Schizophrenia Clinical Trial
Official title:
Development and Validation of an Intervention Targeting Motivational Negative Symptoms: Switch Protocol 2
This study aims to investigate the effects of the Switch intervention on motivation and
associated processes and explore the dynamics between the processes.
A single case approach is followed, with a pre-post and follow-up assessment design, and
continuous ambulatory assessments (experience sampling method (ESM) and step count).
Motivational negative symptoms hinder quality of life and daily functioning of individuals
with schizophrenia spectrum, bipolar and major depressive disorders.
A recently developed intervention, Switch, has shown promising effects on negative symptoms
and functional outcomes. Switch is based on a model that identifies various cognitive,
behavioural and emotional processes related to motivation and goal-directed behaviours:
pleasure anticipation, value-effort-probability computation, (dys)functional attitudes (e.g.,
discouraging thoughts, self-efficacy), planning, initiation, in-the-moment enjoyment,
reminiscence. The intervention combines a person-centred and recovery approach with
cognitive, behavioural and 3rd wave techniques to tackle the obstacles related to motivation
and goal-directed behaviours (i.e., targetting the various cognitive, behavioural and
emotional processes listed above). Thus, an important part of the intervention focuses on the
person's strengths, needs, goals and values. Furthermore, various strategies (e.g., cognitive
defusion, pleasure anticipation, problem solving, reminiscence) are used to encourage
engagement in meaningful personal goals and values.
The Switch intervention is provided either in individual (one-hour sessions), or in a group
setting (two-hour sessions), twice a week for around two months.
There are three types of evaluation: traditional assessment scales of motivational deficits,
apathy, quality of life and daily functioning (pre, post and follow-up at 3 months);
ambulatory assessment including ESM (i.e., daily questionnaires); actigraphy (step count).
The aims of this study is to evaluate the efficacy of Switch in two different settings (i.e.,
individual sessions and a group programme) on motivation/apathy and functional
outcomes/quality of life. Furthermore, we wish to explore the effects of Switch on process
related to motivation and goal-directed behaviours (e.g., pleasure anticipation,
reminiscence, defeatist beliefs, activities' meaningfulness) and on activity (i.e., step
count). Finally, we wish to evaluate the dynamics between the different cognitive,
behavioural and emotional processes related to motivation and goal-directed behaviours.
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