Bibliographic record
Abstract
Motivation for change predicts outcome. Unfortunately, motivation varies considerably in patients with borderline personality disorder (BPD), and many are not highly committed to therapeutic work at least in the early stages of therapy, which leads to poor compliance and high treatment dropout. Motivation is undermined by passivity and demoralization, expectations that someone or something will provide solutions, and a desire to use therapy only as a source of support. Motivation can also be impeded by external factors such as friendships and relationships. For example, significant others who have become accustomed to how the patient behaves may react adversely to attempts to behave differently, especially when these changes affect a status quo that they find comfortable. Consequently, ambivalence about treatment is common: many patients want help but worry about the process, are doubtful about its potential benefits, and are concerned about the effort required. This means that motivation for change cannot be a prerequisite for treatment. Instead, therapists need to become skilled in building motivation: studies show that effective therapists are good at motivating their patients. Readiness to change is not static: it fluctuates according to the effort involved and the level of distress that is anticipated to result from working on a problem. Motivation also depends of the focus of change: it is common for patients to be highly motivated to improve emotional stability but not to work on interpersonal problems or consequences of abuse because of the fears and shame involved. Although poor motivation is a serious problem, there is little research on how best to motivate patients with BPD, forcing us to draw on studies involving other disorders and the general literature on building motivation such as motivational interviewing to identify useful methods. Strategies for Building Motivation Motivation is influenced by other generic interventions. It is closely related to the quality of patient–therapist bond and hence the alliance should be reviewed whenever motivational problems arise. Validation and empathy also help to create a context conducive to a commitment to change. As with other generic interventions, no single intervention dramatically increases motivation. Instead, a commitment to change is built through repeated use of diverse strategies.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.256 | 0.128 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".