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A mixed-methods investigation into impact of motivation type on adherence and effect in iCBT for binge eating disorder
Published online by Cambridge University Press: 19 July 2023
Abstract
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Introduction
Motivation is an important factor in therapy and potentially even more so in an online setting. Earlier research shows that more autonomously motivated patients have better outcomes and completion rates than more controlled motivated patients´. However, little is known about how motivation type influences treatment effect in an online setting and in patients with binge eating disorder specifically.
Objectives
This study set out to investigate how motivation type as per the Self-Determination Theory would affect treatment adherence and effect in a sample of 148 patients, undergoing an Internet-based Cognitive Behavioral Therapy (iCBT) for BED.
Methods
The study was mixed-methods. A sample of 148 patients gave two written qualitative statements regarding their motivation for seeking treatment and reasons for choosing online therapy
The statements were transformed into quantitative units via the condensation method. The themes were categorized according to the model by Ryan and Deci based on level of autonomy and perceived locus of causality.
This was compared with completion rate and outcomes on eating disorder symptomatology. Completion was designated into three groups. Low adherers - less than six sessions (n=54), high adherers – between 7 and 10 sessions (n =56) and full adherers - 10 session plus follow up (n=37).
The effect of the treatment was measured via the Eating Disorder Examination Questionnaire (EDEQ) and Binge Eating Disorder Questionnaire (BEDQ).
Resultsshows the distribution of patients’ motivational types regarding therapy aims
Table 2shows the distribution of patients´motivational types regarding online treatment
Table 3shows the results from morivational types in each setting on BEDQ and EDEQ scores. No significant correlation was found.
Table 1
| Controlled | → | Autonomous | |||
|---|---|---|---|---|---|
| Motivational type: | Introjection | Introjection | Identification | Integration | |
| Patient motivation: | Shame | Weight loss | Psychologicalstress | Insight | In all |
| In all | 25 | 25 | 50 | 48 | 148 |
| Controlled | → | Autonomous | |||
|---|---|---|---|---|---|
| Motivational type: | Introjection | Introjection | Identification | Integration | |
| Patient motivation: | External | Avoidance | Convenience | Reflection | In All |
| In all | 31 | 21 | 81 | 15 | 148 |
| Therapy Aims | BEDQ | 0.92 |
| EDEQ | 0.51 | |
| Why Online Therapy | BEDQ | 0.99 |
| EDEQ | 0.23 |
Conclusions
Perceived locus of causality and level of autonomy, did not affect level of adherence or outcome of treatment in either setting. This unexpected result may suggest that internet-based therapy is less dependent on motivation types, when comparing with face-to-face treatment.
Disclosure of Interest
None Declared
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- Information
- European Psychiatry , Volume 66 , Special Issue S1: Abstracts of the 31st European Congress of Psychiatry , March 2023 , pp. S461
- Creative Commons
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.- Copyright
- © The Author(s), 2023. Published by Cambridge University Press on behalf of the European Psychiatric Association
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