Andrew Hadler is a Consultant Forensic Psychiatrist with Sussex Partnership NHS Foundation Trust, UK and Honorary Lecturer at Brighton and Sussex Medical School. Stephen Sutton is Professor of Behavioural Science and Head of the Behavioural Science Group at the Institute of Public Health, University of Cambridge, UK. Lars Osterberg is Associate Professor (Teaching) at Stanford University School of Medicine, USA, and a Staff Physician at the Veterans Administration Palo Alto Health Care System.

Adherence to long-term therapies is perhaps one of the most important issues that deserves the attention of all stakeholders in the health care field, including doctors, nurses, pharmacists, all health care providers, but also the pharmaceutical industry, health authorities and payers. Everyone agrees that patient adherence, especially for those with chronic diseases, is far from optimal, with catastrophic consequences for the effectiveness of care, which has made more progress in the last 50 years than in the 50 centuries before.The originality of this book relies on the fact that it approaches the problem of adherence in a holistic way, going beyond the term adherence, which was itself already an advance over that of compliance. It proposes replacing it with a more general term, that of engagement. This concept reinforces the involvement of the patient, becoming a true agent in the management of his or her disease. In particular, it is necessary to distinguish between the different phases of this engagement, at the time of treatment initiation, implementation and, last but not least, persistence.This book will be of interest to all care providers. Its ambition is to clarify through theoretical models the mechanisms of patient engagement in treatment, so that practical approaches can be identified to improve it, giving both general indications and specific applications to different groups of patients. An entire section of the book is devoted to care in different contexts: adolescence, the elderly, vulnerable people, the effect of social deprivation cognitive deficits and mental illness. At a time when digital technology and artificial intelligence are transforming the practice of medicine, this book shows their promises and limitations with remarkable intelligence (Chapter 30). Inevitably, the new demands of patients to become agents of their treatment require the development of the concept of shared medical decision making and Chapter 28 devoted to it is especially brilliant. It is this sharing which really defines the concept of engagement, which makes it inseparable from patient education, which truly finds its full meaning in engagement. It is through this process that trust is generated, which is the condition for real patient engagement. It requires that care providers become aware of the human nature of patients, combining the greatness of complex thought with the presence of cognitive and emotional bias. This book therefore sets out the conditions for the real implementation of a person-centered medicine.—Professor Gérard Reach, Professor of Edocrinology and Metabolism, Paris 13 University & Head of the Endocrine Department, Avicenne Hospital, Bobigny, France

