Readiness to change as a moderator of therapy outcome in patients with somatoform disorders

Heider, Jens; Köck, Katharina; Sehlbrede, Matthias; Schröder, Annette

doi:10.1080/10503307.2016.1265686

Cited by 19 publications

(5 citation statements)

References 35 publications

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“…Willingness to change problematic behaviour was found to be a moderator in a study of transdiagnostic face-to-face treatment (Boswell et al, 2012) as well as in an uncontrolled study of face-to-face treatment for participants with somatoform disorders (Heider et al, 2017). Additionally, the "action"-subscale of willingness to change was found to moderate the effect of an online intervention addressing marijuana use among students (Palfai et al, 2016).…”

Section: Introductionmentioning

confidence: 91%

A randomized controlled trial on a smartphone self-help application (Be Good to Yourself) to reduce depressive symptoms

Lüdtke

Pult

Schröder

et al. 2018

Psychiatry Research

121

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Depressive symptoms are common, yet only a subset of individuals receives adequate treatment. To reduce the treatment gap, several online self-help programs have been developed, yielding small to moderate effects. We developed a self-help application for mobile devices addressing depressive symptoms. The aim of this study was to evaluate its feasibility and efficacy in a sample of participants reporting a subjective need for help (a diagnosis of depression was not mandatory). We conducted a randomized-controlled trial (N = 90). The primary outcome was a reduction of depressive symptoms measured with the Patient Health Questionnaire-9 (PHQ-9). Secondary outcomes included improved self-esteem (Rosenberg Self-Esteem Scale) and quality of life (WHOQOL-BREF). The intervention group obtained access to the application for four weeks, the wait-list group received access after the post assessment. No group differences emerged in either outcome in intention-to-treat analyses. Per protocol analyses with frequent users (i.e., several times a week or more) yielded a significant moderate effect on the reduction of depressive symptoms in favor of the treatment group. However, 39% of the participants did not use the application frequently.Mobile self-help applications represent a promising addition to existing treatments, but it is important to increase patients' motivation to use them.

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Section: Introductionmentioning

confidence: 91%

A randomized controlled trial on a smartphone self-help application (Be Good to Yourself) to reduce depressive symptoms

Lüdtke

Pult

Schröder

et al. 2018

Psychiatry Research

121

View full text Add to dashboard Cite

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“…Motivation is one of the most important predictors of adherence to pain management skills 12,65,66 , as well as adherence to other positive health behaviors 10,11,13,67 . It is also predictive of favorable clinical outcomes following treatment 14,68 .…”

Section: Adherence To Pain Self-management Strategies and Clinical Outcomesmentioning

confidence: 99%

“…The central premise of this review is that dysfunction of the mesocorticolimbic system (i.e., brain circuitry associated with hedonic appraisal, reinforcement, and motivated behavior) is associated with attenuated motivation in chronic pain patients, potentially resulting in difficulty adhering to symptom self-management strategies. To support this thesis, we discuss evidence showing that 1) motivation is a strong predictor of adherence to selfmanagement strategies [10][11][12][13][14] , 2) motivation is subserved by the mesocorticolimbic system [15][16][17][18][19] , and 3) mesocorticolimbic dysfunction is present in some individuals with chronic pain [20][21][22][23][24][25] .…”

mentioning

confidence: 99%

Exploring the potential role of mesocorticolimbic circuitry in motivation for and adherence to chronic pain self-management interventions

Letzen

Seminowicz

Campbell

et al. 2019

Neuroscience & Biobehavioral Reviews

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Adherence to pain self-management strategies is associated with favorable psychobehavioral outcomes among individuals with chronic pain. Substantive adherence to treatments teaching these adaptive skills proves challenging, resulting in poor individual and societal outcomes. Evidence demonstrates motivation for behavior change as a key predictor of treatment adherence. Despite behavioral techniques that target motivation, however, nonadherence persists as a barrier to positive clinical outcomes in chronic pain. Understanding the neurobiological mechanisms underlying treatment motivation might highlight novel avenues for augmentative therapies. The purpose of this review is to present theory and evidence that the mesocorticolimbic system (i.e., brain circuitry associated with reward processing and motivation) contributes to treatment motivation among chronic pain patients, ultimately influencing adherence. We review evidence for motivation as a key adherence determinant, detail neuroimaging findings relating mesocorticolimbic circuitry and motivation, and discuss data supporting mesocorticolimbic dysfunction among chronic pain patients. We propose a neurobehavioral model for adherence to pain self-management interventions, listing testable hypotheses. Finally, we discuss potential research and intervention implications from the proposed model.

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“…These factors can be continually reviewed by professionals involved in an MHTR, probation and an MHTR service user when evaluating engagement. Readiness to change has been found to be an indicator for treatment engagement and behavioural change (Krampe et al , 2017; Helder et al , 2017; Micic et al , 2018). MHTR professionals may include treatment preparedness scales within their assessment, as this may help predict treatment completion (Mitchell et al , 2017).…”

Section: Discussionmentioning

confidence: 99%

Community sentence with Mental Health Treatment Requirement (MHTR); an exploration into offenders’ experience of psychological therapy

Butler¹,

Ledwith²

2021

JCP

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Purpose This study aims to explore service users’ experience of psychological therapy as part of a community sentence with a Mental Health Treatment Requirement (MHTR) in Birmingham Courts between January and December 2018. Design/methodology/approach All service users that had therapy in this period were telephoned a month after ending and offered a semi-structured telephone interview. Seven service users agreed to be recorded. This data was then transcribed and analysed using thematic analysis to gain a richer understanding of their lived experience. Findings Themes identified were: Is the MHTR for me? Opening up, enlightening connections and personal change. Service users initially questioned the relevance and burden of the order for them; the experience of therapy allowed them to trust and talk about things unsaid in the past; this helped them to review and reconsider their understanding of themselves and their life choices and what further support they might need. Research limitations/implications Interviews were not completed by an independent interviewer. Experience of working with offender manager supervision additionally available throughout the sentence was not explored. Practical implications What is included in the MHTR information and support needs to be informed by the service user’s perspective, including this can improve engagement. Social implications Therapy was seen as a “a cog in the machine” and wider social inequalities may need to be addressed within the sentence. Originality/value This report focusses on experience of a therapeutic intervention – a key part of a community sentence with an MHTR.

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Readiness to change as a moderator of therapy outcome in patients with somatoform disorders

Cited by 19 publications

References 35 publications

A randomized controlled trial on a smartphone self-help application (Be Good to Yourself) to reduce depressive symptoms

A randomized controlled trial on a smartphone self-help application (Be Good to Yourself) to reduce depressive symptoms

Exploring the potential role of mesocorticolimbic circuitry in motivation for and adherence to chronic pain self-management interventions

Community sentence with Mental Health Treatment Requirement (MHTR); an exploration into offenders’ experience of psychological therapy

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