Skip to main content

Advertisement

Log in

Self-Determination Theory and Outpatient Follow-Up After Psychiatric Hospitalization

  • Brief Report
  • Published:
Community Mental Health Journal Aims and scope Submit manuscript

Abstract

The objective of this study was to assess whether the constructs of self-determination theory—autonomy, competence, and relatedness—are associated with adherence to outpatient follow-up appointments after psychiatric hospitalization. 242 individuals discharged from inpatient psychiatric treatment within the Veterans Health Administration completed surveys assessing self-determination theory constructs as well as measures of depression and barriers to treatment. Medical records were used to count the number of mental health visits and no-shows in the 14 weeks following discharge. Logistic regression models assessed the association between survey items assessing theory constructs and attendance at mental healthcare visits. In multivariate models, none of the self-determination theory factors predicted outpatient follow-up attendance. The constructs of self-determination theory as measured by a single self-report survey may not reliably predict adherence to post-hospital care. Need factors such as depression may be more strongly predictive of treatment adherence.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

References

  • Cronin, P., & Kimball, A. (2014). Success of automated algorithmic scheduling in an outpatient setting. American Journal of Managed Care, 20(7), 570–576.

    PubMed  Google Scholar 

  • Green, C. A., Perrin, N. A., Polen, M. R., Leo, M. C., Hibbard, J. H., & Tusler, M. (2010). Development of the patient activation measure for mental health. Administration and Policy In Mental Health, 37(4), 327–333. doi:10.1007/s10488-009-0239-6.

    Article  PubMed  Google Scholar 

  • Klag, S. M., Creed, P., & O’Callaghan, F. (2010). Early motivation, well-being, and treatment engagement of chronic substance users undergoing treatment in a therapeutic community setting. Substance Use and Misuse, 45(7–8), 1112–1130. doi:10.3109/10826080903499562.

    Article  PubMed  Google Scholar 

  • Kroenke, K., Spitzer, R. L., & Williams, J. B. (2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16(9), 606–613.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Levesque, C. S., Williams, G. C., Elliot, D., Pickering, M. A., Bodenhamer, B., & Finley, P. J. (2007). Validating the theoretical structure of the Treatment Self-Regulation Questionnaire (TSRQ) across three different health behaviors. Health Education Research, 22(5), 691–702. doi:10.1093/her/cyl148.

    Article  PubMed  Google Scholar 

  • Mohr, D. C., Ho, J., Duffecy, J., Baron, K. G., Lehman, K. A., Jin, L., et al. (2010). Perceived barriers to psychological treatments and their relationship to depression. Journal of Clinical Psychology, 66(4), 394–409. doi:10.1002/jclp.20659.

    PubMed  PubMed Central  Google Scholar 

  • Pfeiffer, P. N., Bowersox, N., Birgenheir, D., Burgess, J., Forman, J., & Valenstein, M. (2015). Preferences and barriers to care following psychiatric hospitalization at two veterans affairs medical centers: A mixed methods study. Journal of Behavioral Health Services & Research. doi:10.1007/s11414-015-9460-0.

  • Pfeiffer, P. N., Ganoczy, D., Zivin, K., McCarthy, J. F., Valenstein, M., & Blow, F. C. (2012). Outpatient follow-up after psychiatric hospitalization for depression and later readmission and treatment adequacy. Psychiatric Services (Washington, D. C.), 63(12), 1239–1242. doi:10.1176/appi.ps.201100511.

    Article  Google Scholar 

  • Rowe, C. A., Walker, K. L., Britton, P. C., & Hirsch, J. K. (2013). The relationship between negative life events and suicidal behavior: Moderating role of basic psychological needs. Crisis, 34(4), 233–241. doi:10.1027/0227-5910/a000173.

    Article  PubMed  Google Scholar 

  • Ryan, R. M., & Deci, E. L. (2000). Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. American Psychologist, 55(1), 68–78.

    Article  CAS  PubMed  Google Scholar 

  • Troister, T., Links, P. S., & Cutcliffe, J. (2008). Review of predictors of suicide within 1 year of discharge from a psychiatric hospital. Current Psychiatry Reports, 10(1), 60–65.

    Article  PubMed  Google Scholar 

  • Valenstein, M., Copeland, L. A., Blow, F. C., McCarthy, J. F., Zeber, J. E., Gillon, L., et al. (2002). Pharmacy data identify poorly adherent patients with schizophrenia at increased risk for admission. Medical Care, 40(8), 630–639. doi:10.1097/01.MLR.0000021003.43524.64.

    Article  PubMed  Google Scholar 

  • Williams, G. C., Deci, E. L., & Ryan, R. M. (1998). Building health-care partnerships by supporting autonomy: Promoting maintained behavior change and positive health outcomes. In A. L. Suchman, P. Hinton-Walker, & R. Botelho (Eds.), Partnerships in healthcare: Transforming relational process (pp. 67–87). Rochester, NY: University of Rochester Press.

    Google Scholar 

  • Zimet, G. D., Dahlem, N. W., Zimet, S. G., & Farley, G. F. (1988). The multidimensional scale of perceived social support. Journal of Personality Assessment, 52(1), 30–41.

    Article  Google Scholar 

  • Zuroff, D. C., Koestner, R., Moskowitz, D. S., McBride, C., Marshall, M., & Bagby, M. R. (2007). Autonomous motivation for therapy: A new common factor in brief treatments for depression. Psychotherapy Research, 17(2), 137–147.

    Article  Google Scholar 

Download references

Acknowledgments

This work was undertaken as part of the Veterans Administration’s PACT Demonstration Laboratory initiative, supporting and evaluating VA’s transition to a patient-centered medical home. Funding for the PACT Demonstration Laboratory initiative is provided by the VA Office of Patient Care Services. Funding was also provided by the Department of Veterans Affairs Health Services Research and Development Service (HSR&D). Writing of this manuscript was supported by the Department of Veterans Affairs Office of Academic Affiliations, Advanced Fellowship Program in Mental Illness Research and Treatment, the Veterans Affairs Serious Mental Illness Treatment Resource and Evaluation Center (SMITREC) and the VA Ann Arbor Healthcare System.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Rebecca K. Sripada.

Ethics declarations

Conflict of interest

The authors declare no conflicts of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sripada, R.K., Bowersox, N.W., Ganoczy, D. et al. Self-Determination Theory and Outpatient Follow-Up After Psychiatric Hospitalization. Community Ment Health J 52, 662–666 (2016). https://doi.org/10.1007/s10597-015-9929-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10597-015-9929-6

Keywords

Navigation