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