Doctor of Philosophy
School of Psychology
Williams, Virginia, Values-based interventions to facilitate self-determination and wellbeing in mental health workers following recovery training, Doctor of Philosophy thesis, School of Psychology, University of Wollongong, 2017. http://ro.uow.edu.au/theses1/70
Values can be described as verbal representations of desirable life states (Rokeach, 1973), that can influence moment to moment behaviour (Hayes, 2004). For individuals, values can act like a compass or set of guiding principles that shape and direct choices and actions, particularly in times of conflict or competing priorities. Organisationally, including within the mental health recovery field, the adoption of values statements as a set of guiding principles is common both at the service level and within policy (Farkas & Gagne, 2005). Though these high-level practices are aimed at shaping behaviour of individuals in organisations, research has not previously examined the specific and targeted use of interventions to promote autonomous uptake of desired behaviours by newly trained mental health workers. The motivation of individual staff is often overlooked when organisations attempt to create behavioural changes (Baldwin & Ford, 1998, Ferlie, Fitzgerald, Wood & Hawkins, 2005). The current research investigates the utility of values-based interventions as a means of fostering self-determined commitment to changed work practices. Within organisations, staff wellbeing is increasingly acknowledged as critical to effectiveness (e.g.,, Ramlall, 2013) and is highly relevant in the mental health context where employee "ill-being" is high (Maslach & Jackson, 1981; Russinova et al, 2011). Henceforth, the current research also seeks to clarify the link between autonomous motivation and increased employee wellbeing. The format of the thesis is as follows:
Chapter 1 introduces the bodies of literature underpinning this research, first providing a background to mental health recovery and the acknowledged challenges of operationalising a recovery vision into practice (Slade, 2012; Farkas & Gagne, 2005). Theory related to values and Self Determination Theory (SDT – Deci & Ryan, 1985b) is described, with a specific focus on the potential applicability of values interventions as a specific form of autonomy support, extending the current literature beyond a set of general principles.
Chapter 2 elaborates understanding of the concepts autonomy and autonomous motivation, in addition to detailing the continuum model of motivation acknowledged within SDT. Internalisation – the process through which low autonomy behaviours become more autonomously motivated according to SDT – is described with reference to the current understanding of autonomy supportive practices. Finally, the concept of values as a novel form of autonomy supportive practices to facilitate internalisation of socially determined behaviours and principles is expanded upon to aide deeper conceptual understanding of the processes being targeted in this research.
Chapter 3 outlines the full protocol of this research.
Chapter 4 details an investigation of the impact of a values-focused staff intervention as an adjunct to training in an evidence-based recovery framework (Collaborative Recovery Model - CRM Oades et al., 2005) and compares it to a more traditional method of implementation support. A total of 146 mental health workers from 5 community managed organisations delivering recovery services to individuals across 4 Australian states were randomised to either the values or implementation support condition according to their worksite. Results indicated that values clarification and commitment promoted increased autonomous commitment and plans to implement the newly trained CRM practices compared to implementation planning intervention. Additionally, a specific component of highly autonomous motivation (integrated motivation) was identified as relevant in this context where goals are socially controlled.
Chapter 5 details a longitudinal investigation comparing the impact of ongoing values versus implementation focused staff intervention on CRM related goal striving, and staff wellbeing. Contrary to hypotheses, there was no difference in successful striving towards CRM related goals or wellbeing of mental health workers across a range of measures between the experimental conditions after 6-months. In effort to extend the findings detailed in Chapter 4, this chapter examines the relationship between changes in integrated motivation (i.e., a highly relevant component of autonomous motivation), successful striving toward the CRM principles, and mental health worker wellbeing. Results from the 116 participants who completed intervention components at 6 months indicated a significant positive correlation between increases in integrated motivation and increased successful striving toward CRM principles. Increases in integrated motivation were also significantly negatively correlated with one aspect of employee wellbeing, namely, burnout. The hypothesis that increases in integrated motivation mediates the relationship between changes in successful CRM goal striving and burnout was tested, with modest support for the unique influence of integrated motivation.
Chapter 6 outlines limitations in the coaching protocol, issues related to participant attrition and data loss, in addition to specific issues related to the measurement of key variables (e.g., self-reported rather than objectively rated goal striving). The chapter concludes with suggestions for further research.
Overall, the current research suggests purposeful targeting of values as an adjunct to traditional training may promote greater autonomous motivation within mental health workers. The motivational component “integrated motivation” seems to have particular relevance to optimising autonomous motivation in controlled contexts like the workplace. However, further research to strengthen the effectiveness and fully understand the relevance of values interventions as a method of autonomy supportive practices is required to support translation of increased planned implementation of the CRM principles in to changed practice.