regarding online treatment
Controlled
→
Autonomous
Motivational type:
Introjection
Introjection
Identification
Integration
Patient motivation:
External
Avoidance
Convenience
Reflection
In All
In all
31
21
81
15
148
Table 3
shows the results from morivational types in each setting on BEDQ and EDEQ scores. No significant correlation was found.
Therapy Aims
BEDQ
0.92
EDEQ
0.51
Why Online Therapy
BEDQ
0.99
EDEQ
0.23
Conclusions
Perceived locus of causality and level of autonomy, did not affect level of adherence or outcome of treatment in either setting. This unexpected result may suggest that internet-based therapy is less dependent on motivation types, when comparing with face-to-face treatment.
Disclosure of Interest
None Declared |
| first_indexed | 2024-03-11T07:35:22Z |
| format | Article |
| id | doaj.art-e5971dd713bd4ae69b67b5ac18a72c71 |
| institution | Directory Open Access Journal |
| issn | 0924-9338 1778-3585 |
| language | English |
| last_indexed | 2024-03-11T07:35:22Z |
| publishDate | 2023-03-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | European Psychiatry |
| spelling | doaj.art-e5971dd713bd4ae69b67b5ac18a72c712023-11-17T05:10:15ZengCambridge University PressEuropean Psychiatry0924-93381778-35852023-03-0166S461S46110.1192/j.eurpsy.2023.989A mixed-methods investigation into impact of motivation type on adherence and effect in iCBT for binge eating disorderT. T. Holmberg0M. Sainte-Marie1E. K. Jensen2E. Runge3J. Linnet4M. B. Lichtenstein5K. Tarp6Center for Digital Psychiatry, Region of Southern DenmarkResearch and Innovation Organisation, University of Southern DenmarkCenter for Digital Psychiatry, Region of Southern DenmarkCenter for Digital Psychiatry, Region of Southern DenmarkDepartment of Occupational and Environmental Medicine, Odense University HospitalDepartment of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense C, DenmarkCenter for Digital Psychiatry, Region of Southern Denmark Introduction Motivation is an important factor in therapy and potentially even more so in an online setting. Earlier research shows that more autonomously motivated patients have better outcomes and completion rates than more controlled motivated patients´. However, little is known about how motivation type influences treatment effect in an online setting and in patients with binge eating disorder specifically. Objectives This study set out to investigate how motivation type as per the Self-Determination Theory would affect treatment adherence and effect in a sample of 148 patients, undergoing an Internet-based Cognitive Behavioral Therapy (iCBT) for BED. Methods The study was mixed-methods. A sample of 148 patients gave two written qualitative statements regarding their motivation for seeking treatment and reasons for choosing online therapy The statements were transformed into quantitative units via the condensation method. The themes were categorized according to the model by Ryan and Deci based on level of autonomy and perceived locus of causality. This was compared with completion rate and outcomes on eating disorder symptomatology. Completion was designated into three groups. Low adherers - less than six sessions (n=54), high adherers – between 7 and 10 sessions (n =56) and full adherers - 10 session plus follow up (n=37). The effect of the treatment was measured via the Eating Disorder Examination Questionnaire (EDEQ) and Binge Eating Disorder Questionnaire (BEDQ). Results Table 1 shows the distribution of patients’ motivational types regarding therapy aims Controlled → Autonomous Motivational type: Introjection Introjection Identification Integration Patient motivation: Shame Weight loss Psychological stress Insight In all In all 25 25 50 48 148 Table 2 shows the distribution of patients´motivational types regarding online treatment Controlled → Autonomous Motivational type: Introjection Introjection Identification Integration Patient motivation: External Avoidance Convenience Reflection In All In all 31 21 81 15 148 Table 3 shows the results from morivational types in each setting on BEDQ and EDEQ scores. No significant correlation was found. Therapy Aims BEDQ 0.92 EDEQ 0.51 Why Online Therapy BEDQ 0.99 EDEQ 0.23 Conclusions Perceived locus of causality and level of autonomy, did not affect level of adherence or outcome of treatment in either setting. This unexpected result may suggest that internet-based therapy is less dependent on motivation types, when comparing with face-to-face treatment. Disclosure of Interest None Declaredhttps://www.cambridge.org/core/product/identifier/S0924933823009896/type/journal_article |
| spellingShingle | T. T. Holmberg M. Sainte-Marie E. K. Jensen E. Runge J. Linnet M. B. Lichtenstein K. Tarp A mixed-methods investigation into impact of motivation type on adherence and effect in iCBT for binge eating disorder European Psychiatry |
| title | A mixed-methods investigation into impact of motivation type on adherence and effect in iCBT for binge eating disorder |
| title_full | A mixed-methods investigation into impact of motivation type on adherence and effect in iCBT for binge eating disorder |
| title_fullStr | A mixed-methods investigation into impact of motivation type on adherence and effect in iCBT for binge eating disorder |
| title_full_unstemmed | A mixed-methods investigation into impact of motivation type on adherence and effect in iCBT for binge eating disorder |
| title_short | A mixed-methods investigation into impact of motivation type on adherence and effect in iCBT for binge eating disorder |
| title_sort | mixed methods investigation into impact of motivation type on adherence and effect in icbt for binge eating disorder |
| url | https://www.cambridge.org/core/product/identifier/S0924933823009896/type/journal_article |
| work_keys_str_mv | AT ttholmberg amixedmethodsinvestigationintoimpactofmotivationtypeonadherenceandeffectinicbtforbingeeatingdisorder AT msaintemarie amixedmethodsinvestigationintoimpactofmotivationtypeonadherenceandeffectinicbtforbingeeatingdisorder AT ekjensen amixedmethodsinvestigationintoimpactofmotivationtypeonadherenceandeffectinicbtforbingeeatingdisorder AT erunge amixedmethodsinvestigationintoimpactofmotivationtypeonadherenceandeffectinicbtforbingeeatingdisorder AT jlinnet amixedmethodsinvestigationintoimpactofmotivationtypeonadherenceandeffectinicbtforbingeeatingdisorder AT mblichtenstein amixedmethodsinvestigationintoimpactofmotivationtypeonadherenceandeffectinicbtforbingeeatingdisorder AT ktarp amixedmethodsinvestigationintoimpactofmotivationtypeonadherenceandeffectinicbtforbingeeatingdisorder AT ttholmberg mixedmethodsinvestigationintoimpactofmotivationtypeonadherenceandeffectinicbtforbingeeatingdisorder AT msaintemarie mixedmethodsinvestigationintoimpactofmotivationtypeonadherenceandeffectinicbtforbingeeatingdisorder AT ekjensen mixedmethodsinvestigationintoimpactofmotivationtypeonadherenceandeffectinicbtforbingeeatingdisorder AT erunge mixedmethodsinvestigationintoimpactofmotivationtypeonadherenceandeffectinicbtforbingeeatingdisorder AT jlinnet mixedmethodsinvestigationintoimpactofmotivationtypeonadherenceandeffectinicbtforbingeeatingdisorder AT mblichtenstein mixedmethodsinvestigationintoimpactofmotivationtypeonadherenceandeffectinicbtforbingeeatingdisorder AT ktarp mixedmethodsinvestigationintoimpactofmotivationtypeonadherenceandeffectinicbtforbingeeatingdisorder |