| The American Psychiatric Association in cooperation with the National Remotivation Therapy Organization developed standards for training and practice in 1971 based on the research/evidence cited below prior to 1971.
Some of the studies listed below are from an Annotated Bibliography of Research on Remotivation Therapy authored by John R. Bierma, MA, HFA, CRmT and edited by Connie Brooks Batts, CRmT; Barbara Herlihy-Chavelier, RN, MSN, CRmT and Hugh McElroy, CRmT published in 1992 and copyrighted by the National Remotivation Therapy Organization Inc.
Most of the cited studies described below have been published or referenced in professionally reviewed journals or by Dissertations Abstarcts International or abstracts from the National Library of Medicine, www.pubmed.gov . The doctoral dissertations were reviewed and approved by the sponsoring universities as part of the granting of a terminal degree.
International Research on Remotivation
Alzheimer's Disease
New research on Alzheimers disease supports the efficacy of remotivaiton therapy. Remotivation facilitates the person to focus ouside themselves on objective reality, life outside themselves and their environment. This research shows that subjective self thought on personal problems and feelings may contribute to the development of alzheimers. So remotivation may help prevent or slow alzheimers by facilitating "outsite".
Interpersonal Climate of Acceptance (Step #1 of Remotivation)
Research on acceptance, appreciation, psychoeducation and health empowerment interventions have been added to this summary of research. These catagories of therapies support the efficacy of remotivation as these concepts and methods are incorporated in its delivery.
A recent area of behavioral reseach has been acceptance-based therapies. The primary behavioral concept in remotivation therapy has been creating a climate of acceptance (Step I of Remotivation) in the relationship with each patient and modeling acceptance to group members. This is an area of research that also supports the efficacy of remotivation therapy.
Reseach is important and informs our service to others, but our experience also informs us. Remotivation's use of acceptance has shown it to be an effective method of helping others. This quote from the Wikipedia description of Acceptance and Commitment Therapy captures some of this truth. http://en.wikipedia.org/wiki/Acceptance_and_commitment_therapy
Wilson, Hayes & Byrd [17] explore at length the compatibilities between ACT and the 12-step treatment of addictions and argue, unlike most other psychotherapies, both approaches can be implicitly or explicitly integrated due to their broad commonalities. Both approaches endorse acceptance as an alternative to unproductive control. ACT emphasises the hopelessness of relying on ineffectual strategies to control private experience, similarly the 12-step approach emphasises the acceptance of powerlessness over addiction. Both approaches encourage a broad life reorientation, rather than a narrow focus on the elimination of substance use, and both place great value on the long term project of building of a meaningful life aligned with the clients values. ACT and 12-step both encourage the pragmatic utility of cultivating a transcendent sense of self (higher power) within an unconventional, individualised spirituality. Finally they both openly accept the paradox that acceptance is a necessary condition for change and both encourage a playful awareness of the limitations of human thinking.
Pain. 2011 Mar;152(3):533-42. Epub 2011 Jan 19.
Acceptance-based interventions for the treatment of chronic pain: A systematic review and meta-analysis.
Veehof MM, Oskam MJ, Schreurs KM, Bohlmeijer ET.
University of Twente, Enschede, The Netherlands.
Abstract
Acceptance-based interventions such as mindfulness-based stress reduction program and acceptance and commitment therapy are alternative therapies for cognitive behavioral therapy for treating chronic pain patients. To assess the effects of acceptance-based interventions on patients with chronic pain, we conducted a systematic review and meta-analysis of controlled and noncontrolled studies reporting effects on mental and physical health of pain patients. All studies were rated for quality. Primary outcome measures were pain intensity and depression. Secondary outcomes were anxiety, physical wellbeing, and quality of life. Twenty-two studies (9 randomized controlled studies, 5 clinical controlled studies [without randomization] and 8 noncontrolled studies) were included, totaling 1235 patients with chronic pain. An effect size on pain of 0.37 was found for the controlled studies. The effect on depression was 0.32. The quality of the studies was not found to moderate the effects of acceptance-based interventions. The results suggest that at present mindfulness-based stress reduction program and acceptance and commitment therapy are not superior to cognitive behavioral therapy but can be good alternatives. More high-quality studies are needed. It is recommended to focus on therapies that integrate mindfulness and behavioral therapy. Acceptance-based therapies have small to medium effects on physical and mental health in chronic pain patients. These effects are comparable to those of cognitive behavioral therapy.
Copyright © 2010 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.
PMID: 21251756 [PubMed - in process]
Am J Public Health. 2010 Dec;100(12):2372. Epub 2010 Oct 21.
Mental health promotion as a new goal in public mental health care: a randomized controlled trial of an intervention enhancing psychological flexibility.
Fledderus M, Bohlmeijer ET, Smit F, Westerhof GJ.
