Motivational Incongruence Predicts Subsequent Psychological Distress in Psychotherapy: Within-Person Evidence From Three Samples

Objective: Motivational incongruence refers to insufficient satisfaction of individual motives in interaction with the environment and is assumed to contribute to psychological distress and psychopathology when prolonged. This study examined reduced motivational incongruence as a potential change mechanism in psychotherapy by testing whether within-person decreases in motivational incongruence predict subsequent decreases in general psychological distress. Method: Analyses were based on three psychotherapy samples from two randomized controlled trials and one observational dataset collected in routine care, comprising 1,656 patients in total. In each sample, motivational incongruence and distress were assessed at four to six occasions during treatment using short forms of the Incongruence Questionnaire and the Symptom Checklist-90-R, respectively. Random-intercept cross-lagged panel models (RI-CLPMs) tested prospective within-person effects between motivational incongruence and distress. Latent curve models with structured residuals (LCM-SRs) served as exploratory robustness analyses. Results: Across three samples, the RI-CLPMs yielded significant and large prospective effects of motivational incongruence on subsequent distress. Reverse cross-lagged effects, from distress to subsequent motivational incongruence, were significant in two of the three samples. The exploratory LCM-SR supported the primary motivational incongruence-to-distress effect in one sample but yielded no admissible solutions in the other two. Conclusions: Across three independent psychotherapy samples, within-person reductions in motivational incongruence preceded reductions in distress, consistent with motivational incongruence as a potential transtheoretical change mechanism in psychotherapy. Motivational incongruence may therefore represent a candidate treatment target. Future research should test the proposed causal relationship experimentally and examine which dimensions of motivational incongruence are most relevant for individual patients.