• Foreword viiiPreface xNotes on Authors xiiiNotes on Contributors xivAcknowledgments xxvIntroduction 1Section I Background 151 Treatment Engagement and Adherence: A Review of the Literature 17Christiana O. Oshotse, Hayden Barry Bosworth, and Leah L. Zullig2 What Do Patients Want? Patient Satisfaction and Treatment Engagement 33Ann E. Webb and Robin E. Gearing3 Values‐based Practice and Patient Engagement: Linking Science with People 58Bill (K.W.M.) Fulford4 Informed Consent and the Law: From Patient Compliance to Patient Engagement? 75Richard Huxtable5 Assessing, Measuring, and Monitoring Treatment Engagement 92Donald E. Morisky and Chia‐Hsin Emily ChengSection II Understanding Treatment Engagement 1096 Addressing the Challenges of Neurocognitive Impairment (NCI) on Treatment Engagement 111Roman Shrestha, Pramila Karki, and Michael Copenhaver7 Self‐determination Theory and Autonomy Support to Change Healthcare Behavior 141Martin S. Hagger and Cleo Protogerou8 Attachment Theory, the Therapeutic Alliance, and Treatment Engagement 159Katherine Berry and Adam Danquah9 Clinical Case Formulation of Suboptimal Engagement 172Lawrence Jones and Sunita Guha10 The Contribution of Beliefs to Treatment Engagement 188Vivian Auyeung, Lyndsay D. Hughes, and John A. WeinmanSection III Practical Approaches to Enhance Engagement 20311 Medication and Treatment Beliefs as Determinants of Treatment Engagement 205Rob Horne12 Cognitive Behavioral and eHealth Approaches to Promote Engagement in Treatment 223M. Bryant Howren, Anne I. Roche, and Alan J. Christensen13 Enhancing Treatment Engagement Through Motivational Interviewing 243Stanley R. Steindl and Jason P. Connor14 Positive Approaches to Promote and Support Changes in Health Behavior 259Emily G. Lattie and Anne Cohen15 Communication Skills to Engage Patients in Treatment 274Mollie A. Ruben, Danielle Blanch‐Hartigan, and Judith A. Hall16 Understanding Some Psychodynamic Factors Involved in Suboptimal Engagement 297Geoffrey P. Taylor and Deborah L. Cabaniss17 Enhancing Wellbeing and Motivation for Staff Working with Patients Who Have Inconsistent or Challenging Engagement in Services 313Alex LordSection IV Treatment Engagement in Specific Client Groups 33518 Engaging Patients from Diverse Backgrounds in Healthcare Treatment 337Aswita Tan‐McGrory, Andrea O. Madu, Karey S. Kenst, and Joseph R. Betancourt19 Enhancing Treatment Adherence in Young People with Chronic Diseases 354Michael A. Rapoff and Ali Calkins‐Smith20 Enhancing Treatment Engagement in Older Adults 365Jo Anne Sirey and Patricia Marino21 Treatment Engagement and People with Intellectual Disability 381Roger J. Stancliffe, Seeta Durvasula, Nathan J. Wilson, and Peter Lewis22 Promoting and Maintaining Engagement in Substance Abuse Treatment 399Nikolaj Kunøe23 Working with People with Mental Health Difficulties to Improve Adherence to Medication 430Thomas R.E. Barnes and Peter M. Haddad24 Engaging Socially Excluded Individuals and Communities in Healthcare 455Jed Boardman and David Morris25 Understanding and Overcoming Barriers to Treatment Engagement in Lower‐income Countries 477Andrew L. Ellner, Jessica L. Alpert, Chris Desmond, and Ashwin VasanSection V Designing and Delivering Services to Optimize Patient Engagement 50326 Treatment Engagement: The Experience of Users of Health Services 505Dolly Sen27 Recovery from Ill Health from an Occupational Perspective 515Wendy Bryant and Maggie Winchcombe28 Achieving Patient Engagement Through Shared Decision‐making 531Paul Barr, Glyn Elwyn, and Isabelle Scholl29 Optimizing Service Delivery to Enhance Treatment Engagement 551Sharon Lawn30 Patient Engagement in Treatment in an Information Age 568Fiona Stevenson and Maureen Seguin31 Governing by Risk, or Why Interventions to Improve Health Fail 582Paul CrawshawAfterword: Future Directions 597Index 602

Andrew Hadler is a Consultant Forensic Psychiatrist with Sussex Partnership NHS Foundation Trust, UK and Honorary Lecturer at Brighton and Sussex Medical School. Stephen Sutton is Professor of Behavioural Science and Head of the Behavioural Science Group at the Institute of Public Health, University of Cambridge, UK. Lars Osterberg is Associate Professor (Teaching) at Stanford University School of Medicine, USA, and a Staff Physician at the Veterans Administration Palo Alto Health Care System.