Department of Psychology and Communication of Health and Risk, University of Twente, Enschede, The Netherlands. m.fledderus@utwente.nl
Abstract
OBJECTIVES: We assessed whether an intervention based on acceptance and commitment therapy (ACT) and mindfulness was successful in promoting positive mental health by enhancing psychological flexibility.
METHODS: Participants were 93 adults with mild to moderate psychological distress. They were randomly assigned to the group intervention (n = 49) or to a waiting-list control group (n = 44). Participants completed measures before and after the intervention as well as 3 months later at follow-up to assess mental health in terms of emotional, psychological, and social well-being (Mental Health Continuum-Short Form) as well as psychological flexibility (i.e., acceptance of present experiences and value-based behavior, Acceptance and Action Questionnaire-II).
RESULTS: Regression analyses showed that compared with the participants on the waiting list, participants in the ACT and mindfulness intervention had greater emotional and psychological well-being after the intervention and also greater psychological flexibility at follow-up. Mediational analyses showed that the enhancement of psychological flexibility during the intervention mediated the effects of the intervention on positive mental health.
CONCLUSIONS: The intervention is effective in improving positive mental health by stimulating skills of acceptance and value-based action.
PMID: 20966360 [PubMed - indexed for MEDLINE]
Emotion. 2008 Jun;8(3):419-24.
Effects of acceptance-oriented versus evaluative emotional processing on heart rate recovery and habituation.
Low CA, Stanton AL, Bower JE.
Department of Psychology, University of California, Los Angeles, CA 90095-1563, USA.
Abstract
The effects of emotional processing on stress response trajectories may depend on the nature of processing, as evaluative rumination about emotions can prolong distress. In contrast, observing negative emotions in an accepting manner may promote efficient recovery from stressful situations. The present study examined the effect of acceptance-oriented versus evaluative emotional processing on cardiovascular habituation and recovery. Across two experimental sessions, 81 participants were randomly assigned to write about an ongoing stressful experience while either (1) evaluating the appropriateness of their emotional response (EVAL), (2) attending to their emotions in an accepting way (ACC), or (3) describing the objective details of the experience (CTL). Heart rate was assessed continuously throughout baseline, writing, and recovery. Results suggest that writing about emotions in an evaluative way leads to less efficient heart rate habituation and recovery than processing emotions in an accepting manner. These findings highlight a potential mechanism of mindfulness- and acceptance-based interventions' effects on health outcomes and further suggest that habitually evaluating the appropriateness of one's emotional responses rather than accepting them as they unfold may have consequences for cardiovascular health.
(Copyright) 2008 APA, all rights reserved.
PMID: 18540758 [PubMed - indexed for MEDLINE]
Clin Psychol Rev. 2008 Jan;28(1):1-16. Epub 2007 Sep 18.
Acceptance and mindfulness-based therapy: new wave or old hat?
Hofmann SG, Asmundson GJ.
Department of Psychology, Boston University, 648 Beacon Street, 6th Floor, Boston, MA 02215-2002, United States. shotmann@bu.edu
Abstract
Some contemporary theorists and clinicians champion acceptance and mindfulness-based interventions, such as Acceptance and Commitment Therapy (ACT), over cognitive-behavioral therapy (CBT) for the treatment of emotional disorders. The objective of this article is to juxtapose these two treatment approaches, synthesize, and clarify the differences between them. The two treatment modalities can be placed within a larger context of the emotion regulation literature. Accordingly, emotions can be regulated either by manipulating the evaluation of the external or internal emotion cues (antecedent-focused emotion regulation) or by manipulating the emotional responses (response-focused emotion regulation). CBT and ACT both encourage adaptive emotion regulation strategies but target different stages of the generative emotion process: CBT promotes adaptive antecedent-focused emotion regulation strategies, whereas acceptance strategies of ACT counteract maladaptive response-focused emotion regulation strategies, such as suppression. Although there are fundamental differences in the philosophical foundation, ACT techniques are fully compatible with CBT and may lead to improved interventions for some disorders. Areas of future treatment research are discussed.
PMID: 17904260 [PubMed - indexed for MEDLINE]
Behav Res Ther. 2006 Sep;44(9):1251-63. Epub 2005 Nov 21.
Effects of suppression and acceptance on emotional responses of individuals with anxiety and mood disorders.
Campbell-Sills L, Barlow DH, Brown TA, Hofmann SG.
Department of Psychiatry (0985), University of California, San Diego, 8950 Villa La Jolla Drive, Suite C207, La Jolla, CA 92037, USA. campbell-sills@ucsd.edu
Abstract
The present investigation compared the subjective and physiological effects of emotional suppression and acceptance in a sample of individuals with anxiety and mood disorders. Sixty participants diagnosed with anxiety and mood disorders were randomly assigned to one of two groups. One group listened to a rationale for suppressing emotions, and the other group listened to a rationale for accepting emotions. Participants then watched an emotion-provoking film and applied the instructions. Subjective distress, heart rate, skin conductance level, and respiratory sinus arrhythmia were measured before, during, and after the film. Although both groups reported similar levels of subjective distress during the film, the acceptance group displayed less negative affect during the post-film recovery period. Furthermore, the suppression group showed increased heart rate and the acceptance group decreased heart rate in response to the film. There were no differences between the two groups in skin conductance or respiratory sinus arrhythmia. These findings are discussed in the context of the existing body of research on emotion regulation and current treatment approaches for anxiety and mood disorders.
