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Autonomy support and autonomous motivation in the outpatient treatment of adults with an eating disorder
Author(s) -
Steiger Howard,
Sansfaçon Jeanne,
Thaler Lea,
Leonard Niamh,
Cottier Danaëlle,
Kahan Esther,
Fletcher Emilie,
Rossi Erika,
Israel Mimi,
Gauvin Lise
Publication year - 2017
Publication title -
international journal of eating disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.785
H-Index - 138
eISSN - 1098-108X
pISSN - 0276-3478
DOI - 10.1002/eat.22734
Subject(s) - autonomy , psychology , anorexia nervosa , bulimia nervosa , self determination theory , eating disorders , clinical psychology , psychotherapist , political science , law
Abstract Objective Across diverse clinical problems, therapists’ autonomy support has been found to increase patients’ autonomous motivation for change. Being self‐motivated has, in turn, been linked to superior treatment response. In people undergoing outpatient eating disorder (ED) treatment, we examined associations among ratings of autonomy support received from therapists and other carers, self‐reported engagement in therapy, and clinical outcomes. Method Ninety‐seven women with anorexia nervosa, bulimia nervosa, or a related ED provided measures of motivational status and clinical symptoms at the beginning and end of time‐limited (12–16 weeks) segments of specialized treatment. At mid‐treatment, patients also rated the extent to which they perceived their individual therapists, group therapists, group‐therapy peers, family members, friends, and romantic partners as being autonomy supportive. Results Overall, multiple regression analyses indicated autonomy support to moderate (rather than mediate) the link between initial autonomous motivation and later change in autonomous motivation—with results indicating that, independently of ED diagnosis or treatment intensity, greater perceived autonomy support (from therapists and nontherapists alike) coincided with larger increases in autonomous motivation over the course of therapy. In turn, higher autonomous motivation at end‐of‐therapy coincided with larger reductions in eating symptoms. Discussion Findings suggest that the experience of autonomy support (from therapists and nontherapists) is associated with increasing motivation in people undergoing ED treatment, and that becoming self‐motivated is linked to better outcomes. Such results indicate that support from therapists, relatives, and peers can favorably influence personal engagement in individuals undergoing ED treatment.