Of note, there is controversy regarding the ability of
clinicians to accurately assess motivation, and whether
this predicts anything about the likelihood of engagement
or even treatment outcome. Waller [19] provides a
compelling overview of the complexities involved, including
clinician overreliance on verbal expressions of change.
Interestingly, similar critical analyses are now being extended
to motivational enhancement techniques, noting
that in regard to AN, the evidence is mixed at best [20].
Rieger et al. [21] specifically suggests motivation is not
only required to alter the behavioural aspects of the illness
(namely how much weight are patients are prepared to
gain each week until they reach a healthy weight, and
how motivated they feel to be at a normal weight) but
also feeling of self-efficacy about achieving this. Some
patients will state that they are very motivated to be at a
normal weight and would be prepared to gain up to a
kilo a week to do so, but when asked how confident they
are that they can actually do this, the answer is quite
different.
Of note, there is controversy regarding the ability ofclinicians to accurately assess motivation, and whetherthis predicts anything about the likelihood of engagementor even treatment outcome. Waller [19] provides acompelling overview of the complexities involved, includingclinician overreliance on verbal expressions of change.Interestingly, similar critical analyses are now being extendedto motivational enhancement techniques, notingthat in regard to AN, the evidence is mixed at best [20].Rieger et al. [21] specifically suggests motivation is notonly required to alter the behavioural aspects of the illness(namely how much weight are patients are prepared togain each week until they reach a healthy weight, andhow motivated they feel to be at a normal weight) butalso feeling of self-efficacy about achieving this. Somepatients will state that they are very motivated to be at anormal weight and would be prepared to gain up to akilo a week to do so, but when asked how confident theyare that they can actually do this, the answer is quitedifferent.
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