PMID: 16300723 [PubMed - indexed for MEDLINE]
Patient Educ Couns. 2010 Apr 16. [Epub ahead of print]
Patient education in groups increases knowledge of osteoporosis and adherence to treatment: A two-year randomized controlled trial.
Nielsen D, Ryg J, Nielsen W, Knold B, Nissen N, Brixen K.
Department of Endocrinology, Odense University Hospital, Odense C, Denmark; Institute of Clinical Research, University of Southern Denmark, Denmark.
Abstract
Non-adherence to pharmacological treatment in osteoporosis is a well-recognized problem. We hypothesized that a group-based educational programme would increase patients' knowledge and level of adherence with medical treatment. A total of 300 patients (32 men aged 65+/-9 years and 268 women aged 63+/-8 years), recently diagnosed with osteoporosis, were randomised to either an osteoporosis school programme (four classes of 8-12 participants over four weeks) or a control group. Teaching was multidisciplinary, based on patients' experiences and background and designed to encourage empowerment. Patients' knowledge about osteoporosis and adherence to treatment was assessed with self-completed questionnaires at baseline and after 3, 12, and 24 months. There were no significant differences at baseline between the two groups with respect to knowledge score or level of adherence. At two years' follow-up, the improvement in knowledge score was 2 [0-4] points (median [25-75 percentiles]) in the school group and 0 [-2 to 2] in controls (p<0.001) and self-reported adherence to pharmacological therapy was significantly higher in the school group (92%) compared to the control group (80%), p<0.001. The programme increased knowledge about osteoporosis and increased self-reported adherence to pharmacological treatment over a period of two years. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
PMID: 20400258 [PubMed - as supplied by publisher]
Hu Li Za Zhi. 2010 Apr;57(2):49-60.
[Relationships between emotional distress, empowerment perception and self-care behavior and quality of life in patients with type 2 diabetes.]
[Article in Chinese]
Liu MY, Tai YK, Hung WW, Hsieh MC, Wang RH.
College of Nursing, Kaohsiung Medical University, ROC. wrhsia@kmu.edu.tw.
Abstract
Background: Diabetes mellitus is a chronic disorder prevalent worldwide that, in addition to being costly to manage, severely impacts patient quality life. Therefore, it is extremely important to understand the factors associated with quality of life in diabetic patients. Purpose: The purposes of this study were to investigate relationships between variables including demographics, disease characteristics, emotional distress, empowerment perception, and self-care behavior and quality of life, as well as to identify the important explanatory factors of quality of life in patients with type 2 diabetes. Methods: This study used a design that was cross-sectional, descriptive and correlated. A total of 220 patients diagnosed with type 2 diabetes in the previous ten year period were recruited as participants in this study. Data was collected using a structured questionnaire that incorporated scales to capture demographic, disease characteristic, emotional distress, empowerment perception, self-care behavior and quality of life data. The quality of life scale measured the three domains of satisfaction, impact, and worried about the diabetes. Results: Results included: (1) the standardized score of quality of life was 79.6, considered in the moderate to high range; (2) Education level, age, "diabetes shared care" participation and insulin therapy were variables with significant impact upon quality of life; (3) The more severe the emotional distress, the worse quality of life scores were in every domain; (4) The better the perception of empowerment, the better the score in the satisfaction domain; (5) The better self care behavior was, the better the score in the satisfaction domain; and (6) emotional distress was the most important explanatory factor of quality of life, accounting for 28.7%-53.8% of total variance. Conclusion / Implications for practice: The findings of this study suggested that health professionals should evaluate emotional distress of diabetic patients in the early stage, provide emotional support and consultation and apply empowerment strategy to promote their quality of life.
PMID: 20401867 [PubMed - in process]
Nurs Res. 2010 Apr 16. [Epub ahead of print]
Randomized Control Trial of the Health Empowerment Intervention: Feasibility and Impact.
Crawford Shearer NB, Fleury JD, Belyea M.
Nelma B. Crawford Shearer, PhD, is Associate Professor and Co-director, Hartford Center of Geriatric Nursing Excellence; Julie D. Fleury, PhD, FAAN, is Hanner Professor, Associate Dean for Research, and Director of PhD Program; Michael Belyea, PhD, is Research Professor, College of Nursing and Health Innovation, Arizona State University, Phoenix.
