Navigating Change: Risk, Reward, and Therapeutic Commitment
Key Points
- Engagement is based on the risk-reward concept.
- If the risks are viewed as too high, the individual will disengage.
- If risk and reward are viewed as being of equal weight, the individual will default to old patterns.
- If the rewards are weighted more heavily, the individual leans towards change.
- This is a complicated process for individuals.
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Transcript
Now, one of the things that I am asked quite often is, well, how do you actually engage your clients in therapy?
How do you engage people to be more adherent to treatment, to follow advice, to be meaningfully engaged in their own lives, in their own process? There’s a fundamental aspect that we need to address, which is going to be risk vs reward. If you take anything from this entire module, what I hope you take away is that concept.
Carlson, M. R. (2014). CBT for chronic pain and psychological well-being: A skills training manual integrating DBT, ACT, behavioral activation and motivational interviewing. John Wiley & Sons.,Carlson, M. R. (2017). CBT for psychological well-being in cancer: A skills training manual integrating DBT, ACT, behavioral activation and motivational interviewing. John Wiley & Sons.,Duncan, B. L., & Reese, R. J. (2015). The Partners for Change Outcome Management System (PCOMS): Revisiting the client’s frame of reference. Psychotherapy, 52, 391–401.
But let’s set the stage for that first: is engagement strategies. We need to start looking at thinking, feeling, and doing. Okay. And so I want to get people activated on all three of those aspects. So just appealing to their thinking, like we said, insight doesn't necessitate change. Insight can be its own reward, which means it can feel good to be insightful on something. I can understand things but it doesn’t necessarily lead to any level of change or different engagement.
Carlson, M. R. (2014). CBT for chronic pain and psychological well-being: A skills training manual integrating DBT, ACT, behavioral activation and motivational interviewing. John Wiley & Sons.,Carlson, M. R. (2017). CBT for psychological well-being in cancer: A skills training manual integrating DBT, ACT, behavioral activation and motivational interviewing. John Wiley & Sons.,Duncan, B. L., & Reese, R. J. (2015). The Partners for Change Outcome Management System (PCOMS): Revisiting the client’s frame of reference. Psychotherapy, 52, 391–401.