Evaluating the benefit of implementing 'motivation modification' prior to 'belief modification' in the treatment of delusional beliefs in clients with psychosis
Cognitive-behaviour therapy was used in an attempt to modify the delusional beliefs of six clients with psychosis. It was hypothesised that the empirically vindicated "belief modification" (BM) package (Chadwick & Lowe, 1994) would benefit from being augmented by a "motivation modification" (MM) package which focuses directly on the client's motivation to change. Using single-case methodology, these two cognitive therapies were employed in different phases over two conditions. Three clients received MM therapy before BM therapy, and three clients received BM therapy before MM therapy. Belief conviction was reduced in four of the six participants, whilst two participants demonstratedn o changein belief conviction. The resultst entativelyi ndicatet hat clients receiving MM before BM demonstrateda greater reduction in belief conviction than clients receiving BM before MM. The implications of these results are discussed, and it is argued that motivational issues play an important role in the maintenance of delusions. Future research directions are forwarded for deriving useful models of underlying processesin volved in using motivation modification as an adjunct to belief modification.