This theoretical paper presents arguments for the significance of the location of motivation in the practice of clinical psychology. Identifying the externality and internality of motivation is argued to be clinically relevant in assessing psychopathology as this can potentially resolve comorbidity issues and improve diagnostic reliability. Furthermore, psychotherapeutic interventions can be tailored to the location of motivation. Extrinsically motivated pathological behaviours can be addressed through behaviour-based approaches, while intrinsically motivated behaviours need more long-term and in-depth therapeutic approaches. Lastly, prognosis can be assumed when the location of motivation has been identified – with extrinsically motivated behaviours having better prognosis than intrinsically motivated behaviours. Some directions for future research include testing the validity and reliability of motivation-based diagnosis, evaluating the effectiveness of matching the location of motivation with type of psychotherapy intervention, and comparing the effectiveness of motivation-matched interventions and disorder-based interventions.
This study utilized a sequential explanatory mixed-methods design in understanding the secondary system of therapeutic alliance from the perspectives of parents and caregivers of children with autism. In the quantitative phase, data from the accomplished questionnaires of 124 parent–caregiver dyads were collected and analyzed. Four factors extracted from the literature: treatment attitude, treatment compliance, level of stress, and perceived autism severity were examined as possible predictors of parent–therapist alliance, caregiver–therapist alliance, and parent–caregiver alliance. In the qualitative phase, eight parent–caregiver dyads (who both scored high in their alliance with therapist, alliance with each other, treatment attitude, treatment compliance, and level of stress) were interviewed to probe on their experiences of alliance-building, parenting, and caregiving. The integration of both quantitative and qualitative data led to the formulation of a conceptual framework that explains how the factors influence the secondary system of therapeutic alliance. These findings emphasize that tapping into the personal experiences of parents and caregivers can help in identifying what they value in a working, therapeutic relationship. Moreover, communication, skills training, and feedback among therapists, parents, and caregivers are essential to enhance positive attitude toward treatment, promote compliance to treatment recommendations, and address sources of personal stress. Nevertheless, this study calls for future studies to build into the factors associated with the systemic therapeutic alliance and to implement intervention programs that may target issues relating to attitude toward treatment, compliance to treatment, and experience of parental and caregiver stress.
Introduction: This study focuses on a boy with autism spectrum disorder presenting with biting behaviors that interfere significantly with functioning.
Method: This was a single-case study design examining how techniques of applied behavior analysis can be utilized to decrease the frequency of the child’s biting behavior and increase more adaptive behaviors.
Results: The findings of the functional analysis indicated that other-inflicted biting behaviors were maintained by contingent escape from task demands (demand condition) and access to preferred objects and activities (tangible condition). Moreover, the self-inflicted biting behavior was found to be maintained by sensory stimulation (alone condition). Given these, a structured behavioral intervention, consisting of differential reinforcement of alternative behaviors, coupled with extinction targeted to each function of the behavior, was effective in reducing other-inflicted biting behavior in the demand conditions (67% reduction) and in the tangible conditions (95% reduction) as well as reducing self-inflicted behaviors in the alone conditions (100% reduction). More appropriate, adaptive behaviors like compliance, picture-assisted requests, and oral sensory activities also increased significantly.
Conclusion: These findings indicate that assessment and treatment based on the principles of applied behavior analysis can reduce not only problematic behaviors but also improve adaptive functioning.