Deci and Ryan (1985) proposed that humans pursue different activities and goals throughout life because they are motivated to fulfill three basic psychological needs for Autonomy (A), Relatedness (R) and Competence (C), or the ARC of psychological needs fulfillment (Ryan and Deci 2000a)" (location 310).
To help children and families flourish and remain engaged in therapy, SDT suggests that three basic psychological needs must be met. These include (i) having a sense of control and pursuing one’s own goals (Autonomy), (ii) feeling connected to others in safe, secure relationships (Relatedness) and (iii) feeling capable and able to master the tasks associated with one’s life stage and/or those that are central to one’s goals (Competence)" (location 223).
There are three causality orientations. • An Autonomous causality orientation occurs when there is fulfillment of all three ARC needs. The child thinks, “I want to go to therapy” (A), “My therapist understands me” (R) and “I can do the work” (C). • A strong Control causality orientation occurs when only two needs (for Relatedness and Competence) are met. The child thinks, “I have no choice. I must go to therapy” (low or no A). But, “I like the therapist (R), and I learn a lot (C).” • An Impersonal causality orientation occurs when all three needs are thwarted (low or no ARC). The child thinks, “I have to go to therapy. I don’t like the therapist. What’s the point? I learn nothing.” (447)
Autonomy:
Whatever the individual self-selects because of a perceived sense of personal importance, curiosity or interest is likely to be aligned with autonomous activity engagement, even in challenging circumstances. (351)
Acting autonomously is associated with the understanding that the self is the impetus for action and that the action reflects one’s authentic self. (957)
As an example, if a child merely follows a therapist’s direction out of deference, although he/she is behaving intentionally he/she is not acting autonomously. Autonomous behavior is self-initiated and considered, and the individual understands that he/she is the initiator. (966)
Behaviors that signal autonomy (Box 2.1)
Five ways therapists can support autonomy: (a) "provide meaningful rationales by explaining links between the child's goals and personal benefits," (b) "understand the child's perspective and acknowledges his/her feelings," (c) "use non-controlling language (e.g., "you may...")," (d) "offer choices and provide flexible conditions," (e) "engage with a child's interests, thereby nurturing the child's inner motivational resources." (1060)
These guidelines make it clear that an autonomy-supportive environment is not one where the child is in charge. Therapy will often comprise activities that the child would not ordinarily choose to undertake. The critical elements of an autonomy-supportive environment are that the child’s goals are considered and respected in formulating the outcomes to which therapy is directed, and that the links between the activities and the child’s goals are made explicit. (1074)
Autonomy-supportive strategies in therapy (Table 2.1)
Landreth (2002) recommended a three-step process for limit setting: (i) acknowledge the child’s feelings and desires, (ii) communicate the limit and (iii) identify acceptable, alternative behaviors. (1360) Koestner et al. (1984) found that when limit setting was communicated in a way that acknowledged the perspective of the child (conveyed an understanding of the possible conflict between the limits and the child’s preferences), the limit setting was not perceived as controlling. (1364)
If a child feels that he/she can trust the therapist, then this lays the foundation for sharing and respect, as well as generating the necessary conditions for safe risk taking and learning. Thus, addressing the Relatedness needs in therapy enables a child to act more freely and competently, without excessive control and regulation. (395)
There is considerable evidence that in therapy the quality of the relationship an individual has with his/her therapist is the greatest predictor of successful treatment outcomes (e.g. Karver et al. 2006). The principal method of building this positive relationship is to create a sense of safety and security, warmth and genuineness, where the therapist offers help and invites collaboration throughout the partnership. This is achieved through the practitioner’s emotional engagement, attunement and responsiveness. (1491)
At the end of the day, effective and sustainable therapeutic outcomes are largely dependent on developing alliances and understanding how secondary relationships can be nurtured within the constraints of these unique socio-cultural environments. (1581)
Competence:
When children feel competent to perform a task where there is optimal challenge, then it is more likely that they will engage and then persist in that activity. (399)
increasing a child’s perceptions of competence, which involves exposing children to learning environments that allow steady upward progress, along carefully graded “baby steps” towards mastery, boosts persistence and confidence. (403)
Strengths-based assessments such as the Social and Emotional Assets and Resilience Scales (SEARS) (Merrell 2011) can offer a constructive way of identifying children’s strengths both from their own perspective and also those of salient people around them, such as parents and teachers (see Resource 3.1). The Behavioral and Emotional Rating Scale (Epstein and Sharma 1998) is another means of determining inter- and intra-personal strengths, family involvement, school functioning and affective strength. The process of completing an assessment that employs a strengths perspective can help establish a positive therapeutic relationship. It is well accepted now that strengths-based approaches rather than deficit-oriented models have considerable potential to enhance children’s resilience and optimize self-competence. (1639)
Ensuring that goals remain task- or learning-oriented, wherever possible, rather than ego- or competitively oriented and focused on performance outcomes, is one way of avoiding destructive evaluative processes that may occur within some school and achievement-focused environments. (1649)
A widely used means of identifying goals when working with children, the Canadian Occupational Performance Measure (COPM; Law et al. 2005), can be used effectively with both children and adults.