Adherence to long-term therapies is perhaps one of the most important issues that deserves the attention of all stakeholders in the health care field, including doctors, nurses, pharmacists, all health care providers, but also the pharmaceutical industry, health authorities and payers. Everyone agrees that patient adherence, especially for those with chronic diseases, is far from optimal, with catastrophic consequences for the effectiveness of care, which has made more progress in the last 50 years than in the 50 centuries before.The originality of this book relies on the fact that it approaches the problem of adherence in a holistic way, going beyond the term adherence, which was itself already an advance over that of compliance. It proposes replacing it with a more general term, that of engagement. This concept reinforces the involvement of the patient, becoming a true agent in the management of his or her disease. In particular, it is necessary to distinguish between the different phases of this engagement, at the time of treatment initiation, implementation and, last but not least, persistence.This book will be of interest to all care providers. Its ambition is to clarify through theoretical models the mechanisms of patient engagement in treatment, so that practical approaches can be identified to improve it, giving both general indications and specific applications to different groups of patients. An entire section of the book is devoted to care in different contexts: adolescence, the elderly, vulnerable people, the effect of social deprivation cognitive deficits and mental illness. At a time when digital technology and artificial intelligence are transforming the practice of medicine, this book shows their promises and limitations with remarkable intelligence (Chapter 30). Inevitably, the new demands of patients to become agents of their treatment require the development of the concept of shared medical decision making and Chapter 28 devoted to it is especially brilliant. It is this sharing which really defines the concept of engagement, which makes it inseparable from patient education, which truly finds its full meaning in engagement. It is through this process that trust is generated, which is the condition for real patient engagement. It requires that care providers become aware of the human nature of patients, combining the greatness of complex thought with the presence of cognitive and emotional bias. This book therefore sets out the conditions for the real implementation of a person-centered medicine.—Professor Gérard Reach, Professor of Edocrinology and Metabolism, Paris 13 University & Head of the Endocrine Department, Avicenne Hospital, Bobigny, France

• Foreword viiiPreface xNotes on Authors xiiiNotes on Contributors xivAcknowledgments xxvIntroduction 1Section I Background 151 Treatment Engagement and Adherence: A Review of the Literature 17Christiana O. Oshotse, Hayden Barry Bosworth, and Leah L. Zullig2 What Do Patients Want? Patient Satisfaction and Treatment Engagement 33Ann E. Webb and Robin E. Gearing3 Values‐based Practice and Patient Engagement: Linking Science with People 58Bill (K.W.M.) Fulford4 Informed Consent and the Law: From Patient Compliance to Patient Engagement? 75Richard Huxtable5 Assessing, Measuring, and Monitoring Treatment Engagement 92Donald E. Morisky and Chia‐Hsin Emily ChengSection II Understanding Treatment Engagement 1096 Addressing the Challenges of Neurocognitive Impairment (NCI) on Treatment Engagement 111Roman Shrestha, Pramila Karki, and Michael Copenhaver7 Self‐determination Theory and Autonomy Support to Change Healthcare Behavior 141Martin S. Hagger and Cleo Protogerou8 Attachment Theory, the Therapeutic Alliance, and Treatment Engagement 159Katherine Berry and Adam Danquah9 Clinical Case Formulation of Suboptimal Engagement 172Lawrence Jones and Sunita Guha10 The Contribution of Beliefs to Treatment Engagement 188Vivian Auyeung, Lyndsay D. Hughes, and John A. WeinmanSection III Practical Approaches to Enhance Engagement 20311 Medication and Treatment Beliefs as Determinants of Treatment Engagement 205Rob Horne12 Cognitive Behavioral and eHealth Approaches to Promote Engagement in Treatment 223M. Bryant Howren, Anne I. Roche, and Alan J. Christensen13 Enhancing Treatment Engagement Through Motivational Interviewing 243Stanley R. Steindl and Jason P. Connor14 Positive Approaches to Promote and Support Changes in Health Behavior 259Emily G. Lattie and Anne Cohen15 Communication Skills to Engage Patients in