Tijdschrift voor Psychotherapie

, Volume 36, Issue 3, pp 171–189 | Cite as

Optimaal motiveren van gedragsverandering

Psychologische behoeftebevrediging als de motor van therapiesucces
  • Maarten Vansteenkiste
  • Bart Neyrinck
Artikelen
  • 2.1k Downloads

Samenvatting

In de afgelopen twee decennia is de interesse in het thema behandelingsmotivatie sterk gegroeid, zowel binnen het klinische werkveld als in de klinische onderzoekswereld. Hierbij werden talrijke klinisch-motivationele modellen (bijvoorbeeld: transtheoretisch model van verandering, motiverende gespreksvoering, socratisch motiveren) ontwikkeld. In de motivatiepsychologie en specifieker in de Zelfdeterminatietheorie (ZDT) werd de relevantie van motivationele processen voor therapiesucces onderzocht. ZDT wordt in deze bijdrage geïntroduceerd omdat zij vooralsnog vrij ongekend is in de klinische wereld, maar een aanvulling en uitdieping kan zijn voor frequent gehanteerde klinisch-motivationele modellen. Hierbij wordt aangegeven:

a  dat het originele onderscheid intrinsieke-extrinsieke motivatie werd verlaten ten voordele van het onderscheid autonome of vrijwillige en gecontroleerde of verplichtende motivatie;

b  dat de bevrediging van de psychologische basisbehoeften van autonomie, competentie en relationele verbondenheid de motor is voor de ontwikkeling en handhaving van autonome motivatie.

We bespreken in deze bijdrage empirische evidentie voor deze claims.