In the context of Self-Determination Theory (SDT), competence concerns the psychological need to experience confidence in one’s capacity to affect outcomes, and as such refers to both the belief in capability and actual competence during action and achievement of one’s goals. (2033)
Appropriate external support that is sensitively delivered may be effective, however, in helping children to work successfully towards self-identified goals and, through this process, come to see themselves as competent individuals. (2051)
Alex’s self-perceptions of competence appear to be based on comparative evaluations against peers’ performance. Using externally referenced criteria, such as benchmarking performance against normative standards rather than self-referenced criteria (e.g. “personal bests”), when forming perceptions of one’s own competence can be associated with decreased persistence and engagement in challenging tasks, particularly where success is not guaranteed. (2111)
Incremental views of ability are associated with having “personal best” reference points and a view that ability can change if more effort and persistence are invested in activity performance. (2119)
Having a growth mindset is associated with the belief that if sufficient effort and learning are invested in an activity, then this will lead to improved outcomes. The opposite view sees ability as being largely determined from birth; a perspective known as having an entity or fixed belief. (2146)... As an example, children who were praised for their intelligence were found to have strong fixed views of intelligence compared to children who were praised for effort (Mueller and Dweck 1998). (2159)... Theory and research have demonstrated that children with a fixed view of their ability tend to pursue performance (also known as ego-oriented) goals while those with an incremental view pursue mastery (also known as task- or learning-oriented) goals (Rudolph 2010). (2173)
There are three avenues available to the therapist to develop children’s self-perceived competence. The first of these is to increase opportunities for experiencing success through realization of achievable goals. As children see that they are successful in meeting their goals, their self-perceived competence will improve. The second approach is to develop children’s problem-solving abilities, particularly with respect to barriers to successful attainment of self-selected goals. The third mechanism is the feedback the child receives related to his/her performance. (2264)
Feedback that is critical of performance or effort undermines intrinsic motivation and hinders a child’s sense of competence (Deci and Ryan 2008a). Extrinsic feedback that provides useful information about options for doing something differently to achieve the child’s desired goal and does not evaluate performance supports ARC psychological need satisfaction (Chatzisarantis and Hagger 2009). At times, competence feedback can be undermining (see Table 4.1). When used judiciously, extrinsic feedback can add to the intrinsic feedback the child receives about his/her performance and may support self-perceptions of competence (Fredenburg, Lee and Solomon 2001). When a child participates in activities and experiences accomplishment, extrinsic feedback can be a useful adjunct to sustaining motivation during periods of learning that may not appear directly to result in goal attainment (McGill 2006). A practitioner’s skills in providing extrinsic feedback must be refined and expertly applied. This requires attention to language (see Chapter 5 for more information), timing and body language. (2282)
Planned reward structures can have a negative effect on interest in pursuing tasks for their own sake (i.e. intrinsic motivation) (Deci et al. 1999). However, providing a reward after a child has reached a specific goal or met a criterion of performance is argued to have no adverse effects on self-determination (Eisenberger, Pierce and Cameron 1999). Arguably, behavior-specific task performance feedback that is unexpected does not deplete intrinsic motivation (Eisenberger et al. 1999). Thus the catchphrase “catching kids doing things correctly and telling them so” has empirical support for its efficacy. (692)
Both approaches concur that providing a reinforcer for a behavior that is intrinsically motivating represents poor practice. However, it must be recognized that not all behaviors a child is required to undertake are intrinsically motivating. Indeed, Brophy (2009) pointed out the somewhat limiting nature of focusing too much on intrinsic motivations. He also argued that children are unlikely to come across the exciting, engaging aspects of learning if left to their own interests. This certainly applies to some of the tasks likely to be required if therapy is to be successful. (1397)
