Motivation in Aphasia Treatment: Self-Determination Theory Applied to the FOURC Model

Purpose: Although the importance of motivation to successful rehabilitation is frequently acknowledged in the aphasia literature, little evidence-based guid-ance has been provided on how to support it. The purpose of this tutorial is to introduce a well-validated theory of motivation, self-determination theory (SDT); explain its role as the foundation for the FOURC model of collaborative goal setting and treatment planning; and explain how it may be applied during reha-bilitation to support the motivation of people with aphasia. Method: We provide an overview of SDT, explore the link between motivation and psychological wellness, and discuss how psychological needs are addressed in SDT and the FOURC model. Concrete examples from aphasia therapy are used to illustrate main concepts. Conclusions: SDT offers tangible guidance for supporting motivation and well-ness. SDT-based practices support positive forms of motivation, which is one of the targets of FOURC. An understanding of SDT's theoretical foundation will help clinicians maximize the impact of collaborative goal setting and aphasia therapy more generally.