Impact of Motivational Techniques on Mentally Ill People - Research Paper Example

Running Head: Investigation of the relationships between beliefs, causative components and social acceptance of mentally ill people. By Name: Institution: Instructor: Module: Date: Abstract The general public often have stigmatised attitudes towards mentally ill persons. This raises major factors that hinder such people from seeking medication, rehabilitation and recovery. The objective of this paper is to investigate how a simple motivational interviewing technique can decrease stigmatized attitudes towards schizophreneric people. The study conducted 413 high school students in a randomized paired-design trial by subjecting them to a 10 min motivational interview. Attitudes to Mental Illness Questionnaire (ANIQ) was used to determine effects of various procedures on stigmatized attitudes (luty, Umoh, & Nuamah, 2009). According to the study results, there was an observable significant improvement in stigma scores on attitudes towards alcoholic people but not to those having schizophrenia. Clinically, implications of this study revealed that a brief intervention strategy through motivational interviews challenges the stigma of mental illness (Luty et al., 2009). Table of contents Abstract 2 Table of contents 3 1.0 Introduction 4 1.1 Theories and models 5 1.2 Hypotheses 6 2.0 Method 6 2.1 Participants 6 3.0 Design 6 3.1 Procedure 7 3.2 Data Analysis 7 4.0 Results and Discussion 7 5.0 Summary and conclusions 9 References 10 1.0 Introduction There is a resurgence of policy efforts and research on stigmatization, with the aim of engendering discrimination and prejudice. By focusing on the issue of mental illness by drawing from stigma studies across social sciences fields it is necessary to put into consideration the social interaction context. This context is dynamic with media, organizations and cultural diversity generating the “difference” label or mark. Social network theory, labeling theory, media influence, limited capacity model, theories of welfare sate, and social psychology of discrimination and prejudice all serve to demystify the complex stigma web (Jack, Lang, & Olafsdottir, 2008). Stigma according to Biernat and Dovido (2000) is a social construction which devalues other people based on distinguishing marks or characteristics. The world Psychiatric Association and World Health Organization recognizes that discrimination and stigma attached to mental illness disorders is associated strongly to disability, suffering and poverty (Corrigan et al., 2003).A report by National Health service Safer services observed that stigma is a major barrier to access of treatment and prevention of increased cases of suicide (Luty et al., 2009). As a result the Royal College of Psychiatrists’ initiated a 5-year campaign dubbed ‘changing Minds’, which had aim of sensitizing positive attitudes towards mentally ill persons, encouraging patient advocacy, educating the general public on the tractability, and challenging discriminations and misinterpretations of the true nature of mental illness. Based on results from the Royal College of Psychiatrists’, drug addicted and alcoholic people are the highly stigmatized lot in the total population of mentally ill people. Majority of the participants thought they were unpredictable, dangerous and hard to engage in discourse with. Three out of five respondents thought they are responsible to their prevailing condition. However, this opinion was endorsed by a fraction of only 6% in relation to schizophrenia. This formed the basis of this paper, by choosing to analyze methods that can identify and scale down negative attitudes towards mentally challenged people (Luty et al., 2009). One method employed in this study to address stigmatized attitudes is motivational interviewing. Where participants are given a list of problems to test their attitudes causes to themselves and to others, and why change is necessary according to their views. Motivational interview is a brief primary care treatment intervention strategy adopted for persons with alcohol dependency. It is delivered easily through a five min consultation for people with little interest or insight in further treatment. The interview procedure is widely applied for individuals having various problems like Obesity, low-esteem, psychosis, eating disorders, substance abuse disorders and non-adherence to medication (Luty et al., 2009). Therefore this method will be ideal in this study for changing attitudes towards mentally ill people, especially in situations where respondents’ motivational change is questionable as is the case in general public. This paper aims in determining if the motivational interview technique can significantly lower stigmatized attitudes meted out by the general public to mentally ill (schizophrenia) people (Luty et al., 2009). 1.1 Theories and models Information provided by classic studies in early 1950s and 1970s show missing links in the understanding of mental disorders and the negative attitudes preventing treatments, causes and outcomes (Jack et al., 2008). Subsequently, technology advances in scientific knowledge, consumer advocacy movements, and drive of mental health care out of long term schools heightened public knowledge but reduced community-based stigma. However, in 1990s, research has focused on dissemination of information into public domain through empirical data analysis. Several pilot projects have been initiated world wide through world psychiatric association. Up to today few attempts have been initiated to assess what influences shape stigma. This could be due to conceptualized measurement methods and application of various dimensional methods drawn from different cultural research (Jack et al., 2008). 1.2 Hypotheses 1. Does perception of behaviour as an indicator of mental illness correlate with the belief that mental illness has a physical cause. 2. Does public perception of behaviour as an indicator of mental illness correlates with the belief that mental illness has a physical. 3. Does perception of behaviour as an indicator of mental illness correlate with preferred social acceptance. 2.0 Method 2.1 Participants Participants were recruited using vignette format from 413 high school students. There were no exclusion or inclusion criteria other than testing ability to given a written informed affirmative. The project passed the institutions’ research ethics requirements on subject treatment. 