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<p>Evidence-based practices (EBP) shown to be effective in mental health remain widely unavailable to vulnerable treatment-seeking populations. Provider training often improves EBP-related knowledge and skills, yet these gains are insufficient to facilitate on-going practice change and increased quality of care in community service settings. Self-Determination Theory (SDT), an empirically validated behavior change theory, can shed light upon factors involved in the knowledge-to-practice gap by elucidating ways in which training can promote internally regulated motivation and capacity to sustain effective practices in real-world settings. This study investigated whether a mental health training program was associated with improved motivation-related outcomes posited by SDT, including work-related self-efficacy, intrinsic motivation, and work engagement, and whether self-efficacy was indirectly related to enhanced work engagement through increased levels of intrinsic motivation, congruent with the theory. The study sample consisted of providers working on intensive mental health teams in a large public mental health system who elected to participate in a psychosocial intervention training program. Changes in self-efficacy, intrinsic motivation, and work engagement were measured before and after a 10-week training module. Structural equation modeling (SEM) was used to estimate and test relationships among the constructs of interest including the presence of an indirect relationship between self-efficacy and enhanced work engagement via intrinsic motivation as posited by SDT. Participants viewed the training positively and rated it as having a high degree of utility. Findings indicated significant increases in self-efficacy (<i>t</i> = 2.55; <i>p</i> &lt; 0.01), intrinsic motivation (<i>t</i> = 2.47; <i>p</i> &lt; 0.01), and work engagement (<i>t</i> = 2.46; <i>p</i> &lt; 0.01) from before until after training. A structural model (<i>N</i> = 144) showed a good fit to the data and evidence for intrinsic motivation acting as a partial mediator of the relationship between self-efficacy and work engagement (indirect effect = 0.14, <i>p</i> &lt; 0.01); 34% of model total effects on work engagement were mediated by intrinsic motivation. Results provide preliminary support for the applicability of SDT to mental health training design and evaluation. Training to enhance intrinsically motivated implementation behavior may help generate drive toward sustainable practice behavior change in complex and resource constrained systems of care. </p>

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Fostering Motivation for Practice Change: Using Self-Determination Theory to Guide Mental Health Training

  • 期刊论文

  • 发表日期：

    2026年2月24日

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  • Lisa Davis,
  • Enrique Orlina,
  • Elizabeth Mackey,
  • Michael McCreary,
  • Jennifer P. Wisdom,
  • La Tina Jackson,
  • Alejandro Silva,
  • Emi Bojan,
  • Sacha Fernandez,
  • Elizabeth Bromley

摘要

Evidence-based practices (EBP) shown to be effective in mental health remain widely unavailable to vulnerable treatment-seeking populations. Provider training often improves EBP-related knowledge and skills, yet these gains are insufficient to facilitate on-going practice change and increased quality of care in community service settings. Self-Determination Theory (SDT), an empirically validated behavior change theory, can shed light upon factors involved in the knowledge-to-practice gap by elucidating ways in which training can promote internally regulated motivation and capacity to sustain effective practices in real-world settings. This study investigated whether a mental health training program was associated with improved motivation-related outcomes posited by SDT, including work-related self-efficacy, intrinsic motivation, and work engagement, and whether self-efficacy was indirectly related to enhanced work engagement through increased levels of intrinsic motivation, congruent with the theory. The study sample consisted of providers working on intensive mental health teams in a large public mental health system who elected to participate in a psychosocial intervention training program. Changes in self-efficacy, intrinsic motivation, and work engagement were measured before and after a 10-week training module. Structural equation modeling (SEM) was used to estimate and test relationships among the constructs of interest including the presence of an indirect relationship between self-efficacy and enhanced work engagement via intrinsic motivation as posited by SDT. Participants viewed the training positively and rated it as having a high degree of utility. Findings indicated significant increases in self-efficacy (t = 2.55; p < 0.01), intrinsic motivation (t = 2.47; p < 0.01), and work engagement (t = 2.46; p < 0.01) from before until after training. A structural model (N = 144) showed a good fit to the data and evidence for intrinsic motivation acting as a partial mediator of the relationship between self-efficacy and work engagement (indirect effect = 0.14, p < 0.01); 34% of model total effects on work engagement were mediated by intrinsic motivation. Results provide preliminary support for the applicability of SDT to mental health training design and evaluation. Training to enhance intrinsically motivated implementation behavior may help generate drive toward sustainable practice behavior change in complex and resource constrained systems of care.