Abstract
BACKGROUND:: Older adults prefer to stay in their homes for as long as possible but are often unaware of the resources in their community to help them to remain in their home. Access to resources may be important among older adults, representing a critical area for intervention. OBJECTIVES:: The study aim was to evaluate the feasibility of the Health Empowerment Intervention (HEI) and to explore the impact of the HEI on the theoretical mediating variables of health empowerment and purposeful participation in goal attainment and the outcome variable of well-being with homebound older adults. METHOD:: Fifty-nine eligible homebound older adults were randomly assigned to the intervention group or the comparison group. The HEI consisted of 6 weekly visits, whereas the comparison group received a weekly newsletter for 6 weeks. Participants were measured at baseline, after the 6-week protocol, and at 12 weeks. Data were analyzed using descriptive statistics, t test, chi, and analysis of covariance. RESULTS:: There was a significant difference between groups in education. The participants in the intervention found the sessions to be helpful in recognizing resources. In addition, participants in the intervention group had significantly higher scores in the mediator purposeful participation in goal attainment, F(2, 83) = 3.71, p = .03. There was no significant main effect for the mediator health empowerment; however, the intervention group increased in the subscale personal growth from baseline to 12 weeks, F(1, 83) = 3.88, p = .05. DISCUSSION:: This randomized control trial provided initial support for the hypothesis that homebound older adults receiving the HEI would find the intervention acceptable and have significantly improved health empowerment, purposeful participation in goal attainment, and well-being than an attentional comparison group receiving a weekly newsletter.
PMID: 20404773 [PubMed - as supplied by publisher]
J Gerontol A Biol Sci Med Sci. 2008 Mar;63(3):298-307.
Multidimensional preventive home visit programs for community-dwelling older adults: a systematic review and meta-analysis of randomized controlled trials.
Huss A, Stuck AE, Rubenstein LZ, Egger M, Clough-Gorr KM.
Department of Geriatrics, Inselspital University of Bern Hospital, Bern, Switzerland.
Erratum in:
- J Gerontol A Biol Sci Med Sci. 2009 Feb;64(2):318.
Abstract
BACKGROUND: Multidimensional preventive home visit programs aim at maintaining health and autonomy of older adults and preventing disability and subsequent nursing home admission, but results of randomized controlled trials (RCTs) have been inconsistent. Our objective was to systematically review RCTs examining the effect of home visit programs on mortality, nursing home admissions, and functional status decline. METHODS: Data sources were MEDLINE, EMBASE, Cochrane CENTRAL database, and references. Studies were reviewed to identify RCTs that compared outcome data of older participants in preventive home visit programs with control group outcome data. Publications reporting 21 trials were included. Data on study population, intervention characteristics, outcomes, and trial quality were double-extracted. We conducted random effects meta-analyses. RESULTS: Pooled effects estimates revealed statistically nonsignificant favorable, and heterogeneous effects on mortality (odds ratio [OR] 0.92, 95% confidence interval [CI], 0.80-1.05), functional status decline (OR 0.89, 95% CI, 0.77-1.03), and nursing home admission (OR 0.86, 95% CI, 0.68-1.10). A beneficial effect on mortality was seen in younger study populations (OR 0.74, 95% CI, 0.58-0.94) but not in older populations (OR 1.14, 95% CI, 0.90-1.43). Functional decline was reduced in programs including a clinical examination in the initial assessment (OR 0.64, 95% CI, 0.48-0.87) but not in other trials (OR 1.00, 95% CI, 0.88-1.14). There was no single factor explaining the heterogenous effects of trials on nursing home admissions. CONCLUSION: Multidimensional preventive home visits have the potential to reduce disability burden among older adults when based on multidimensional assessment with clinical examination. Effects on nursing home admissions are heterogeneous and likely depend on multiple factors including population factors, program characteristics, and health care setting.
PMID: 18375879 [PubMed - indexed for MEDLINE]
Home Healthc Nurse. 2010 Mar;28(3):191-7.
The Gatekeeper Program: proactive identification and case management of at-risk older adults prevents nursing home placement, saving healthcare dollars program evaluation.
Barrett DL, Secic M, Borowske D.
Gatekeeper & Geriatric Services Southwest General Health Center, Middleburg Heights, OH 44130, USA.
Abstract
The Gatekeeper Program is an innovative community and hospital partnership focused on prevention of premature nursing home placement. Utilizing trained volunteers, who come into contact with older adults through their everyday jobs, the program provides assistance to over 1600 older adults. Positive program outcomes include reducing emergency department (ED) and hospital admissions and a 14 million dollar savings in healthcare costs related to nursing home placement.
PMID: 20308813 [PubMed - in process]
Home Health Care Serv Q. 2007;26(3):61-80.
Level of empowerment and health knowledge of home support workers providing care for frail elderly.
Johnson CS, Noel M.
Faculty of Kinesiology and Health Studies, University of Regina, Regina, Saskatchewan, Canada.
