Autonomy-supportive therapeutic relationship model: a self-determination approach for physical rehabilitation professionals

Langdon, J., Schlote, R., Harris, B., Burdette, G., & Rothberger, S. (2015). Effects of a training program to enhance autonomy supportive behaviors among youth soccer coaches. J. Hum. Sport Exerc., 10(1), pp.114. This study aimed to evaluate the prevalence and implementation of a training emphasizing the use of autonomy supportive coaching behaviors among youth soccer coaches in game-play situations as well as evaluating its effects on motivational processes among athletes. Participants included youth sport soccer coaches and their intact teams. Coaches received a series of autonomy-supportive coaching training interventions based on successful programs in general and physical education (Reeve, Jang, Carrell, Jeon & Barch, 2004; Cheon, Reeve & Moon, 2012). Athletes completed questionnaires to assess perceived autonomy support, basic need satisfaction, and motivation (Harris & Watson, 2011). Observations indicated coaches were not able to significantly modify their behaviors, yet reflectively reported modest implementation of autonomy supportive behaviors. Coaches believed the training influenced their coaching style/philosophy in regards to the coach-athlete relationship and communication styles, emphasizing choice and rationales. Continued research is needed to enhance use of autonomy supportive behaviors with volunteer coaches in a youth sport environment. Key words: AUTONOMY SUPPORTIVE COACHING, SELF-DETERMINATION THEORY, YOUTH SPORT.

WHAT IS KNOWN ON THE SUBJECT?: Numerous studies have shown that organizational and managerial factors have significant effects on nurses' workplace well-being. There are few studies on the effects of nurses' perceptions of their supervisors' autonomy-supportive behaviours on their workplace well-being. There are few studies on the determinants of nurses' workplace well-being within a psychiatric context. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: This study examines the psychological processes underlying the relationship between nurses' perceptions of their supervisors' autonomy-supportive behaviours and their workplace well-being. Mental health nurses' perceptions of their supervisors' autonomy-supportive behaviours are indirectly and positively related to their workplace well-being through their positive effects on psychological need satisfaction. Autonomy and competence need satisfaction has stronger effects on workplace well-being than relatedness need satisfaction. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: When their supervisor gives nurses a meaningful rationale for tasks and acknowledges their feelings and views, they feel more autonomous, competent and related to others. It is important for nurses to feel autonomous and competent in order to experience well-being at work. Nurses' workplace well-being might be positively and negatively linked to quality of care and turnover intentions, respectively. Abstract Introduction There is growing interest in the relationships between work factors and nurses' workplace well-being. However, there has been very little research on the psychological processes underlying the relationships between nurses' perceptions of supervisors' autonomy-supportive managerial style and their workplace well-being. Aim/question Drawing on self-determination theory, we explored the mediating role of psychological need satisfaction (autonomy, competence and relatedness) in the relationships between nurses' perceptions of supervisors' autonomy-supportive managerial style and their workplace well-being, using a prospective design. Method A prospective questionnaire was given to nurses in eight French psychiatric units. Data were collected from a sample of 294 French nurses who completed measures of perceived supervisors' autonomy-supportive behaviours at Time 1 and of psychological need satisfaction, work engagement and job satisfaction at Time 2 one year later. Results Results revealed that nurses' perceptions of supervisors' autonomy-supportive managerial style were indirectly and positively related to their vigour, dedication, absorption and job satisfaction one year later through their positive effects on psychological need satisfaction. Discussion/implications for practice Overall, this paper sheds light on the indirect effect of nurses' perceptions of supervisors' autonomy-supportive behaviours on their workplace well-being. Theoretical contributions and future directions, as well as implications for practice, are discussed.

