Running head: CRITIQUE AUTONOMY-SUPPORTIVE THERAPEUTIC RECREATION
Critique of The Effect of Autonomy-Supportive Therapeutic Recreation Programming on
Integrated Motivation for Treatment among Persons who Abuse Substances
Sarah Dupree
Brigham Young University
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CRITIQUE AUTONOMY-SUPPORTIVE THERAPEUTIC RECREATION
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Critique of The Effect of Autonomy-Supportive Therapeutic Recreation Programming on
Integrated Motivation for Treatment among Persons who Abuse Substances
This study was done in order to see if there was a correlation in being intrinsically
motivation to seek treatment and the success of the treatment. Also looked at is the autonomous
and therapeutic recreational aspects of the program. In this critique I will summarize the
research, point out the strengths and weaknesses of the article, discuss the future applications of
this study, and share my thoughts and questions on the study.
Summary
The purpose of the study was to examine the effect of an autonomy-supportive
therapeutic recreation program on motivation for treatment and the perceived autonomy of the
environment. The study was used to test the effectiveness of different treatment types: empathy
and choice, empathy and rationale, or empathy, choice and rationale, along with a control group.
Participants for the study were seeking outpatient substance abuse treatment. There was
39 participants total, dropping 11 from the original 50 due to premature discharge from the
treatment. Participants were mostly male and ranging from 20 to 55 in age. Six were in the
empathy and choice group, three were in the empathy and rationale group, nine were in the
empathy, choice, and rationale group, and twenty-one participants were in the control group.
The therapeutic recreation program was eight one-hour sessions happening twice a week
along a four week span. The program addressed relationships, relapse prevention, problem
solving, stress management, effective communication, social support, and recreation as a
modality. Participants also completed two questionnaires; the Treatment Motivation
CRITIQUE AUTONOMY-SUPPORTIVE THERAPEUTIC RECREATION
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Questionnaire, measuring integrated motivation for treatment before and after treatment and the
Treatment Climate Questionnaire, measuring perceived autonomy-supportive environment.
The study uses the Self-Determination Theory and autonomy-supportive environment.
SDT states that competence (being effective in social interactions and expressing one’s
capacities), relatedness (sense of connectedness, belonging, and community), autonomy (being
the origin of one’s own behavior) are all psychological needs for optimal human growth and
functioning. Autonomy-supportive program provides choices, takes perspectives, and provides a
rationale as a way to target motivation.
There are three types of motivation discussed in this study: intrinsic, extrinsic, and
amotivation. Amotivation has no regulation (acting without knowing) and intrinsic motivation
has intrinsic regulation (doing something for its own sake). Extrinsic motivation has external
(compliance, rewards, and punishments), introjected (internal feeling of obligation), identified
(outcomes of doing such a behavior), and integrated (doing something because it is congruent
with self) regulation (Cogswell, J & Negley, 2011).
Strengths
Patients that had greater intrinsic reasons for seeking treatment were more trusting of
their counselors and had better recovery outcomes. Also if patients felt like they were in a more
autonomy-supportive environment they were more likely to adhere to the medication schedule
and take ownership of their behavior.
The therapeutic recreation program enhanced effective problem solving skills, assisted in
clients in identifying non-chemical alternatives, increased sense of freedom, increased sense of
control and more intrinsic motivation. Also over the four weeks participants were able to acquire
new skills and gain more insight into their reason for being in treatment. After the TR program
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clients reported feeling more engaged, looking forward to group, and excited about the group’s
planned activity.
Weaknesses
There were plenty of weaknesses with this study. The groups were not randomized. They
were small in sample size. They were uneven. They were not always taught by the same
facilitator. The patients were coerced into participating in the study by being offered an incentive
for the participation. This is directly contradictive to the point of the study because they are no
longer intrinsically motivated. The tests show no statistical conclusion that this study even
proved anything.
Uses/Applications
The study did find that TR was important in treating substance abuse. TR engages
participants by using recreation and leisure to teach life skills that support recovery. Also by the
process of assessment, planning, and implementation we can eliminate impromptu group
meetings and stress clinical preparedness.
Personal/ Interesting
Addiction is a leisure disease, and dysfunctional leisure is a symptom of addiction. Most
people are introduced to their ‘fixes’ while they are a participating in leisure. Therefore
addictions are a disease of leisure and when people stop frequenting certain aspects of leisure
because they do not offer alcohol and/or drug use then dysfunctional leisure becomes a symptom
of addiction.
The costs of substance abuse for America (crimes, social welfare, medical care, work,
and treatment) add up to 67 billion dollar per year.
CRITIQUE AUTONOMY-SUPPORTIVE THERAPEUTIC RECREATION
References
Cogswell, J & Negley, S (2011). The Effect of autonomy-supportive therapeutic recreation
programming on integrated motivation for treatment among persons who abuse
substances. Therapeutic Recreation Journal, 45 (1), 47-61.
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