Treatment 274Mollie A. Ruben, Danielle Blanch‐Hartigan, and Judith A. Hall16 Understanding Some Psychodynamic Factors Involved in Suboptimal Engagement 297Geoffrey P. Taylor and Deborah L. Cabaniss17 Enhancing Wellbeing and Motivation for Staff Working with Patients Who Have Inconsistent or Challenging Engagement in Services 313Alex LordSection IV Treatment Engagement in Specific Client Groups 33518 Engaging Patients from Diverse Backgrounds in Healthcare Treatment 337Aswita Tan‐McGrory, Andrea O. Madu, Karey S. Kenst, and Joseph R. Betancourt19 Enhancing Treatment Adherence in Young People with Chronic Diseases 354Michael A. Rapoff and Ali Calkins‐Smith20 Enhancing Treatment Engagement in Older Adults 365Jo Anne Sirey and Patricia Marino21 Treatment Engagement and People with Intellectual Disability 381Roger J. Stancliffe, Seeta Durvasula, Nathan J. Wilson, and Peter Lewis22 Promoting and Maintaining Engagement in Substance Abuse Treatment 399Nikolaj Kunøe23 Working with People with Mental Health Difficulties to Improve Adherence to Medication 430Thomas R.E. Barnes and Peter M. Haddad24 Engaging Socially Excluded Individuals and Communities in Healthcare 455Jed Boardman and David Morris25 Understanding and Overcoming Barriers to Treatment Engagement in Lower‐income Countries 477Andrew L. Ellner, Jessica L. Alpert, Chris Desmond, and Ashwin VasanSection V Designing and Delivering Services to Optimize Patient Engagement 50326 Treatment Engagement: The Experience of Users of Health Services 505Dolly Sen27 Recovery from Ill Health from an Occupational Perspective 515Wendy Bryant and Maggie Winchcombe28 Achieving Patient Engagement Through Shared Decision‐making 531Paul Barr, Glyn Elwyn, and Isabelle Scholl29 Optimizing Service Delivery to Enhance Treatment Engagement 551Sharon Lawn30 Patient Engagement in Treatment in an Information Age 568Fiona Stevenson and Maureen Seguin31 Governing by Risk, or Why Interventions to Improve Health Fail 582Paul CrawshawAfterword: Future Directions 597Index 602

Andrew Hadler is a Consultant Forensic Psychiatrist with Sussex Partnership NHS Foundation Trust, UK and Honorary Lecturer at Brighton and Sussex Medical School. Stephen Sutton is Professor of Behavioural Science and Head of the Behavioural Science Group at the Institute of Public Health, University of Cambridge, UK. Lars Osterberg is Associate Professor (Teaching) at Stanford University School of Medicine, USA, and a Staff Physician at the Veterans Administration Palo Alto Health Care System.

Adherence to long-term therapies is perhaps one of the most important issues that deserves the attention of all stakeholders in the health care field, including doctors, nurses, pharmacists, all health care providers, but also the pharmaceutical industry, health authorities and payers. Everyone agrees that patient adherence, especially for those with chronic diseases, is far from optimal, with catastrophic consequences for the effectiveness of care, which has made more progress in the last 50 years than in the 50 centuries before.The originality of this book relies on the fact that it approaches the problem of adherence in a holistic way, going beyond the term adherence, which was itself already an advance over that of compliance. It proposes replacing it with a more general term, that of engagement. This concept reinforces the involvement of the patient, becoming a true agent in the management of his or her disease. In particular, it is necessary to distinguish between the different phases of this engagement, at the time of treatment initiation, implementation and, last but not least, persistence.This book will be of interest to all care providers. Its ambition is to clarify through theoretical models the mechanisms of patient engagement in treatment, so that practical approaches can be identified to improve it, giving both general indications and specific applications to different groups of patients. An entire section of the book is devoted to care in different contexts: adolescence, the elderly, vulnerable people, the effect of social deprivation cognitive deficits and mental illness. At a time when digital technology and artificial intelligence are transforming the practice of medicine, this book shows their promises and limitations with remarkable intelligence (Chapter 30). Inevitably, the new demands of patients to become agents of their treatment require the development of the concept of shared medical decision making and Chapter 28 devoted to it is especially brilliant. It is this sharing which really defines the concept of engagement, which makes it inseparable from patient education, which truly finds its full meaning in engagement. It is through this process that trust is generated, which is the condition for real patient engagement. It requires that care providers become aware of the human nature of patients, combining the greatness of complex thought with the presence of cognitive and emotional bias. This book therefore sets out the conditions for the real implementation of a person-centered medicine.