این پژوهش به‌بررسی تاثیر رفتارهای حمایتی استقلال معلمان زبان انگلیسی بر آمادگی زبان‌آموزان برای کسب استقلال می‌پردازد. به‌این منظور، پرسشنامة آمادگی برای کسب استقلال در میان ۲۴۰ زبان‌آموز سطح متوسط در پنج آموزشگاه شهر کرمانشاه در ایران توزیع و جمع‌آوری شد. سپس محققان چهار معلم را براساس هشت اصل ارتقا استقلال نظریه خودسازماندهی در هشت جلسه دو الی سه ساعته آموزش دادند و زبان‌آموزان شرکت‌کننده را به‌دو گروه آزمایش و کنترل ۱۲۰ نفره تقسیم کردند. گروه آزمایش طی شش ماه تحت آموزش زبان توسط چهار معلم تعلیم دیده قرار گرفتند. گروه کنترل نیز به‌کلاس‌های معمول خود ادامه دادند. پرسشنامه آمادگی برای کسب استقلال مجدداً در دو گروه آزمایش و کنترل اجرا شد و نتایج آن با پرسشنامه اولیه مقایسه شد. نتایج تحلیل آمار نشان داد که رفتارهای حمایتی استقلال معلمان گروه آزمایش در پنج زمینه تغییر و بهبود ایجاد کرده است که همگی اجزای مفهوم استقلال می‌باشند: مسئولیت‌پذیری بیشتر، شناخت خود به‌عنوان یک یادگیرنده، شناخت بهتر محیط یادگیری، آشنایی بیشتر با مراحل یادگیری، و آغازگری بیشتر در فعالیت‌های منجر به‌یادگیری. کاربردهای آموزشی این مطالعه مورد بحث قرار گرفته‌اند.

To determine the utility of the motion sensitivity quotient (MSQ) in diagnosing pediatric vestibular migraine (VM) and to characterize the role of motion sensitivity and headache control on vestibular rehabilitation (VR) outcomes in pediatric VM. Retrospective cohort analysis. Pediatric tertiary referral center. Children (≤18 years old) with dizziness who completed vestibular testing from January 2016 to August 2022, diagnosed with either VM or another vestibular disorder. VR, which included MSQ testing. Initial MSQ, number and duration of vestibular physical therapy (PT) sessions, PT goals met, and posttreatment MSQ. Two hundred fifty-seven patients met study criteria. MSQ was not a reliable diagnostic marker in pediatric VM as there was no difference in initial MSQ between VM and non-VM patients (9.4 vs. 7.8 in non-VM, p = 0.014). Both VM (n = 116) and non-VM (n = 141) patients demonstrated significant improvement in MSQ after VR (p = 0.004). However, VM patients tended to be less likely to meet at least one PT goal (60 vs. 77% in non-VM, p = 0.016, d = 0.37), although not significant. VM patients with more frequent headaches had significantly higher initial MSQ (p = 0.008). VM patients with more frequent headaches or higher initial MSQ tended to require increased number and longer duration of VR (small/medium effect size although not statistically significant after Bonferroni correction). VR is an effective treatment for both VM and non-VM pediatric patients. VM patients, especially those with severe motion sensitivity or poorly controlled headaches, may be less responsive to VR and may require increased frequency and duration of VR. Our findings propose the importance of counseling pediatric patients with severe motion sensitivity or uncontrolled migraines regarding realistic expectations of their VR course.

A high degree of psychiatric disorders has repeatedly been described among patients with organic vertigo syndromes and attributed to vestibular dysfunction. Yet almost no investigations exist which differentiate between various organic vertigo syndromes with regard to psychiatric comorbidity. The following prospective, interdisciplinary study was carried out to explore whether patients with different organic vertigo syndromes exhibit different psychological comorbidities. 68 patients with organic vertigo syndromes (benign paroxysmal positioning vertigo (BPPV) n = 20, vestibular neuritis (VN) n = 18, Menière's disease (MD) n = 7, vestibular migraine (VM) n = 23) were compared with 30 healthy volunteers. All patients and control persons underwent structured neurological and neuro-otological testing. A structured diagnostic interview (-I) (SCID-I) and a battery of psychometric tests were used to evaluate comorbid psychiatric disorders. Patients with VM and MD showed significantly higher prevalence of psychiatric comorbidity (MD = 57%, VM = 65%) especially with anxiety and depressive disorders, than patients with VN (22%) and BPPV (15 %) compared to normal subjects (20 %). These elevated rates of comorbidities resulted in significantly elevated odds-ratios (OR) for the development of comorbid psychiatric disorders in general (for VM OR = 7.5, for MD OR = 5.3) and especially for anxiety disorders (for VM OR = 26.6, for MD OR = 38.7). As a consequence, a structured psychological and psychometric testing and an interdisciplinary therapy should be proceeded in cases with complex and prolonged vertigo courses, especially in patients with VM and MD. Possible reasons of these unexpected results in VM and MD are discussed.