Abstract
The purpose of this study was to assess the profile of home support workers (HSWs) caring for the frail elderly and to determine the perceived empowerment levels and general health knowledge of these support workers. Background, work-profile, empowerment level and health knowledge related to seniors of 64 HSWs were assessed using questionnaires. Findings revealed the majority of workers to be middleaged women, and their health knowledge scores were low. Empowerment levels were moderate as was formal power. Findings demonstrate the need to revise the curriculum of HSWs to include health topics, as well as the need for continued education and strategies to enhance empowerment levels.
PMID: 17804353 [PubMed - indexed for MEDLINE]
Psychoeducation for Three Categories of Patients
Psychoeducation, as explained earlier, is health education combined with behavioral counseling. The counseling component of psychoeducation deals with emotions, perceptions, coping, relaxation, and self-care. Psychoeducation is of value for three categories of patients: (1) Those with major chronic diseases; (2) persons scheduled to undergo surgical procedures; and (3) high users of health care services. Psychoeducation can help—
n Improve coping with pain, distress, and other unpleasant symptoms
n Improve adherence to recommended regimens of care
The literature demonstrating the need for and effectiveness of psychoeducation in patients with chronic disease, those scheduled for surgery, and those with a somatization disorder is reviewed briefly in each of the following sections of this report.
Nitzkin, J. L., & Smith, S. (2004). Clinical preventive services in substance abuse and mental health update: From science to services (DHHS Publication No. (SMA) 04-3906). Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration.
FEBS Journal 272 (2005) 2347-2361 doi:10.1111/j.1742-4658.2005.04677.x
© 2005 FEBS
Nature, nurture and neurology: gene–environment interactions in neurodegenerative disease
FEBS Anniversary Prize Lecture delivered on 27 June 2004 at the 29th FEBS Congress in Warsaw
Tara L. Spires1 and Anthony J. Hannan2
1 MassGeneral Institute for Neurodegenerative Disease, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA
2 Howard Florey Institute, University of Melbourne, Australia
A. J. Hannan, Howard Florey Institute, National Neuroscience Facility, University of Melbourne, Parkville, VIC 3010, Australia Fax: + 61 39348 1707 Tel: + 61 38344 7316 + 61 38344 7316 E-mail: ajh@hfi.unimelb.edu.au
Group psychoeducation reduces recurrence and hospital admission in people with bipolar disorder
Colom F, Vieta E, Martinez-Aran A et al.A randomized trial of the efficacy of group psychoeducation in the prophylaxis of recurrences in bipolar patients whose disease is in remission.Arch Gen Psychiatry 2003;60:402–407.
http://ebmh.bmj.com/cgi/content/full/6/4/115
Commentary by Jan Scott, MD FRC Psych
Professor of Psychological Treatments Research
Institute of Psychiatry, UK
Excerpt in part: ...The study by Colom et al demonstrates that group psycho-education is equally acceptable to, but more effective than a non-directive group intervention provided for an equivalent period of time by the same therapists. As with family therapy, this effect was primarily a result of a significant reduction in depressive relapses. Although we do not know enough about mechanisms of action, differential efficacy or cost versus benefit of the different psychological approaches now being evaluated in randomised controlled trials, the clear picture emerging is that adjunctive psychotherapies are beneficial in terms of reducing symptoms, relapse rates, medication non-adherence and improving social adjustment.
Sullivan FR, Bird ED, Alpay, M and Cha, JJ. Remotivation and Huntington's Disease, Journal of Neuroscience Nursing, June 2001, Vol 33, Number 3, pages 126-142. Full article Internet Address http://www.aann.org/ce/pdf/jnn6-01.pdf
Six case studies are presented that demonstrate improved physical, mental and social functioning in persons with HD when a more stimulating environment is provided via remotivation therapy. It leads to increased self-awareness, self-esteem and an improved quality of life, even in late stage Huntington's disease.
In 2002 the American Association of Neuroscience Nurses featured this article on the benefits of remotivation to persons with Huntingtons disease as an online continuing education course for nursing credit.
Koy K, Ray R, Lee J, Nair A, Ho T, Ang PC. Dementia in elderly patients: can the 3R stimulation program improve mental status. Age Ageing 1994; 23: 195-9. Abstract internet location http://ageing.oupjournals.org/cgi/content/abstract/23/3/195?ijkey=DOVJK6WH3VdKA
This study concluded that an 8 week program of weekly sessions of reminiscence, reality orientation, and remotivation at a day care center caused a significant improvement in mental status as measured by the Mental Status Questionaire of Kahn et al. Pre and post testing showed an improvement at the 0.001 level of significance. Scores of the subjects in the control group significantly deteriorated during the same period at the 0.001 level of significance.
