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Open Access Study protocol

Motivation and treatment engagement intervention trial (MotivaTe-IT): the effects of motivation feedback to clinicians on treatment engagement in patients with severe mental illness

Eline C Jochems1*, Cornelis L Mulder1, Arno van Dam2, Hugo J Duivenvoorden3, Sylvia CM Scheffer2, Willem van der Spek4 and Christina M van der Feltz-Cornelis456

Author affiliations

1 Department of Psychiatry, Epidemiological and Social Psychiatric Research institute, Erasmus University Medical Centre, Dr. Molewaterplein 50, Rotterdam, 3015 GE, The Netherlands

2 GGZ Westelijk Noord Brabant, Post Office Box 371, Bergen op Zoom, 4600 AJ, The Netherlands

3 2e De Carpentierstraat 232, The Hague, 2595 HN, The Netherlands

4 GGZ Breburg, Post Office Box 770, Tilburg, 5000 AT, The Netherlands

5 Faculty of Social Sciences, Tilburg University, Post Office Box 90153, Tilburg, 5000 LE, The Netherlands

6 Netherlands Institute of Mental Health and Addiction (Trimbos Institute), PO Box 725, Utrecht, 3500 AS, The Netherlands

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Citation and License

BMC Psychiatry 2012, 12:209  doi:10.1186/1471-244X-12-209

Published: 24 November 2012

Abstract

Background

Treatment disengagement and non-completion poses a major problem for the successful treatment of patients with severe mental illness. Motivation for treatment has long been proposed as a major determinant of treatment engagement, but exact mechanisms remain unclear. This current study serves three purposes: 1) to determine whether a feedback intervention based on the patients’ motivation for treatment is effective at improving treatment engagement (TE) of severe mentally ill patients in outpatient psychiatric treatment, 2) to gather insight into motivational processes and possible mechanisms regarding treatment motivation (TM) and TE in this patient population and 3) to determine which of three theories of motivation is most plausible for the dynamics of TM and TE in this population.

Methods/design

The Motivation and Treatment Engagement Intervention Trial (MotivaTe-IT) is a multi-center cluster randomized trial investigating the effectiveness of feedback generated by clinicians regarding their patients’ treatment motivation upon the patients’ TE. The primary outcome is the patients’ TE. Secondary outcomes are TM, psychosocial functioning and quality of life. Patients whose clinicians generate monthly motivation feedback (additional to treatment as usual) will be compared to patients who receive treatment as usual. An estimated 350 patients, aged 18 to 65 years, with psychotic disorders and/or severe personality disorders will be recruited from outpatient community mental health care. The randomization will be performed by a computerized randomization program, with an allocation ratio of 1:1 (team vs. team or clinician vs. clinician) and patients, but not clinicians, will be blind to treatment allocation at baseline assessment. Due to the nature of the trial, follow-up assessment can not be blinded.

Discussion

The current study can provide important insights regarding motivational processes and the way in which motivation influences the treatment engagement and clinical outcomes. The identification of possible mechanisms through which changes in the outcomes occur, offers a tool for the development of more effective future interventions to improve TM and TE.

Trial registration

Current Controlled Trials NTR2968