Exploring fulfillment of basic psychological needs in patients with dental anxiety: an investigation grounded in self-determination theory

OBJECTIVE: This qualitative study aimed to investigate how patients with severe dental anxiety perceived cognitive behavioral therapy (CBT) delivered by interdisciplinary teams consisting of psychologists and dental personnel. MATERIAL AND METHODS: Twelve individual semi-structured interviews were conducted at the Oral Health Center of Expertise in Eastern Norway, using an exploratory qualitative design. The analysis was guided by Braun and Clarke's thematic analysis. Self-determination theory (SDT) was applied as the theoretical and analytical framework. RESULTS: The qualitative analysis identified five themes shaping patients' experiences with CBT and progress in managing dental treatment: Establishing positive relationships with the psychologist and dental personnel, Experiencing enhanced competence in managing one's anxiety, Discovering the opportunity to use one's own capacities, Identifying factors nurturing plans for future dental visits, and Experiencing additional effects on quality of life. These results underscore the importance of autonomy-supportive treatment that fulfills patients' basic psychological needs (BPNs) for autonomy, competence, and relatedness, thereby fostering more autonomous motivation and desired behavioral changes. CONCLUSIONS: The findings indicate that CBT provided by interdisciplinary teams may benefit from adopting SDT as a framework, integrating autonomy-supportive principles to fulfill patients' BPNs. This approach may enhance CBT's patient-centered effectiveness and potentially improve patients' quality of life.