motivatiedeficit, onmacht of een dubbeltje op zijn...
TRANSCRIPT
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Motivatiedeficit, onmacht of een dubbeltje op zijn kant?
Herstel en re-integratie bij afhankelijkheid
Charlotte Vanovenberghe CM – KULeuven
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30%
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Intrinsiek – extrinsiek
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Autonomie
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Relationele verbondenheid
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Competentie
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30%
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Zelfdeterminatietheorie
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Zelfdeterminatietheorie
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Zelfdeterminatietheorie
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Extern
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Zelfdeterminatietheorie
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Introjectie
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Zelfdeterminatietheorie
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Zelfdeterminatietheorie
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Zelfdeterminatietheorie
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Autonome motivatie -therapietrouw
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Autonome motivatie -
methadonbehandeling
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Alcohol
Ryan, R. M., Plant, R. W., & O'Malley, S. (1995). Initial motivations for alcohol treatment: Relations with patient characteristics, treatment involvement, and dropout.
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Onderzoek
TherapietrouwGewichtsverlies:
↑ interne ↓ externe M
Alcoholafhankelijkheid: ↑ interne ↑ externe M
Methadon: ↑ interne soms ↑ externe M
MAAR intern steeds voorwaarde
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Motivational Interviewing
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Motivational Interviewing
“Motiverende Gespreksvoering is een op samenwerking gerichte
gespreksstijl die iemands eigen motivatie en bereidheid tot
verandering versterkt.”
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SSRR
DDEE
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SSRR
DDEE
Express Empathy
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SSRR
DDEEDevelop Discrepancy
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Keuzevrijheid
Liang Meng Qingguo Ma
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Keuzevrijheid
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SSRR
DDEE
Roll with Resistance
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SSRR
DDEE
Support Self-efficacy
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Change talk
Barnett, e.a. From counselor skill to decreased marijuana use: Does change talk matter?
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MI
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Lundahl, B., & Burke, B. L. (2009). The effectiveness and applicability of motivational interviewing: A practice‐friendly review of four meta‐analyses.
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GMI – middelenafhankelijkheid
Santa Ana et. Al. (2005). Efficacy of group motivational interviewing (GMI) forpsychiatric inpatients with chemical dependence.
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MI – intrinsieke motivatie?
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ZDT – MI
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Take home message
• Cave gedwongen hulpverlening
• Externe motivatie kan succesvol zijn, maar enkel als vergezeld door interne motivatie
• Cave expertrol
• Motiverende gesprekstechnieken interfereren niet met de lopende behandeling
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ReferentiesAltman, H., Evenson, R., & Cho, D. (1978). Predicting length of stay by patients hospitalized for alcoholism or drug dependence. Journal of Studies on Alcohol, 39, 197-201.
Burke, B. L., Arkowitz, H., & Menchola, M. (2003). The efficacy of motivational interviewing: a meta-analysis of controlled clinical trials.
Barnett, E., Moyers, T. B., Sussman, S., Smith, C., Rohrbach, L. A., Sun, P., & Spruijt-Metz, D. (2014). From counselor skill to decreasedmarijuana use: Does change talk matter?. Journal of substance abuse treatment, 46(4), 498-505.
Larimer, M. E., & Palmer, R. S. (1999). Relapse prevention: An overview of Marlatt's cognitive-behavioral model. Alcohol research and Health, 23(2), 151-160.
Markland, D., Ryan, R. M., Tobin, V. J., & Rollnick, S. (2005). Motivational interviewing and self–determination theory. Journal of social andclinical psychology, 24(6), 811-831.
Meng, L., & Ma, Q. (2015). Live as we choose: The role of autonomy support in facilitating intrinsic motivation. International Journal of Psychophysiology, 98(3), 441-447.
Miller, W. (1985). Motivation for treatment: A review with special emphasis on alcoholism. Psychological Bulletin, 98, 84-107.
Ryan, R. M. (1995). Psychological needs and the facilitation of integrative processes. Journal of personality, 63(3), 397-427.
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(3), 279-297.
Santa Ana, E. J., Wulfert, E., & Nietert, P. J. (2007). Efficacy of group motivational interviewing (GMI) for psychiatric inpatients with chemical dependence. Journal of Consulting and Clinical Psychology, 75(5), 816.
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ReferentiesSheldon, K. M., Joiner, T., & Williams, G. (2003). Motivating health: Applying self-determination theory in the clinic. Yale: Yale University Press
Simoneau, H., & Bergeron, J. (2003). Factors affecting motivation during the first six weeks of treatment. Addictive behaviors, 28(7), 1219-1241.
Stein, L. A. R., & Lebeau-Craven, R. (2002). Motivational interviewing and relapse prevention for DWI: A pilot study. Journal of drug issues, 32(4), 1051-1070.
Vansteenkiste, M., & Sheldon, K. M. (2006). There's nothing more practical than a good theory: Integrating motivational interviewingand self‐determination theory. British journal of clinical psychology, 45(1), 63-82.
Warneken, F., & Tomasello, M. (2009). The roots of human altruism. British Journal of Psychology, 100(3), 455-471.
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(10), 1858-1872.
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(1), 115.
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. Rochester: University of Rochester Press.
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(5), 675-696.