Based on self-determination theory, adolescents’ leisure-time (LT) physical activity (PA) behaviour may depend on the extent by which they perceive an environment as autonomy-supportive. The present study aimed to investigate whether adolescents’ perception of autonomy-supportive behaviour from their peers is related to adolescents’ objectively measured LT moderate-to-vigorous physical activity (MVPA) through perceived psychological needs satisfaction and intrinsic motivation towards PA. School students (n=215) aged between 12 to 15 years old (age: 13.20±0.96 yrs) completed self-reported measures of perceived peers’ autonomy support, psychological needs satisfaction, and intrinsic motivation in the context of LT PA. In addition, study participants wore an accelerometer (Acti-Graph GT3X) to monitor their MVPA. Results of the structural equation modelling revealed that perceived autonomy support from peers had a significant and positive effect on perceptions of all three psychological need satisfaction in LT, which, in turn, had a significant and positive effect on adolescents’ intrinsic motivation. Adolescents’ LT PA was significantly predicted by their intrinsic motivation towards PA. Only one pathway through autonomy need satisfaction was revealed by which adolescents’ perception of their peers’ autonomy-supportive behaviour is related to intrinsic motivation and MVPA. The findings of the current study highlight the role of peers’ autonomy-supportive behaviour on adolescents objectively measured PA through motivational processes in the context of LT.

Patients with vestibular migraine are susceptible to motion sickness. This study aimed to determine whether the severity of posture instability is related to the susceptibility to motion sickness. We used a visual motion paradigm with two conditions of the stimulated retinal field and the head posture to quantify postural stability while maintaining a static stance in 18 patients with vestibular migraine and in 13 age-matched healthy subjects. Three parameters of postural stability showed differences between VM patients and controls: RMS velocity (0.34 ± 0.02 cm/s vs. 0.28 ± 0.02 cm/s), RMS acceleration (8.94 ± 0.74 cm/s2 vs. 6.69 ± 0.87 cm/s2), and sway area (1.77 ± 0.22 cm2 vs. 1.04 ± 0.25 cm2). Patients with vestibular migraine showed marked postural instability of the head and neck when visual stimuli were presented in the retinal periphery. The pseudo-Coriolis effect induced by head roll tilt was not responsible for the main differences in postural instability between patients and controls. Patients with vestibular migraine showed a higher visual dependency and low stability of the postural control system when maintaining quiet standing, which may be related to susceptibility to motion sickness.

Background: Vestibular migraine (VM) is a condition characterized by regular attacks of vertigo and imbalance, along with migraine symptoms or signs. However, the role of the gut-brain axis (GBA) in mediating the severity of VM symptoms, particularly in the Pakistani population, remains poorly understood. This study aims to elucidate the relationship between GBA dysfunction and the severity of VM.Methodology: This cross-sectional study was conducted from May 2024 to April 2025 at Jinnah Hospital, Lahore, in collaboration with the Neurology and ENT departments. Convenience sampling was employed to recruit 386 participants diagnosed with VM. Data were collected using three primary instruments: the Gastrointestinal Symptom Rating Scale (GSRS), the Migraine Disability Assessment Test (MIDAS), and the Vertigo Symptom Scale-Short Form (VSS-SF). Demographic and lifestyle data were also collected. Pearson correlation, independent t-tests, analysis of variance (ANOVA), and multiple linear regression were used to study the correlation between GBA dysfunction and VM severity.Results: The sample included 386 participants, with males (296, 77%) and participants aged 60 years or older (154, 40%). Positive correlations were significant between gastrointestinal symptoms, migraine-related disability, and the severity of vertigo (P < 0.001; 95% confidence interval (CI) 0.06-0.18). Multiple linear regression analysis revealed that the severity of gastrointestinal symptoms (95% CI 0.15-0.55), older age (95% CI 2.70-7.70), and a high rate of vertigo incidences (95% CI 0.27-2.23) were significant predictors of increased migraine disability and vertigo symptom severity (P < 0.05). Anxiety and depression were also found to be related to severe symptoms, and this may indicate that mental health is also linked to GBA dysfunction in VM.Conclusions: The study demonstrates an association between GBA-related symptoms and greater VM severity. These findings highlight the potential importance of assessing gastrointestinal and psychological comorbidities in the management of VM, particularly in Pakistani clinical settings where such factors may be overlooked. Future research should investigate the therapeutic potential of gut-targeted interventions using longitudinal designs and objective measures to clarify causal relationships and assess efficacy.

