A Group Intervention for Motivational Deficits: Preliminary Investigation of a Blended Care Approach Using Ambulatory Assessment.
Group therapy plus quick phone nudges can wake up motivation in adults with serious mental illness, but only if they stick with the program.
01Research in Context
What this study did
Bénédict et al. (2022) tested a new way to help adults who feel stuck and unmotivated. They ran a two-month program called Switch. It mixed weekly group meetings with short pings on the participants' own phones.
The pings are called ecological momentary interventions, or EMIs. They popped up during the day to nudge people to act on their goals. Everyone had a serious mental illness and said they felt apathetic at the start.
What they found
People who finished the program felt less apathy and got more done each day. These gains showed up only in the completers, not in everyone who signed up.
The study had no control group, so we can't be sure the change came from Switch plus EMI. Still, the trend was positive for those who stayed.
How this fits with other research
The result lines up with Alfonsson et al. (2015), who also ran group behavioral activation. Both studies lifted mood, but Sven's group did not cut binge-eating episodes. The difference shows that behavioral activation helps energy and mood, yet you must add extra parts when the target is a specific habit like overeating.
Fradet et al. (2025) and PCummings et al. (2024) extend the idea further. They paired apps with telehealth groups for autistic teens and toddlers. All four studies say the same thing: a human group plus a phone prompt can work across ages and diagnoses.
Krafft et al. (2019) tested an app without group meetings. Their ACT-matrix app gave only small gains to help-seeking adults. Putting the pieces together, the group part may be the engine, and the app is the gas that keeps it running between sessions.
Why it matters
If you run adult groups for depression, schizophrenia, or any condition that kills motivation, you can borrow this blend. Keep your in-person sessions, then add two or three daily phone prompts that ask, "What will you do next?" Start small: one prompt in the morning and one at lunch. Track who keeps the app open and who drops out, because the benefit only appears for people who stay engaged.
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02At a glance
03Original abstract
Motivational deficits are an important predictor of functional outcomes in individuals with a serious mental illness such as schizophrenia and mood spectrum disorders. The aim of the present study was to explore the feasibility, acceptability, and preliminary efficacy of a group version of "Switch," an intervention that targets motivational deficits, enriched with an ecological momentary intervention (EMI) approach (i.e., prompts on the participants' smartphone to encourage the use of trained strategies in their daily life). Eight participants with schizophrenia, schizoaffective, or major depressive disorder entered the study. The intervention took place twice a week for 2 months. Assessment measures included traditional evaluations of motivational negative symptoms, apathy, quality of life and daily functioning, in addition to ambulatory assessment methods strategies, including the experience sampling method (ESM) to assess motivation and related processes, and actigraphy (daily step-count) to assess participants' activity level. Four participants were considered as non-completers (followed less than 2/3 of the program) and four were considered as completers. Only completers presented a decrease in amotivation/apathy and an improvement in functional outcomes after the intervention and at follow-up. Furthermore, mixed-effects ESM models showed significant interaction effects on multiple processes related to motivation, indicating improvements only in completers: heightened motivation, increased engagement in meaningful and effortful activities, better mood, higher levels of confidence, increased frequency of projection into the future (pleasure anticipation), and of positive reminiscence. This preliminary investigation provides evidence that Switch may be an effective intervention, with specific effects on motivation and associated processes.
Behavior modification, 2022 · doi:10.1177/01454455211047605