Literatuur

  1. Appelo, M. (2007). Socratisch motiveren. Amsterdam: Boom.Google Scholar
  2. Assor, A., Roth, G. & Deci, E.L. (2004). The emotional costs of perceived parental conditional regard: A self-determination theory analysis. Journal of Personality, 72, 47-87. Google Scholar
  3. Assor, A., Vansteenkiste, M. & Kaplan, A. (2009). Identified and introjection approach and introjection avoidance motivations in school and in sport: The limited benefits of self-worth strivings. Journal of Educational Psychology, 101, 482-497.Google Scholar
  4. Bandura, A. (1996). Enhancing human functioning the social cognitive way. International Journal of Psychology, 31, 4631-4631.Google Scholar
  5. Buckner, J.D. & Schmidt, N.B. (2009). A randomized pilot study of motivation enhancement therapy to increase utilization of cognitive-behavioral therapy for social anxiety. Behaviour Research and Therapy, 47, 710-715.Google Scholar
  6. Curry, S.J., Wagner, E.H. & Grothaus, L.C. (1990). Intrinsic and extrinsic motivation for smoking cessation. Journal of Consulting and Clinical Psychology, 58, 310-316.Google Scholar
  7. Curry, S.J., Wagner, E.H. & Grothaus, L. C. (1991). Evaluation of intrinsic and extrinsic motivation interventions with a self-help smoking cessation program. Journal of Consulting and Clinical Psychology, 59, 318-324.Google Scholar
  8. Dean, H.Y., Touyz, S.W., Rieger, E. & Thornton, C.E. (2008). Group motivational enhancement therapy as an adjunct to inpatient treatment for eating disorders: A preliminary study. European Eating Disorders Review, 16, 256-267.Google Scholar
  9. Deci, E.L., Eghrari, H., Patrick, B.C. & Leone, D. (1994). Facilitating internalization: The self-determination theory perspective. Journal of Personality, 62, 119-142.Google Scholar
  10. Deci, E.L. & Ryan, R.M. (1985). Intrinsic motivation and self-determination in human behavior. New York: Plenum Publishing Co.Google Scholar
  11. Deci, E.L. & Ryan, R.M. (2000). The ‘what’ and ‘why’ of goal pursuits: Human needs and the self-determination of behavior. Psychological Inquiry, 11, 227-268.Google Scholar
  12. Deci, E.L. & Ryan, R.M. (2002) (Eds). Handbook of self-determination research. Rochester, NY: University Of Rochester Press.Google Scholar
  13. Delmeiren, G. (2006). De rol van motivatie in de behandeling van eetstoornissen: Drop-out en gewichtsveranderingen bij opgenomen patiënten. Ongepubliceerde Licenciaatsverhandeling. Leuven: KU Leuven.Google Scholar
  14. DiClemente, C.C. (1999). Motivation for change: Implications for substance abuse treatment. Psychological Science, 10, 209-213.Google Scholar
  15. Drieschner, K.H. & Boomsma, A. (2008). The Treatment Motivation Scales for forensic outpatient treatment (TMS-F): Construction and psychometric evaluation. Assessment, 15, 224-241.Google Scholar
  16. Drieschner, K.H., Lammens, S.M.M. & van der Staak, C.P.F. (2004). Treatment motivation: An attempt for clarification of an ambiguous concept. Clinical Psychology Review, 23, 1115-1137.Google Scholar
  17. Engle, D. & Arkowitz, H. (2008). Viewing resistance as ambivalence: Integrative strategies for working with resistant ambivalence. Journal of Humanistic Psychology, 48, 389-412.Google Scholar
  18. Fortier, M.S., Sweet, S., O’Sullivan, T. L. & Williams, G.C. (2007). A self-determination process model of physical activity adoption in the context of a randomized controlled trial. Psychology of Sport and Exercise, 8, 741-757.Google Scholar
  19. Geller, J. (2002). What a motivational approach is and what a motivational approach isn’t: Reflections and responses. European Eating Disorders Review, 10, 155-160.Google Scholar
  20. Goldfried, M.R. & Davila, J. (2005). The role of relationship and technique in therapeutic change. Psychotherapy: Theory, Practice, Training, 42, 421-430.Google Scholar
  21. Grolnick, W.S., Deci, E.L. & Ryan, R.M. (1997). Internalization within the family: The self-determination theory perspective. In J.E. Grusec & L. Kuczynski (Eds), Parenting and children’s internalization of values: A handbook of contemporary theory (pp. 135-161). New York: Wiley.Google Scholar
  22. Halvari, A.E.M. & Halvari, H. (2006). Motivational predictors of change in oral health: An experimental test of self-determination theory. Motivation and Emotion, 30, 295-306.Google Scholar
  23. Hampton-Robb, S., Qualls, R.C. & Compton, W.C. (2003). Predicting first-session attendance: The influence of referral source and client income. Psychotherapy Research, 13, 223-233.Google Scholar
  24. Hermans, D., Eelen, P., & Orlemans, H. (2007). Inleiding tot de gedragstherapie. Houten: Bohn Stafleu van Loghum. Google Scholar
  25. Jang, H. (2008). Supporting students’ motivation, engagement, and learning during an uninteresting activity. Journal of Educational Psychology, 100, 798–811.Google Scholar
  26. Lundahl, B. & Burke, B.L. (2009). The effectiveness and applicability of motivational interviewing: A practice-friendly review of four meta-analyses. Journal of Clinical Psychology, 65, 1232-1245.Google Scholar
