Motivational Enhancements in Schizophrenia

This chapter reviews the role of motivation in learning outcomes, a relevant topic for cognitive remediation programs which seek to enhance learning of neuropsychological skills. The literature indicates that people with schizophrenia who participate in cognitive remediation are more likely to benefit from the programs if they are intrinsically motivated to work on the tasks to improve their cognition. This intrinsic motivation refers to the motivation to attend the program because improved cognition is valued as a goal in and of itself. Since participants are not always intrinsically motivated when they enroll in cognitive remediation programs, it is important for clinicians to know that intrinsic motivation can be manipulated by applying certain instructional techniques and that when these techniques are used, the learning outcomes are increased. There is now evidence that people with schizophrenia respond to some of the same instructional techniques known to enhance intrinsic motivation in healthy students. The adaptable nature of intrinsic motivational processes in schizophrenia provides a platform from which to design effective cognitive remediation programs to enhance not only cognition but also functional outcome.