Expanding the concept of motivation to change: the content of patients' wish to recover from anorexia nervosa.

OBJECTIVE

Motivational approaches to anorexia nervosa (AN) have mainly concerned motivational quality and quantity. We investigated the content of patients' wish to recover.

METHOD

Eighteen women, aged 18-39, with AN were interviewed in depth using a phenomenological study design. Interviews were tape-recorded, transcribed, and analyzed using the QSR-N*Vivo software program.

RESULTS

Four motivational content areas characterized informants' wishes to recover: "Sense of vitality" (e.g., joy, concentration, spontaneity, energy); "Sense of autonomy" (e.g., choosing to recover, new methods of mastery, self-determination); "Sense of insight" (e.g., awareness, seeing nuances, limitation of goals, self-knowledge); and "Negative consequences" (e.g., loss of future, costs to own children, feeling sick or thin, social costs, physical costs).

CONCLUSION

Our sample of AN patients' motivation to recover may be described using three dimensions: content, quality, and quantity, and may also include motives with no behavioral intention. Sustained therapeutic success may rest upon the therapist's ability to identify and ally with the patient's motives to recover.