3.0 Design The test was a brief 4-item mental Illness Questionnaire (AMIQ), self-completion and with good psychometric properties which can be used universally in other situations. The questionnaire was adapted from Norman and Mallia’s (1983) study and was used to validate 413 high school students voluntarily. The participants were asked to read a short vignette about an imaginary case description before answering four questions. Each question was rated by a five point score likert scale (Minimum -1 and Maximum +2; while blank questions don’t know and neutral scored 0). Combining the scores for the five questions gave each a vignette (between -10 and +10). The test was retested for reliability after 2 to 4 weeks with p = 0.702 (n=256), construct validity alpha = 0.933 (n=413) and alternate test reliability compared to Corrigan et al’s attribution questionnaire p = 0.704 (n= 256) 3.1 Procedure Two copies of questionnaire were made. Each student was interviewed in isolation. The interview consisted of 14 participants (7 male and 7 female), aged between 12 to 16.questions adapted from a popular manual and were administered conducted by the interviewer. Two interviews were conducted for each participant. Two students (one male and one female) from a different school were recruited to act as control, and were randomly assigned sampled but within the same age range. The second test was conducted for each participant to give views on the disorder addressed in the motivational interview. 3.2 Data Analysis Comparison of differences in the subgroups resulted from non-parametric and correlation coefficients tests. The statistical significance of results was calculated using Wilcoxon’s matched-pairs signed- ranks test. Measurements were found to be normally distributed, although standard errors, means and population sizes effect have been quoted for convenience purposes. 4.0 Results and Discussion Results suggest that although belief components were not in general highly related, the perceived severity of mental disorders has a positive relationship to attributes of physical causes, which is then negatively related to social acceptability. The beliefs in psychological etiology and medication are also closely related to higher social acceptance of mentally challenged, while belief in medical treatment has a negative relationship to social acceptance. Data available also suggests differences between males and females in their levels of social acceptance to mentally ill. The differences may be attributed to differences in beliefs over the psychological etiology or perceived suitability of psychological treatment. Inference from correlation analysis justifies this assertion, first there was no differences in demographic characteristics between experimental and control groups. Secondly, Measurement of indices show age (Mean = 14.6 years, s.d = ). Improvement in stigma scores was observed in attitudes towards (table 1; AMIQ scores= 1.2, s.e = 0.5) and paired match Wilcoxon singed-ranked test p= 0.006). The median difference in scores (MD = 14 (N= 256), these scores are a reversal to Norman & Malla social distance scores, hence consistent on beliefs validation. Table 1. Attitude components Questions Possible range of combined ratings possible range of average ratings 1. perception of behaviour as mental illness 1 1-7 1-7 2. Belief in physical causes 2 1-7 1-7 3. Belief in psycho-social causes 3 and 4 2-14 1-7 4. Preferred social acceptance 5,6,7,8 and 9 5.35 1-7 Table 2. Results of motivational interviewing, scores1 variables Control group Experimental group P (two-sided Wilcoxon test) Behaviour perception -0.8 (s.e = 0.4) 1.2 (s.e = 0.5) 0.006 Physical causes -1.1 (s.e = 0.5) -1.5 (s.e = 0.4) 0.035 Psycho-social causes -0.6 (s.e = 0.5) 1.3 (s.e = 0.4) 0.005 Social acceptance -0.7 (s.e = 0.4) 1.4 (s.e = 0.5) 0.004 5.0 Summary and conclusions The use of AMIQ in this study was found to be convenient because it is easily validated. Other methods for available tend to take longer time or address experiences of stigma by mentally ill people. For example Anti-stigma methods like ‘changing Minds’ campaign only give factual information by addressing misconceptions about mentally ill people. Although the other methods, including cognitive behavioural reduce stigma, their effects are relatively small if negative outcomes in mental disorders are disseminated. For this reason, motivational interviewing avoids generation of resistance among participants compared to the therapists’ reasons for attitude changes. In this study, motivational interviewing results provided small but statistically significant improvement of 2 % change in attitude with effect size of 0.43 which can be conventionally termed to be a modest achievement. However, media’s role negative schizophrenia presentation is to blame for low attitudes In conclusion, motivational interviewing was a modest method which improved stigmatized attitudes of general public perception towards mentally ill people. If this method is applied by strategically targeting landlords, employers or family members, it can yield a better improvement. Therefore, this study opens an avenue for further research by refining the method on a large scale. References Biernat, M., & Dovidio, J. F. (2000). Stigma and stereotypes. In The Social Psychology of Stigma. Ed. Heatherton, T. F., Kleck, R. E., & Hebel, M. R., pp. 88 –125. New York: Guilford Press. Corrigan, P., Markowitz, F.E., Watson, A., Rowan, D., Kubiak, M.A. (2003).An attribution model of public discrimination towards people with mental illness. Journal of Health and Social Behaviour, (44),162 –79. Norman, R.M., & Malla, A.K (1983). Adolescents’ attitudes towards mental illness: Relationship between components and sex differences. Social Psychiatry, (18), 45-50 Luty, J., Umoh, O., & Nuamah, S.F. (2009). Effect of brief motivational interviewing on stigmatized attitudes towards mental illness. Psychiatric Bulletin, 33, 212- 214. Retrieved October 8, 2009 from Jack, K. M., Lang, A., & Olafsdottir, S. (2008).Rethinking Theoretical Approaches to Stigma: A Framework Integrating Normative Influences on Stigma. Retrieved October 8, 2009 from . Read More

