PURPOSE: The aim of this study was to induce flow experience by providing a physical activity to each participant and exploring the affecting factors in the capture of flow experience in persons with schizophrenia.

BACKGROUND: According to the flow theory, flow experience is a subjective psychological status and happens while individuals participate in activities with full concentration. The individuals within flow status would have clear goals, full sense of control of their actions, forget about the time and self, and yield pleasant feelings to life. Thus, in occupational therapy (OT) practice, the “just-right challenge” has been encouraged to help people obtain flow experience through activity participation. However, lack of motivation to participate in activity is often observed among persons with schizophrenia, who may have the dysfunction of personal causations caused by chronic disability.

While discussing the dysfunction of personal causation, the concept of causality orientation in self-determination theory has been considered to have proficiency and included three different motivational orientations labeled autonomy, controlled, and impersonal; the autonomy orientation in which persons act out of interest in and valuing of what is occurring; the control orientation in which the focus is on rewards, gains, and approval; and the impersonal orientation characterized by anxiety concerning competence.

However, in OT practice, the flow theory and self-determination theory have not been applied widely, and several major problems in persons with schizophrenia including emotional status, attention deficits, lack of motivation, and poor daily activity participation that relate to flow experience have not been well examined.

DESIGN: Cross-sectional design

PARTICIPANTS: A total of 100 adults diagnosed with schizophrenia or schizoaffective disorder were recruited. Study data were collected at psychiatric outpatient clinics, day hospitals, and vocational rehabilitation programs in Taipei, Taiwan.

METHOD: Instruments included Dispositional Flow Scale–2, Activity participation and restriction questionnaire, General Causality Orientation Scale, Satisfaction With Life Scale, Beck Depression Inventory–II, and Chu's Attention Test; then each participant was guided to participate in the table tennis activity with an interactive Ping-Pong ball launcher for 50 balls (the speed of the ball was determined by each participant), followed by responding to Flow State Scale and Leisure Satisfaction Scale; Positive and Negative Symptom Scale was also applied.

ANALYSIS: The statistics software R 3.1.3 was applied to conduct linear regression on the data.

RESULTS: The results showed that dispositional flow tendency, leisure satisfaction, autonomy orientation, attention function, and autonomy support can significantly predict the experience of flow state (R² = .7593, adjusted R² = .7316), F(10, 87) = 27.4402, p <.001.

DISCUSSION: The deficiencies of motivational orientation and attention function may hinder persons with schizophrenia in experiencing flow state while participating in physical activities; thus, the recommendations were made for incorporation of the strategies for facilitating intrinsic motivation and attention training program into the intervention for persons with schizophrenia in order to increase flow experience through activity participation.

IMPACT STATEMENT: The results of this study may serve as a piece of evidence in occupational clinical practice to establish the foundations in further inquiring into the intervention outcomes of occupational therapy.

Stavrou, N. A. (2008). Intrinsic motivation, extrinsic motivation and amotivation: Examining self-determination theory from flow therapy perspective. In F. M. Olsson (Ed.), New developments in the psychology of motivation (pp. 1–24). New York: Nova Science.