  27. Markland, D., Ryan, R. M., Tobin, V.J. & Rollnick, S. (2005). Motivational interviewing and self-determination theory. Journal of Social and Clinical Psychology, 24, 811-831.Google Scholar
  28. Michalak, J., Klappheck, M.A. & Kosfelder, J. (2004). Personal goals of psychotherapy patients: The intensity and the ‘why’ of goal-motivated behavior and their implications for the psychotherapeutic process. Psychotherapy Research, 14, 193-209.Google Scholar
  29. Miller, W.R. (1996). Motivational interviewing: Research, practice, and puzzles. Addictive Behaviors, 21, 835-842.Google Scholar
  30. Miller, W.R. & Rollnick, S. (2002). Motivational interviewing. New York: Guilford.Google Scholar
  31. Miller, W.R. & Rose, G.S. (2009). Toward a Theory of Motivational Interviewing. American Psychologist, 64, 527-537.Google Scholar
  32. Ntoumanis, N., Edmunds, J. & Duda, J.L. (2009). Understanding the coping process from a self-determination theory perspective. British Journal of Health Psychology, 14, 249-260.Google Scholar
  33. Pelletier, L.G., Fortier, M.S., Vallerand, R.J. & Brière, N.M. (2001). Associations among perceived autonomy support, forms of self-regulation, and persistence: A prospective study. Motivation and Emotion, 25, 279-306.Google Scholar
  34. Pelletier, L.G., Tuson, K.M. & Haddad, N.K. (1997). Client motivation for therapy scale: A measure of intrinsic motivation, extrinsic motivation, and amotivation for therapy. Journal of Personality Assessment, 68, 414-435.Google Scholar
  35. Prochaska, J. O., DiClemente, C. C., & Norcross, J. C. (1992). In search of how people change: Applications to addictive behavior. American Psychologist, 47, 1102-114.Google Scholar
  36. Rogers, C. R. (1951). Client-centered therapy. Boston: Houghton-Mifflin.Google Scholar
  37. Roth, G., Assor, A., Niemiec, C.P., Ryan, R.M. & Deci, E.L. (2009). The emotional and academic consequences of parental conditional regard: Comparing conditional positive regard, conditional negative regard, and autonomy support as parenting practices. Developmental Psychology, 45, 1119–1142.Google Scholar
  38. Ryan, R.M. (1982). Control and information in the intrapersonal sphere: An extension of cognitive evaluation theory. Journal of Personality and Social Psychology, 43, 450-461.Google Scholar
  39. Ryan, R.M. (1995). Psychological needs and the facilitation of integrative processes. Journal of Personality, 63, 397-427.Google Scholar
  40. Ryan, R.M. & Connell, J.P. (1989). Perceived locus of causality and internalization – examining for acting in 2 domains. Journal of Personality and Social Psychology, 57, 749-761.Google Scholar
  41. Ryan, R.M. & Deci, E.L. (2000). Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. American Psychologist, 55, 68-78.Google Scholar
  42. Ryan, R.M. & Deci, E.L. (2008a). A self-determination theory approach to psychotherapy: The motivational basis for effective change. Canadian Psychology, 49, 186-193.Google Scholar
  43. Ryan, R.M. & Deci, E.L. (2008b). From ego-depletion to vitality: Theory and findings concerning the facilitation of energy available to the self. Social and Personality Psychology Compass, 2, 702-717.Google Scholar
  44. Ryan, R.M., Lynch, M.F., Vansteenkiste, M. & Deci, E.L. (in druk). Motivation and autonomy in counseling, psychotherapy, and behavior change: A look at theory and practice. Counseling Psychologist. Google Scholar
  45. Ryan, R.M., Patrick, H., Deci, E.L. & Williams, G.C. (2008). Facilitating health behaviour change and its maintenance: Interventions based on self-determination theory. The European Health Psychologist, 10, 2-5.Google Scholar
  46. 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, 279-297.Google Scholar
  47. Seligman, M.E.P. (1975). Helplessness: On depression, development, and death. San Francisco: W.H. Freeman.Google Scholar
  48. Senecal, C., Nouwen, A. & White, D. (2000). Motivation and dietary self-care in adults with diabetes: Are self-efficacy and autonomous self-regulation complementary or competing constructs? Health Psychology, 19, 452-457.Google Scholar
  49. Sheeran, P., Aubrey, R. & Kellett, S. (2007). Increasing attendance for psychotherapy: implementation intentions and the self-regulation of attendance-related negative affect. Journal of Consulting and Clinical Psychology, 75, 853-863.Google Scholar
  50. Sheldon, K.M., Williams, G.C. & Joiner, T. (2003). Self-determination theory in the clinic: Motivating physical and mental health. New Haven, CT: Yale University Press.Google Scholar
  51. Silva, M. N., Markland, D. A., Minderico, C. S., Vieira, P. N., Castro, M. M., Coutinho, S.S., Santos, T. C., Matos. M.G., Sardinha, L. B., & Teixeira, P. J. (2008). A randomized controlled trial to evaluate self-determination theory for exercise adherence and weight control: Rationale and intervention description. BMC Public Health, 8, 234-247.Google Scholar
  52. Skinner, E.A. & Edge, K. (2002). Self-determination, coping, and development. In E.L. Deci & R.M. Ryan (Eds), Handbook of self-determination research (pp. 297-337). Rochester, NY: University Of Rochester Press.Google Scholar
