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Table 6 Examples of courses of cognitions on medication through the sessionsa

From: Medication adherence in patients with schizophrenia: a qualitative study of the patient process in motivational interviewing

a: Pattern 1 Not ambivalent, motivated for medication adherence (case 12)

Session 1

• I fear the way people, like colleagues or a potential partner, will look at me if they know I’m being treated.

• I’m not going to quit medication.

Session 2

• Medications prevent me from experiencing a relapse in psychosis.

• For the time being I need medication.

Session 3

• Provisionally, I’ll stay on medication, I might never quit.

• There are so many people taking medication.

Session 4

• No cognitions on medication expressed in this session.

b: Pattern 2 Not ambivalent, no motivation for medication adherence (case 7)

Session 1

• The medication causes me a lot of trouble, makes me tired and gives me too much saliva.

• I don’t think those medications are important for me.

Session 2

• This medication is bad, I don’t need it, I quit using it.

• I’m fine if I don’t use medication.

Session 3

• Sometimes, medication is important.

• When I live at home, I won’t use medication.

Session 4

• I want to quit medication, I’m fine.

c: Pattern 3 Ambivalence solved, motivated for medication adherence (case 14)

Session 1

• It makes sense to take medication and I need it, but the dose should not be too high.

• Medications have effect, but they also cause side effects. When are the gains bigger than the harm?

Session 2 (no audio track available)

Session 3

• Medication makes me feel less myself.

• Medication helps me to experience positive periods of time.

Session 4

• Medications should be used wisely, I should not experiment with it.

• I need to use this medication dose because the impact of psychosis on my life is so big, so I need to prevent that from happening.

d: Pattern 4 Ambivalent, not solved (case 4)

Session 1

• When things are going better, I stop taking my pills.

• When I’m feeling fine, this is not just caused by the pills, but also because I’m taking good care of myself.

Session 2

• No cognitions on medication expressed in this session.

Session 3

• I’m not sure if the medications have an effect.

• I don’t want to be a guinea pig by unceasing changing of my medication, not knowing their effects.

Session 4

• It would be much easier to accept medication if it didn’t cause side effects.

Session 5

• No cognitions on medication expressed in this session.

Session 6

• In the long-term, medication is addictive.

• I’m certain that quitting medication won’t make me relapse.

Session 7

• No cognitions on medication expressed in this session.

Session 8

• I fear medication-addiction because of long-term use.

• If I were in control, it would be fine to use the medication for one more year.

Session 9

• I’m not sure whether the pro’s weight out the cons.

  1. aCognitions are explicitly or implicitly expressed by the patient. Sessions may have contained more cognitions, for reasons of space limitation we used maximal two cognitions per session