Background Although studies based on self-determination theory have shown a relation between teachers’ autonomy-supportive teaching behaviors and students’ positive outcomes in physical education (PE), only a few studies have tested the relation between autonomy support and students’ actual game-play performance in a PE context. Purpose The purpose of this study was to examine whether physical education (PE) teachers’ autonomy-supportive behaviors would predict high school students’ actual game-play performance in PE activities. Method A total of 286 students (M age = 15.24, SD = 3.99) reported on their perceptions of their teachers’ autonomy-supportive behaviors, their experience of need satisfaction, and their autonomous motivation toward learning PE activities questionnaires. Teachers (N = 7, female = 3, M age = 38.57) and an expert rater measured students’ actual game-play performance with a comprehensive behavioral assessment tool. Results The results revealed that teachers’ autonomy support correlated positively with students’ psychological variables of need satisfaction, and autonomous motivation. Need satisfaction and autonomous motivation positively correlated with game performance either measured by teachers or measured by the expert rater. A path analysis showed that autonomy support positively predicted actual game performance measured by the expert rater (β = .05; p < .05) through need satisfaction and autonomous motivation. Conclusion The results suggest that PE teachers’ autonomy-supportive teaching styles promote not only students’ need satisfaction and autonomous motivation in PE activities, but also their actual game-play performance.

Objective: Vestibular migraine (VM) is one of the most common causes of recurrent vertigo, but the neural mechanisms that mediate such symptoms remain unknown. Since visual symptoms and photophobia are common clinical features of VM patients, we hypothesized that VM patients have abnormally sensitive low-level visual processing capabilities. This study aimed to investigate cortex abnormalities in VM patients using visual evoked potential (VEP) and standardized low-resolution brain electromagnetic tomography (sLORETA) analysis.Methods: We employed visual stimuli consisting of reversing displays of circular checkerboard patterns to examine “low-level” visual processes. Thirty-three females with VM and 20 healthy control (HC) females underwent VEP testing. VEP components and sLORETA were analyzed.Results: Patients with VM showed significantly lower amplitude and decreased latency of P1 activation compared with HC subjects. Further topographic mapping analysis revealed a group difference in the occipital area around P1 latency. sLORETA analysis was performed in the time frame of the P1 component and showed significantly less activity (deactivation) in VM patients in the frontal, parietal, temporal, limbic, and occipital lobes, as well as sub-lobar regions. The maximum current density difference was in the postcentral gyrus of the parietal lobe. P1 source density differences between HC subjects and VM patients overlapped with the vestibular cortical fields.Conclusion: The significantly abnormal response to visual stimuli indicates altered processing in VM patients. These findings suggest that abnormalities in vestibular cortical fields might be a pathophysiological mechanism of VM.

Rehabilitation programs for myocardial infarction (MI) survivors are designed to alter survivors' self-care patterns and to improve long-term physical and psychological outcomes. The purpose of this study was to examine the relationship between participation in cardiac rehabilitation and health state; days of reduced activity; anxiety; depression; self-esteem; quality of life; and performance of exercise, diet, medication, stress-modification, and smoking-reduction self-care behaviors after MI. Interviews were conducted with 197 women and men 1 to 2 years after their initial MI to measure health state, mood, self-esteem, quality of life, and relevant self-care behaviors. Rehabilitation center records were reviewed to determine participation in rehabilitation programs. Rehabilitation participation was significantly associated with health state; days of reduced activity; self-esteem; quality of life; and performance of exercise, diet, and medication self-care. These findings suggest that participation in cardiac rehabilitation is a worthwhile intervention that facilitates recovery from myocardial infarction.