This study was selected in a critical review of the literature by the Occupational Therapy Evidence-based Practice Research Group, McMaster University, Hamilton, Ontario. Internet address
http://www-fhs.mcmaster.ca/rehab/ebp/pdf/activity.pdf
The review of the selected studies used the RevMan software from the Cochrane Collaboration. This analysis concluded that activity programme versus control condition produced outcomes that demonstrate a positive effect for the treatment condition of
Koppel P, Carnes E, Grozier E. Remotivation Therapy and Rehabilitative Day Care Cost Effective for Acutely Ill Elders. The Gerontologist, Vol 32, Special Issue II, October 1992, page 5.
This abstract of a presentation at an annual meeting of the Gerontological Society of America describes a study of the outcomes and benefits of a remotivation program on an acute medical surgical ward of the Winchester Hospital in Winchester, MA. Those patients receiving remotivation therapy, compared to those who did not, showed clinical improvement resulting in discharge from the hospital one day earlier than the control group.
Results:
Herlihy, Barbara Doyle, RN, MSN, Remotivation Therapy in the Social Rehabilitation of the Mentally Ill, Thesis for Masters in Science in Nursing, Anna Maria College; May 1987. For copies write: Barbara Doyle Herlihy, 3 Glasgow Circle, Hudson, NH 03051,Tel 603-883-3702
Results:
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Clients in a state hospital, a community residence of ten mentally ill women, a social club for the mentally ill and a rehabilitation day program all showed improvement in reports and observation by staff after participation in remotivation sessions
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Members increased in measures of self-esteem and fullfillment
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Social functioning increased with greater self-actualization
Harris, JE, and Bodden JL. An activity group experience for disengaged elderly persons, Journal of Counseling Psychology, Vol. 25, 325-330, 1978.
This study compared remotivation to a control group of elder persons living in the community in their homes. This is one of the few home health care studies of remotivaiton therapy. The clients were living independently in the community but who at the beginning of the study would not leave their homes to visit other people.
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Activity level
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Life satisfaction
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16 Item Personality Factor Questionaire (Cattell 1949) in factors of ego strength, trust-suspicion, anxiety, intoversion-extroversion and dependence-independence
Results:
- Compared to the control group, the remotivation group improved significantly in every measure except one of the 16 factors
Greenfield D. Remotivation Therapy: A Test of A Major Assumption of Treatment with Domiciled Geriatric Veterans. Texas Tech University, 1977, Chairman Jack L. Bodden, Department of Psychology, Dissertation Abstracts International, Order No. 77-25, 507, 193 pages.
This study compared two treatment groups and a control group. Treatment group I received 3 remotivation sessions per week for 4 weeks followed by 3 psychotherapy sessions per week for four weeks, a total of 8 weeks. Treatment group II received only psychotherapy for 3 sessions per week for 8 weeks. Outcomes were measured with the Affect Balance Scale, Life Satisfaction Index A, Remotivaiton Initial Evaluation, Nurses Observation Scale, and the Depression Adjective Check List.
Results:
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Treatment group I receiving 4 weeks of remotivation before psychotherapy was more active at midpoint and at the end of the 8 weeks than Treatment group II which received only psychotherapy
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Treatment group I was better adjusted to ward life at midpoint than both Treatment group II and the control group.
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Improvements gained after 4 weeks of remotivation were lost in Treatment group I after receiving psychotherapy.
This study assumed that remotivation was a warm up or preparitory treatment for psychotherapy. To the contrary, psychotherapy following remotivation resulted in the loss of gains that come from remotivation therapy.
Beal D, Duckro P, Elias J, Hecht E. Graded Group Procedures for Long Term Regressed Schizophrenics. Journal of Nervous and Mental Disease, 1977, 164 (2): 102-106.
This study compared the benefits of remotivation followed by physical activity with remotivation followed by more remotivation and remotivation followed by group psychotherapy as measurd with:
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Matarazzo and Weins Verbalization Unit (a measure of verbalization and social interaction)
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Structured Group Task Completion (a measure of independently planning and doing an activity)
Results:
- The remotivation group followed by the physical activity group and the remotivation followed by remotivation group showed significantly more verbalization than the remotivation group followed by psychotherapy or the control group.
- The amount of verbal interaction was significantly different between all groups in the following order of greatest to the lowest interaction:
Remotivation + Physical Activity Group
Remotivation + Remotivation Group
Remotivation + Psychotherapy
No Treatment Control Group
- Only the Remotivation + Physical Activity Group successfully planned and carried out an independent structured activity.
Pruitt, Sr J. The effects of Remotivation Technique on Patients, Staff Attitudes, and Staff Care of the Patient. Columbia Teachers College, 1976. Sponsor: Professor Ruth Bennett, Dissertation Abstracts International, Order No. 76-13, 493, 143 pages.
