Switch, a new intervention that targets motivational negative symptoms in people with schizophrenia: An uncontrolled pilot study

Abstract

Objective People diagnosed with schizophrenia experience difficulties in their daily life, which is best explained by motivational negative symptoms. This study explores the feasibility, acceptability, and efficacy of Switch, a new multifactorial intervention that targets motivational deficits. Method Eight participants with schizophrenia or schizoaffective disorder followed around 30 individual sessions of Switch over 12 months. Participants and their informants were interviewed at baseline (T0), at 6 months (T1), at the end of the intervention (T2), and at 6 months follow‐up (T3). Results T0–T1 paired sample t tests showed large improvements on motivational deficits, general negative symptoms, and apathy and functional outcomes (both as rated by informants). At T2 and T3, moderate to large improvements were maintained. Switch was well accepted by participants. Conclusions This preliminary investigation provides evidence that Switch may be a feasible, acceptable, and effective intervention specifically designed to target motivational deficits and improve daily functioning.

A Group Intervention for Motivational Deficits: Preliminary Investigation of a Blended Care Approach Using Ambulatory Assessment

“…The Switch intervention was created based on a model of motivation and goal directed behaviours and followed the same principles as previously described (Thonon, Levaux, et al, 2020;Thonon, Van Aubel, et al, 2020). Furthermore, different principles of learning were adhered to in order to enhance the potential of the intervention in the group format.…”

“…Yet, adequate treatment schemes for motivational negative symptoms have been largely lacking. In the past few years, however, new interventions that specifically target motivational deficits have been developed and tested (e.g., Favrod et al, 2019;Thonon, Levaux, Della Libera, & Larøi, 2020). For example, our research group has found promising results from the "Switch" intervention provided in individual sessions, with specific improvements on motivational negative symptoms and functional outcomes (Thonon, Levaux, et al, 2020), as well as particular effects on daily life measures of savouring abilities, cognition (e.g., discouraging beliefs), and the engagement in meaningful and effortful activities (Thonon, Van Aubel, Lafit, Della Libera, & Larøi, 2020).…”

Idiographic analyses of motivation and related processes in participants with schizophrenia following a therapeutic intervention for negative symptoms

“…In a previous study [9], we presented a model of motivation in schizophrenia that integrates various emotional/hedonic, (neuro) cognitive and behavioural processes that are related to motivation and goaldirected behaviours and that are often dysfunctional in individuals with schizophrenia. This model was predominantly inspired by the model developed by Kring and Barch, which follows the course of hedonic processes, from the anticipation of a reward to its obtainment [10].…”

“…Finally, the experience of successfully moving towards one's goal can be Fig. 1 Three-level model of motivation (reproduced with permission from [9]) recalled (reminiscence) and can feed further anticipation (for a more detailed description and an illustration, see [9]).…”

“…We developed an intervention, Switch, that targets the multiple elements and processes identified in the aforementioned model [9], using various strategies that have proven to be beneficial as delivered separately or in other clinical populations (e.g., [11][12][13][14][15][16]). A pilot study was conducted with 8 participants with schizophrenia spectrum disorders who followed Switch for a year (30 sessions on average).…”