Model of motivation in schizophrenia: Development and validation of a multifactorial intervention aiming to enhance daily functioning and quality of life

People diagnosed with schizophrenia experience a number of difficulties in their daily life. An important barrier to daily functioning and quality of life is negative symptoms, motivational deficits in particular. Negative symptoms are, however, resistant to pharmaceutical treatment. Yet, very few interventions that target negative symptoms are available and those studies that have included such interventions suffer from a number of limitations. The goal of this research project was to develop a multifactorial intervention, “Switch”, based on a solid model of motivation in schizophrenia which identifies the various affective, cognitive and behavioural processes that underpin motivation and goal-directed behaviours. Switch targets the specific dysfunctions that appear in the processes identified in this model and uses a variety of therapeutic tools. The efficacy and effectiveness of the Switch intervention is evaluated through three studies. The first pilot study evaluates the efficacy of Switch delivered in individual sessions for around one year. The second study assesses the effectiveness of Switch in a naturalistic setting, through three case-studies. The third study evaluates the preliminary efficacy of the group version of Switch. The second and third studies include daily-life assessments which allow to generate hypotheses on how motivation and related processes evolve during the course of the intervention. Finally, a fourth study evaluates the dynamics between the processes related to motivation and goal-directed behaviours through network analyses. Together these four studies provide preliminary evidence that Switch is a promising psychotherapeutic intervention that may increase motivation and guide individuals with schizophrenia on a more enjoyable and meaningful path, and emphasize the benefits of integrating various processes, with a particular focus on hedonic capacities.