Aims The purpose of this research was to understand the experience of older adults who completed an 8-week cervical spine home exercise program (HEP) designed to reduce visual reliance for postural stability, potentially impacting fall risk. Methods Nineteen older adults completed a semi-structured, one-on-one interview. Qualitative verbatim data from one open-ended prompt, “Tell me about your experience with the home exercise program,” were analyzed using an inductive, emergent approach. Results Eleven subthemes emerged within two overarching themes: motivational factors and perceived barriers. Two subthemes within the motivational factors category aligned with the Self-Determination Theory (SDT): autonomy and competence, impacting motivation. Participants reported a positive HEP experience despite the perceived barriers of time and commitment required for HEP completion. Conclusion This study provides insight into the experiences of older adults participating in an HEP and highlights the importance of considering their fundamental psychological needs when designing HEPs, impacting motivation and adherence.

Previous research on leader support was mainly based on the theory of social exchange, whereas few empirical studies have been derived from another motivational frame work. This study based on self-determination theory (SDT: Deci & Ryan) investigated leaders’ autonomy-supportive behavior within the organizational context. Leader’s autonomy support means from employees’ perspectives, providing greater choice, and encouraging self-initiation. Results from a sample of 65 managers working in Chinese enterprises showed four specific leader behaviors, including trust and respect of employees, instructing of employees’ career planning, counseling and recognizing, as well as positive monitoring and feedback that may give rise to employees’ perceived autonomy support. Discussion focused on the importance of leader’s autonomy-supportive behavior and pointed out some prospects for the future research.

Empowering leaders delegate authority, grant autonomy, and assign responsibilities to individuals or teams. Drawing on empowerment theory and self-determination theory (SDT), the present study hypothesizes that daily empowering leadership is related to employee work engagement through (a) psychological empowerment, and (b) the satisfaction of basic psychological needs. We collected data among 86 Norwegian Navy cadets during a 30-day transatlantic voyage (response = 97%; n = 2022 observations). Consistent with hypotheses, results of multilevel mediation path analysis showed that daily leader autonomy support and development support were positively related to daily employee work engagement through psychological empowerment and satisfaction of the needs for autonomy, relatedness, and competence. Moreover, leaders’ autonomy-supportive behaviour was most strongly related to psychological empowerment (not need satisfaction) and indirectly to work engagement when development support was high (vs. low). We discuss how these findings support and contribute to empowering leadership literature, as well as the practical implications.

To assess vestibular (i.e., passive self-motion) perception in patients diagnosed with persistent postural-perceptual dizziness (PPPD). Case-controlled, cross-sectional, observational investigation. Single-center laboratory-based study. Thirteen patients with PPPD, 13 age-matched healthy control volunteers. Of those with PPPD, eight had co-occurring vestibular migraine (VM). All participants completed a vestibular threshold test battery reflecting perception with predominant inputs from ( a ) the otoliths (1-Hz interaural y -axis translation, 1-Hz superior-inferior z -axis translation), ( b ) the semicircular canals (2-Hz yaw rotation, 2-Hz tilts in the planes of the vertical canal pairs), and ( c ) and canal-otolith integration (0.5-Hz roll tilt). Direction-recognition thresholds for each vestibular threshold test condition. Across all patients with PPPD, higher thresholds for superior-inferior z -translations thresholds in comparison to age-matched healthy control participants were identified ( p < 0.001). Those patients with co-occurring VM and PPPD (PPPD/+VM) displayed significantly higher z -translation thresholds ( p = 0.006), whereas patients with PPPD without VM (PPPD/-VM) displayed significantly higher roll tilt thresholds ( p = 0.029). Patients with PPPD did not display a global worsening of passive self-motion perception as quantified by vestibular perceptual thresholds. Instead, patients with PPPD displayed elevated thresholds for only roll tilt and z -translation thresholds, with the relative change in each threshold impacted by the co-occurrence of VM. Because both z -translation and roll tilt motions are reliant on accurate gravity perception, our data suggest that patients with PPPD may exhibit impaired processing of graviceptive cues.