This study used a pre post test design with the group serving at its own control group. The outcomes were measured both clinical, administative and environmental factors in a nursing facility using the following:
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Kogan Attitude Toward Old People Scale
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Berger Self-Acceptance Scale
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Initial Patient Evaluation Form
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Humanization of Patient Care Index
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Brayfield and Rothe's Index of Job Satifaction
Results:
- The attitudes of staff members toward the elderly who conducted the remotivation groups with their own patients that they were assigned to care significantly improved. These staff included nurse aides and licensed practical nurses.
- The attitudes of staff such as registered nurses and administrators who did not conduct remotivation sessions with patients did not improve and in some cases became more negative toward the elderly during the time of the research study.
- The behavior of the patients participating in the remotivation groups significantly improved.
Dennis, H, Remotivation Therapy for the Elderly: A Surprising Outcome, Journal of Gerontological Nursing, Vol. 2, No. 6, November-December, 1976.
In this study compared remotivation to a control group. The control group was eliminated because of high attrition. The remotivation group tended to be more depressed and less satisfied with life. These clients were geriatric patients at a state hospital.
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Zung Depressin Scale
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Life Satisfaction Scale
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Fergus Falls Behavior Rating Scale
Results:
- Remotivation moved to be more depressed and less satisfied (p=.02)
- Ward behavior did not change
- Author suggests that remotivation caused cognitive dissonance which lead to the group to realize the reality of their lives was not consistant with their ideal. This is consistant with some theories of motivation.
Thralow, J and Watson, C. Remotivation for Geriatric Patients Using Elementary School Students, American Journal of Occupational Therapy, Vol. 28, No. 8, September, 1974.
This study included a control group and remotivation group that lasted 16 weeks. Outcomes were assessed at 11 and 20 weeks.
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NOSIE
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Remotivation Self Evaluation Scale
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Morale Self Evaluation Scale
Results:
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NOSIE 11 weeks results improved in neatness, total positive and overall score (p=.05), interest, irritablility and total negative score (p=.02)
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NOSIE 20 weeks results improved in a positive direction in neatness, total positive and overall score (p=.20)
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Remotivation Self Evaluation results 11 weeks relationships improved (p=.05) and movement to the positive in areas of travel, community interest, hospital life and activities (p=.02)
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Remotivatin Self Evaluation results 20 weeks significant improvement occurred in the the areas 0f hosptial life (p=.01), travel and relationships (p=.05, and movement in the positive took place in activities (p=.02)
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Morale Scale results at 11 weeks positive movement (p=.02) and no change at 20 weeks.
Arje, FB. Project Share: Reactions of Residents of a Home for the Aged to a Selected Remotivation Technique. Columbia University, Department of Education, 1973, Sponsor: Ruth G. Bennet. Dissertation Abstracts International, Order No. 73-25, 154. 304 pages.
This study compared a group receiving remotivation therapy and a control group. The outcomes were measured using:
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Socialization Index
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Mental Status Schedule and Geriatric Supplement
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The Philadelphia Geriatric Center Morale Scale
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American Psychiatric Assocation/Smith Kline and French Participant Observation Instruments
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Individual Progress Records from the medical record, participation in recreational programs, creative activities and competitive activities, and
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Index of Activities of Daily Living.
Results:
- Remotivation group socialization scores,mental status scores and morale score were significantly better than the control group scores
- Remotivation group's behavior improved most in the areas of interest, appreciation, relations with other in the group, enjoyment of group sessions, improved behavior in group sessions, reduction in restlessness on the ward and an increased interest in activities in general
- While the remotivation group improved in creative activities and recreation participation, the control group scores decreased in these measures during the 21 treatment period
- The remotivation group showed an increase in competitive activities while the control group showed no change.
- The remotivation group improved significantly in activities of daily living in those residents receiving skilled heavy long term care. They improved in the areas of dressing, toileting, transfer from bed to chair and from wheelchair to chair and in the ability to feed oneself. Those receiving intermedicate long term care improved in bathing themselves.
- The control group became significantly more dependent upon staff for activities of daily living
Dana, R, and Barling P. Structured Treatment Environments and Pathological Behaviors, Psychological Reports, Vol. 32, 991-994, 1973.
This study compared a group on an admissions ward receiving attitude therapy and a remotivation group on a chronic ward to a control group on an admissions ward. The length and frequency was not reported.
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Measure of pathological behaviors
Results:
Beard, M, Matts, F, and Byrd D. Effects of Sensory Stimulation and Remotivation on Schizophrenic Persons, Journal of Psychiatric Nursing and Mental Health Services, March-April, 1972.
This study found no significant difference between the stimulation/remotivation group and the control group after one session per week for nine weeks.
Bovey JA. The Effects of Intensive Remotivation Techniques on Institutional Geriatric Mental Patients in a State Mental Hospital. North Texas State University, 1971, Major Professor: George C. Beamen, Department of Clinical Psychology. Disseratation Abstacts International, Order No. 72-4064, 121 pages.