There is ample evidence (see box 2.4) that the use of reinforcers produces behavior change. However, a number of writers have identified incompatibilities between the use of rewards and SDT. They point to the evidence that rewards weaken intrinsic motivation and argue that their employment is interpreted as controlling, thus undermining the perception of autonomy (see Ryan et al. 2011 for a discussion). This is not universally accepted, however. The use of operant techniques (often called the behavioral approach) need not be detrimental to a child’s capacity to be self-determining if they are applied thoughtfully. (1402)
There will be many goals of therapeutic intervention that are necessary but are not intrinsically motivating. One example is toilet training, which is often the focus of intervention, especially for children with a developmental disability. It is unlikely that a child will be intrinsically motivated to undertake this training; however, it is an important life skill and is very successfully addressed through the use of a well-developed shaping program that uses reinforcers, which are faded as the behavior becomes established. Good practice using principles based on operant theory requires a sophisticated integration of a range of strategies and is more than merely offering a reward for the engaging in or completing a behavior (see Box 2.4). Operant approaches do not necessarily mean that someone other than the child selects goals. Many approaches using operant methods explicitly have the goal of moving the behavior being taught under the child’s control and/or developing the child’s skills to the point where he/she is able to use these methods to reach self-selected goals. The thoughtful application of reinforcers does not necessitate the absence of autonomy support, therefore. Many therapists who adopt. (1407)
Deci and Ryan (2000b) do not argue with the claim that operant methods change behavior. They are concerned, however, that such strategies will undermine the child’s autonomy and self-regulatory abilities, particularly in relation to intrinsically motivated behaviors. The use of reinforcers for behaviors that are intrinsically motivating (that is, the individual undertakes the activity merely for the enjoyment derived from engaging in the behavior) may reduce this property of the behavior and, therefore, should be avoided. (See Akin-Little et al. 2004; Carton 1996; Henderlong and Lepper 2002 for a full discussion of the issues.) Reinforcement is a process that contains information (feedback) of use to the child. It will be most effectively used in therapy if the feedback is provided in a way that is informational rather than controlling and when the child is taught to recognize the competence information that is available in feedback. It is essential that practitioners consider issues of timing and predictability when introducing, maintaining and eventually fading out reinforcement schedules (see Box 2.5). (1423)
An interesting point to note is that established behaviors that are rewarded unpredictably are more likely to be reproduced. Behaviors that are new to the child are more likely to be adopted if reinforcement occurs every time the behavior occurs. Once established, however, it is imperative to move to an intermittent schedule to inoculate against extinction. (1435)
Teaching children the processes of self-reinforcement and emphasizing the contribution these skills can make to their autonomy is also a helpful way of ensuring that operant approaches are supporting of autonomous functioning. Finally, when working with families, it is important to ensure that sufficient attention is paid to teaching parents about the fading of reinforcers—a topic that is generally neglected when parents are involved in providing reinforcement to their child—and about how to support the child to develop his/her own skills in goal setting, self-monitoring and self-reinforcing. (1438)
Ryan and Deci (2000b) state clearly that the principles of SDT do not apply to tasks that are not intrinsically motivating and make it clear that there will be occasions when the most appropriate thing to do is for the therapist to promote external motivation. Under these circumstances, the use of external reward structures is appropriate—these are used to engage a child in a task in which he/she is not. (1450)
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