  53. Snyder, C.M.J. & Anderson, S.A. (2009). An examination of mandated versus voluntary referral determinant of clinical outcome. Journal of Marital and Family Therapy, 35, 278-292.Google Scholar
  54. Soenens, B., Vansteenkiste, M., Goossens, L., Duriez, B. & Niemiec, C. (2008). The intervening role of relational aggression between psychological control and friendship quality. Social Development, 17, 661-681.Google Scholar
  55. Stinckens, N. (2008). Werken met de innerlijke criticus: microtheorie van een procestaak. In G. Lietaer, G. Vanaerschot, J.A. Snijders & R.J. Takens (red.), Handboek Gesprekstherapie (pp. 433-456). Utrecht: De Tijdstroom.Google Scholar
  56. Tierny, D.W., & McCabe, M.P. (2002). Motivation for behavior change among sex offenders: A review of the literature. Clinical Psychology Review, 22, 113-129.Google Scholar
  57. Treasure, J. & Ward, A. (1997). A practical guide to the use of motivational interviewing in anorexia nervosa. European Eating Disorders Review, 5, 102-114.Google Scholar
  58. Vandereycken, W. (2006). Denial of illness in anorexia nervosa. A conceptual review: Part 1 Diagnostic significance and assessment. European Eating Disorders Review, 14, 341-351.Google Scholar
  59. Vandereycken, W. & Vansteenkiste, M. (2009). Let eating disorder patients decide: Providing choice may reduce early drop-out from inpatient treatment. European Eating Disorders Review, 17, 177-183.Google Scholar
  60. Vansteenkiste, M., Ryan, R.M. & Deci, E.L. (2008). Self-determination theory and the explanatory role of psychological needs in human well-being. In L. Bruni, F. Comim & M. Pugno (Eds.), Capabilities and happiness (pp. 187-223). Oxford: Oxford University Press.Google Scholar
  61. Vansteenkiste, M. & Sheldon, K. M. (2006). There’s nothing more practical than a good theory: Integrating motivational interviewing and self-determination theory. British Journal of Clinical Psychology, 45, 63-82.Google Scholar
  62. Vansteenkiste, M., Sierens, E., Soenens, B. & Lens, W. (2007). Willen, moeten en structuur: over het bevorderen van een optimaal leerproces. Begeleid Zelfstandig Leren, 37, 1-27.Google Scholar
  63. Vansteenkiste, M., Simons, J., Lens, W., Sheldon, K.M. & Deci, E.L. (2004). Motivating learning, performance, and persistence: The synergistic role of intrinsic goals and autonomy-support. Journal of Personality and Social Psychology, 87, 246-260.Google Scholar
  64. Vansteenkiste, M., Simons, J., Lens, W., Soenens, B. & Matos, L. (2005). Examining the motivational impact of intrinsic versus extrinsic goal framing and autonomy-supportive versus internally controlling communication style on early adolescents’ academic achievement. Child Development, 2, 483-501. Google Scholar
  65. Vansteenkiste, M., Soenens, B. & Vandereycken, W. (2005). Motivation to change in eating disorder patients: A conceptual clarification on the basis of self-determination theory international. Journal of Eating Disorders, 37, 207-219.Google Scholar
  66. Vansteenkiste, M., Soenens, B., Beyers, W., & Lens, W. (2008). Waarom we doen wat we niet graag doen: Het internalisatieproces toegelicht. Kind en Adolescent, 2, 64-79.Google Scholar
  67. Vansteenkiste, M., Verstuyf, J., Soenens, B. & Neyrinck, B. (2010). De complexiteit van beloningen verder belicht vanuit de zelfdeterminatietheorie: Worden ze als controlerend of informerend ervaren? Psychopraktijk, 2, 22-26.Google Scholar
  68. Vitousek, K., Watson, S. & Wilson, G.T. (1998). Enhancing motivation for change in treatment-resistant eating disorders. Clinical Psychology Review, 18, 391-420.Google Scholar
  69. Westra, H.A., Dozois, D.J.A. & Marcus, M. (2007). Expectancy, homework compliance, and initial change in cognitive-behavioral therapy for anxiety. Journal of Consulting and Clinical Psychology, 75, 363-373.Google Scholar
  70. 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, 1858-1872.Google Scholar
  71. 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 (pp. 233-254). Rochester, NY: University Of Rochester Press.Google Scholar
  72. Williams, G.C., McGregor, H.A., Sharp, D., Levesque, C., Kouides, R.W., Ryan, R.M. en anderen. (2006). Testing a self-determination theory intervention for motivating tobacco cessation: Supporting autonomy and competence in a clinical trial. Health Psychology, 25, 91-101.Google Scholar
  73. Williams, G.C., Rodin, G.C., Ryan, R.M., Grolnick, W.S. & Deci, E.L. (1998). Autonomous regulation and adherence to long-term medical regimens in adult outpatients. Health Psychology, 17, 269-276. Google Scholar
  74. 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, 115-126.Google Scholar
  75. 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, 675-696.Google Scholar
  76. Zuroff, D.C., Koestner, R., Moskowitz, D.S., McBride, C., Marshall, M. & Bagby, R.M. (2007). Autonomous motivation for therapy: A new common factor in brief treatments for depression. Psychotherapy Research, 17, 137-148.Google Scholar

Copyright information

© Bohn Stafleu van Loghum 2010

Authors and Affiliations

  • Maarten Vansteenkiste
  • Bart Neyrinck

There are no affiliations available

Personalised recommendations