Motivation and Success in Therapy

  • Author / Creator
    Buhr, Erin
  • Motivation is essential to achieve success in therapy, and as such, a lack of motivation is a significant problem for clients as they work to meet their goals. In this dissertation, I describe two studies that sought to understand better the factors that affect client motivation in order to provide more information so researchers and therapists can improve support to their clients. In the first study, I examined motivation from a self-determination theory perspective using a correlational survey design. One hundred and twelve individuals who had pursued one-on-one therapy completed a survey measuring their basic psychological needs and several therapeutic outcomes, such as motivation type (autonomous, introjected, and intrinsic motivation), effort, intention to persist, well-being, and perceived therapeutic improvement. I conducted a cluster analysis, which resulted in four combinations of the basic psychological needs: 1) needs met, 2) moderately met, 3) lower competence, and 4) needs unmet. The profiles were then tested to determine their association with various outcomes; specifically, I investigated whether the profiles were associated with the therapeutic outcomes listed above. In line with self-determination theory, the cluster with all the basic needs met was associated with the best outcomes. Participants in this cluster had higher autonomous motivation, effort, and therapeutic improvement than those in the other clusters. There were also some differences between the other clusters, and all results are discussed in light of practical implications for therapists, study limitations, and directions for future research. In the second study, I examined client experiences of low motivation from a qualitative perspective. Much of the literature on motivation in therapy is quantitative, where researchers statistically test theoretical constructs in relation to outcomes, as was the case for my first study. Although there are benefits to this approach, a limitation is that it can be prohibitive of determining whether motivational theories are missing key components of clients’ experience of motivation. I interviewed six individuals and conducted thematic analysis to understand better factors that contributed to a lack of motivation for therapy. I generated the following themes: 1) client/therapist voice, 2) efficacy beliefs, 3) therapist abilities, 4) relationships with others, and 5) triggered by a low point. I examined these themes in light of current theory and found that many were consistent with factors used in self-determination theory (autonomy, competence, relatedness), although the theme of being triggered by a low point stands out as separate from motivational theory. I discuss how the results apply not only to theory but to other aspects of research and practice, and conclude by commenting on limitations and directions for future research. Overall, through this dissertation, I illustrate that self-determination theory is valuable in improving our understanding of how therapists can foster autonomous motivation and other positive outcomes among clients by supporting their basic psychological needs. I highlight a summary of the most important results in the final discussion.

  • Subjects / Keywords
  • Graduation date
    Spring 2019
  • Type of Item
  • Degree
    Doctor of Philosophy
  • DOI
  • License
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