    Three out of five respondents thought they are responsible for their prevailing condition. However, this opinion was endorsed by a fraction of only 6% about schizophrenia. This formed the basis of this paper, by choosing to analyze methods that can identify and scale down negative attitudes towards mentally challenged people (Luty et al., 2009).

            One method employed in this study to address stigmatized attitudes is motivational interviewing. Where participants are given a list of problems to test their attitudes causes to themselves and others, and why change is necessary according to their views. A motivational interview is a brief primary care treatment intervention strategy adopted for persons with alcohol dependency. It is delivered easily through a five min consultation for people with little interest or insight in further treatment. The interview procedure is widely applied for individuals having various problems like Obesity, low-esteem, psychosis, eating disorders, substance abuse disorders, and non-adherence to medication (Luty et al., 2009).

            Therefore this method will be ideal in this study for changing attitudes towards mentally ill people, especially in situations where respondents’ motivational change is questionable as is the case in the general public. This paper aims in determining if the motivational interview technique can significantly lower stigmatized attitudes meted out by the general public to mentally ill (schizophrenia) people (Luty et al., 2009).

            Information provided by classic studies in the early 1950s and 1970s shows missing links in the understanding of mental disorders and the negative attitudes preventing treatments, causes, and outcomes (Jack et al., 2008). Subsequently, technology advances in scientific knowledge, consumer advocacy movements, and drive of mental health care out of long-term schools heightened public knowledge but reduced community-based stigma. However, in the 1990s, research has focused on the dissemination of information into the public domain through empirical data analysis. Several pilot projects have been initiated worldwide through the world psychiatric association. Up to today, few attempts have been initiated to assess what influences shape stigma. This could be due to conceptualized measurement methods and the application of various dimensional methods drawn from different cultural research (Jack et al., 2008).

Participants were recruited using a vignette format from 413 high school students. There were no exclusion or inclusion criteria other than the testing the ability to give a written informed affirmative. The project passed the institutions’ research ethics requirements on subject treatment.

            The test was a brief 4-item Mental Illness Questionnaire (AMIQ), self-completion, and with good psychometric properties which can be used universally in other situations. The questionnaire was adapted from Norman and Mallia’s (1983) study and was used to validate 413 high school students voluntarily. The participants were asked to read a short vignette about an imaginary case description before answering four questions. Each question was rated by a five-point score Likert scale (Minimum -1 and Maximum +2; while blank questions don’t know and neutral scored 0). Combining the scores for the five questions gave each a vignette (between -10 and +10). 

Two copies of the questionnaire were made. Each student was interviewed in isolation. The interview consisted of 14 participants (7 male and 7 female), aged between 12 to 16.questions were adapted from a popular manual and were administered conducted by the interviewer. Two interviews were conducted for each participant. Two students (one male and one female) from a different school were recruited to act as a control and were randomly assigned sampled but within the same age range. The second test was conducted for each participant to give views on the disorder addressed in the motivational interview.

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