A group receiving remotivation therapy was compared to a group to which the leader simply read and to a control group. The outcomes were measured using:
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Hospital Adjustment Scale 1 measuring communication and interpersonal relations,
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Hospital Adjustment Scale 2 measuring care of self and social responsibilities
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Hospital Adjustment Scale 3 measuring work, activity and recreation involvement
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Hospital Adjustment Scale 4 measuring total score of 1-3
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Bender-Gestalt Test measuring environmental awareness and,
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Draw a Person Test measuring self concept. and the Draw a Person
Results:
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The group receiving remotivation therapy significantly improved over the control group on all six measures at the .01 or .001 level of significance.
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The group who was simply read to significantly improved over the control group in measures 2, 4, 5 and 6, but in the the measures 1 communication and interpersonal relations and in 3 work, activity and recreation involvement it was not improved.
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In measure 6 self concept as measured by the Draw a Person Test, the remotivation therapy group's improvement was significantly more than the improvement of the read to group and over the control group at the .05 level of significance.
Stermlicht, M, Stiegel, L and Deutsch M, Evaluation of a Remotivation Program with Institutionalized Retarded Youngsters, Training School Bulletin, Vol. 68 (2), 82-86, 1971.
This study was a single group design with a pre and post test format. Three sessions were conducted per week for twelve weeks.
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Kuhlmann Test of Mental Development
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Vineland Social Maturity Scale
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Adjective Checklist
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Behavioral Rating Scale: Subscales I. Orientation, II. Personal Characteristics, III. Social and IV. Verbal Behavior
Results:
- Significant improvement was made in the Total BRS (p=.01)
- Significant improvement was made in the BRS I Orientation (p=.01)
- Significant improvement was made in the BRS III Social (p=.01)
- Remotivation was effective in motivating the clients to be more sociable and alert, but not to change their personality.
Beard M, Bidus DR. A Study of the Effects of Remotivation on Social Competence, Social Interests and Personal Neatness. Journal of Psychiatric Nursing and Mental Health Services, July-August, 1968.
This study used the treatment group as its control group by testing and retesting over time before the treatment of remotivation was initiated. The outcomes were measured using:
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Revised Nurse's Observation Scale for Inpatient Evaluation (a measure of social competence, social interest and personal neatness)
Results:
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The group improved significantly at the 0.0001 level in the area of social interest.
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The group was divided into subgroups by diagnosis, age, length of hospital stay and number of hospital admissions
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Demented patients improved in social interest but not in competence or neatness
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Schizophrenic patients improved both in competence and interest but not in neatness
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Those 60+ year old improved in competence and interest but not in neatness
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Those less than 60 years old improved in interest but not in competence or neatness
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Those in the hospital over 13 years improved in competence only.
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Those in the hospital less than 13 years improved in interest only.
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Those with one hospital admission improved in both competence and interest but not in neatness
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Those with two hospital admission or more improved in interest only.
Kinbrell, D and Luckey R. Remotivation of Institutionalized Epileptics, Perceptual and Motor Skills, 1966, Vol 23, page 770.
This is a significant study on remotivation's effectiveness as a method of teaching/education/learning. It compared a traditional lecture/discussion method of education to the use of remotivation session format to teach the same information.
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Free Association Portion of the Rorschach Test: number of responses (R), time to first response (T/first Rs), form quality (F+) and human content (H). Scored by Beck's system
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Rating Scale of interest, comprehension of subject matter, ability to respond to direct questions, frequency of volunteering information, relevancy of verbal expression, level of patient's self-awareness, attention to the proceedings, degree of cooperation, consideration of other patients and degree of self-confidence manifested
Results:
- Remotivation was significantly higher than lecture/discussion on the number of responses and time to first response (.05 level of significance)
- Both groups improved in form quality
- Remotivation was rated significantly higher in all ten catagories than the lecture/discussion group
Long, RS Jr. A Study of Staff-Patient Changes in Expectancy, Attitudes and Behavior Following the Introduction of a Remotivation Technique into the Ward Routine of a Mental Hospital. University of Washington, Department of Psychology, 1965, Chairman: Abel G. Ossorio. Dissertation Abstracts International, Order No. 66-467, 190 pages.
This study used the scientificly controld research design cited in this list of research. It used the Solomon Four Group Design. The outcome measured used were:
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L-M Fergus Behavior Rating Scale
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Initial Remotivation Evaluation Rating Scale
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Progress Report Rating Scale
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Current Status Rating Scale
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Prediction Rating Scale
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Custodial Mental Illness Ideology Scale (a measured of behavior change
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Ward Time Samples
Results:
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Behavior change improved for those in the remotivation groups at the highly significant 0.0001 level. Those patients living on the chronic long term treatment wards improved more that those on the acute treatment wards.
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Staff attitudes improved by changing from custodial to humanistic on the chronic wards, but did not reach significance on the acute wards.
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Ward time samples indicated that the remotivation groups significantly moved from negative behaviors to neutral behaviors.
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