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Handbook of Remotivation Therapy

	Introduction

What is remotivation therapy? The purpose of this short anthology is to enlighten readers about the birth, growth, decline, and gradual reemergence of this mental health therapy technique. The book targets mental health care professionals, but makes the case that remotivation therapy techniques are useful for anyone or any organization that takes care of people.

According to the book, "remotivation is a technique of simple group therapy, objective in nature, used with a group of patients in an effort to reach the ‘unwounded’ areas of each patient’s personality and to get them thinking about reality in relation to themselves. Remotivation differs from other therapies because it focuses on the patients’ abilities rather than disabilities" (p 13). Remotivation therapy was started in the 1940s by Dorothy Hoskins Smith, who used rhythm and poetry to engage clients who are mute at a Veterans Administration (VA) hospital. It gained momentum up to the 1970s, but a gradual decline followed from the mid-1970s through the 1990s, due to the deinstutionalization movement. Recently, there has been a gradual resurgence of interest in remotivation therapy, and its application has been broadened from patients with mental illness to any patient who can benefit from psychosocial support.

It should be noted that in order to practice remotivation therapy, each organization must have a certified remotivation therapist on staff. Certification is offered though the National Remotivation Therapy Organization at the basic and advanced level, and is open to any interested person. Although remotivation therapy is offered in a group setting, carryover of the principles to individual interactions with patients is encouraged. Currently, remotivation therapy is not reimbursed by insurers.

The first 5 chapters explain the history and tenets of remotivation therapy, as summarized above. A basic remotivation therapy session typically involves a group of about 6 people who meet once a week for 30 to 60 minutes. The remotivation therapist guides the group through 5 steps: creating a climate of acceptance (greetings), bridge to reality (poetry reading), sharing the world we live in (open-ended questions), an appreciation of the work of the world (sharing opinions and values), and climate of acceptance (summary and closure).

Chapter 6 is titled "Evidence-Based Remotivation," but unfortunately the evidence is unconvincing. Thirteen studies are cited, most from the 1950s through the 1970s. Few details are provided. Without going to the original literature, the reader is unable to discern key elements such as methodology, the size of the subject populations, the length of the follow-up, or the specific outcome measures.

Chapters 7 through 17 illustrate how remotivation therapy could be applied in a variety of settings, including extended care facilities, adult day care, correctional settings, and substance abuse programs. Specific populations discussed include those with Huntington disease and Alzheimer disease. Chapter 8, "Remotivation Therapy and Rehabilitation," may be of particular interest to physical therapists. Actual scripts of questions and answers are provided to illustrate how rehabilitation staff could use remotivation therapy to teach a patient to perform an activity such as an exercise program, but they come across as elementary and superficial. An example of these elementary scripts can be found on page 69:

1. What is your favorite season? (fall)
   
2. What games are played in the fall? (football)
   
3. Name some of the positions on a football team. (kicker)
   
4. What body part does the kicking? (legs)
   

The style of the book is easy to read, but falls short in providing evidence and analysis. The chapters are written by a variety of authors, often resulting in redundancy of material and a lack of depth and flow. There are limited references at the end of each chapter, but no diagrams or illustrations.

In summary, this book serves as a historical overview and promotional tool for remotivation therapy. The passion the editors and chapter authors feel for remotivation therapy is evident, but the evidence is thin and reimbursement for this intervention is nil. Nevertheless, there is something compelling about this common sense approach that may appeal to the core values of physical therapy. It’s about treating others well because "it is assumed that each person has a set of values which makes him or her important and worthwhile as an individual and a member of society" (p 13). I would hope that we, as physical therapists and physical therapist assistants, are practicing this with each of our patients; in this case, this book would be a gentle reminder, but not a valuable contribution to a physical therapy library.

Ann M York

Des Moines University
Des Moines, Iowa

	Footnotes

 
Dr York is Assistant Professor with the Post Professional Doctor of Physical Therapy Program. She previously taught in the Psychology Department at Lincoln Trail College in Illinois.

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This Article Full Text (PDF) Submit a response Alert me when this article is cited Alert me when Rapid Responses are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by York, A. M Search for Related Content PubMed Articles by York, A. M Related Collections Psychosocial: Other Social Bookmarking                      What's this?