—Professor Gérard Reach, Professor of Edocrinology and Metabolism, Paris 13 University & Head of the Endocrine Department, Avicenne Hospital, Bobigny, France

• Foreword viiiPreface xNotes on Authors xiiiNotes on Contributors xivAcknowledgments xxvIntroduction 1Section I Background 151 Treatment Engagement and Adherence: A Review of the Literature 17Christiana O. Oshotse, Hayden Barry Bosworth, and Leah L. Zullig2 What Do Patients Want? Patient Satisfaction and Treatment Engagement 33Ann E. Webb and Robin E. Gearing3 Values‐based Practice and Patient Engagement: Linking Science with People 58Bill (K.W.M.) Fulford4 Informed Consent and the Law: From Patient Compliance to Patient Engagement? 75Richard Huxtable5 Assessing, Measuring, and Monitoring Treatment Engagement 92Donald E. Morisky and Chia‐Hsin Emily ChengSection II Understanding Treatment Engagement 1096 Addressing the Challenges of Neurocognitive Impairment (NCI) on Treatment Engagement 111Roman Shrestha, Pramila Karki, and Michael Copenhaver7 Self‐determination Theory and Autonomy Support to Change Healthcare Behavior 141Martin S. Hagger and Cleo Protogerou8 Attachment Theory, the Therapeutic Alliance, and Treatment Engagement 159Katherine Berry and Adam Danquah9 Clinical Case Formulation of Suboptimal Engagement 172Lawrence Jones and Sunita Guha10 The Contribution of Beliefs to Treatment Engagement 188Vivian Auyeung, Lyndsay D. Hughes, and John A. WeinmanSection III Practical Approaches to Enhance Engagement 20311 Medication and Treatment Beliefs as Determinants of Treatment Engagement 205Rob Horne12 Cognitive Behavioral and eHealth Approaches to Promote Engagement in Treatment 223M. Bryant Howren, Anne I. Roche, and Alan J. Christensen13 Enhancing Treatment Engagement Through Motivational Interviewing 243Stanley R. Steindl and Jason P. Connor14 Positive Approaches to Promote and Support Changes in Health Behavior 259Emily G. Lattie and Anne Cohen15 Communication Skills to Engage Patients in Treatment 274Mollie A. Ruben, Danielle Blanch‐Hartigan, and Judith A. Hall16 Understanding Some Psychodynamic Factors Involved in Suboptimal Engagement 297Geoffrey P. Taylor and Deborah L. Cabaniss17 Enhancing Wellbeing and Motivation for Staff Working with Patients Who Have Inconsistent or Challenging Engagement in Services 313Alex LordSection IV Treatment Engagement in Specific Client Groups 33518 Engaging Patients from Diverse Backgrounds in Healthcare Treatment 337Aswita Tan‐McGrory, Andrea O. Madu, Karey S. Kenst, and Joseph R. Betancourt19 Enhancing Treatment Adherence in Young People with Chronic Diseases 354Michael A. Rapoff and Ali Calkins‐Smith20 Enhancing Treatment Engagement in Older Adults 365Jo Anne Sirey and Patricia Marino21 Treatment Engagement and People with Intellectual Disability 381Roger J. Stancliffe, Seeta Durvasula, Nathan J. Wilson, and Peter Lewis22 Promoting and Maintaining Engagement in Substance Abuse Treatment 399Nikolaj Kunøe23 Working with People with Mental Health Difficulties to Improve Adherence to Medication 430Thomas R.E. Barnes and Peter M. Haddad24 Engaging Socially Excluded Individuals and Communities in Healthcare 455Jed Boardman and David Morris25 Understanding and Overcoming Barriers to Treatment Engagement in Lower‐income Countries 477Andrew L. Ellner, Jessica L. Alpert, Chris Desmond, and Ashwin VasanSection V Designing and Delivering Services to Optimize Patient Engagement 50326 Treatment Engagement: The Experience of Users of Health Services 505Dolly Sen27 Recovery from Ill Health from an Occupational Perspective 515Wendy Bryant and Maggie Winchcombe28 Achieving Patient Engagement Through Shared Decision‐making 531Paul Barr, Glyn Elwyn, and Isabelle Scholl29 Optimizing Service Delivery to Enhance Treatment Engagement 551Sharon Lawn30 Patient Engagement in Treatment in an Information Age 568Fiona Stevenson and Maureen Seguin31 Governing by Risk, or Why Interventions to Improve Health Fail 582Paul CrawshawAfterword: Future Directions 597Index 602