The Predictive Capacity of Self-Reported Motivation vs. Observed Motivational Language in Cognitive Behavioural Therapy for Generalized Anxiety Disorder
Poulin, Lauren Elizabeth
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Client change motivation is considered a key factor in psychotherapy. Existing research on motivation has largely relied on self-report, which is prone to response bias and inconsistently related to treatment outcome. In contrast, early observed client in-session language may be a more valid measure of initial motivation. The present study investigated 85 clients undergoing cognitive behavioural therapy alone (CBT) or CBT infused with motivational interviewing (MI-CBT) for generalized anxiety disorder. The aims were: (1) to compare the predictive capacity of motivational language vs. self-reported motivation, and (2) to examine the influence of treatment condition on motivational language. Findings revealed motivational language explained up to 38% of outcome variance, even 1-year posttreatment. In contrast, self-reported motivation failed to predict outcome. Moreover, MI-CBT was associated with a decrease in detrimental motivational language compared to CBT alone. These findings support attending to motivational language in CBT and responding to these markers using MI.