Motivating

Source: Online Behavior Guidelines | Lifestyle in Healthcare Coalition

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The Motivating strategy focuses on Wanting: patients must be motivated to change and see the benefits of behavior change. This chapter covers three techniques.

1. Self-persuasion

With self-persuasion, patients are encouraged to convince themselves of the benefits of behavior change. This is more effective than when someone else tries to convince them.

Tip

Self-generated arguments are more convincing than arguments from others - people trust their own reasons more.

Why does this work?

• People tend to be consistent with their own statements
• Self-generated arguments feel more relevant and personal
• It reduces resistance to external persuasion

Step-by-step plan

1. Give the patient a statement to think about, for example:

   • “Name reasons why exercise would be good for you”
   • “What would it mean for you to quit smoking?”

2. Let the patient come up with 1-3 reasons - not too many, that backfires

3. Ask about personal benefits - what would it specifically yield for this person?

Methodological requirements

• Ask for self-generated arguments, don’t provide them yourself
• Limit the number of requested reasons (1-3 is optimal)
• Ensure the question is neutral

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2. Future visualization

With this technique, you let the patient think about a desirable or undesirable future outcome of their behavior.

Two approaches

Approach	Focus	Example
Positive	Desirable future	”Imagine being healthy in 5 years…”
Negative	Undesirable future	”Imagine still smoking in 5 years…”

Caution

Use the negative approach carefully - it can evoke fear that paralyzes rather than motivates.

Step-by-step plan

1. Let the patient think about a future outcome (5 years, 10 years)

2. Let the patient immerse themselves in the situation and feeling:

   • How would you feel?
   • What could you do that you can’t do now?
   • What would you look like?

3. Connect to current choices - what can you do now to achieve/avoid that future?

Tips

• Use concrete, vivid descriptions
• Let the patient visualize themselves, don’t describe too much
• Link back to achievable first steps

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3. Rewards

With this technique, a reward is offered in prospect when the patient performs the desired behavior.

Types of rewards

Type	Description	Example
Material	Tangible reward	Gift, money, points
Social	Recognition from others	Compliment, likes, shares
Self-reward	Personal treat	Something nice, free time
Intrinsic	Good feeling	Pride, satisfaction

Step-by-step plan

1. Establish the goal - this can be an outcome or process goal

2. Let the patient think of a motivating reward that:

   • Is personally relevant
   • Is feasible to give
   • Does not reward unhealthy behavior (e.g., no cake after exercising)

3. Suggest examples of types of rewards:

   • Self-reward: “Treat yourself to a movie”
   • Social reward: “Share your success with friends”
   • Savings system: “After 10 workouts, a massage”

Methodological requirements

• Reward must immediately follow the behavior (don’t wait too long)
• Reward must be proportional to the effort
• Avoid rewards that stimulate unhealthy behavior
• Alternate between small frequent and larger occasional rewards

Examples

• Ommetje app | Brain Foundation - gamification with rewards
• Step counter apps with achievements
• Loyalty cards at gyms

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Scientific foundation

• Muller, B.C., et al. (2016).”; to change or not to change, that is the question”. Self-persuasion increases intentions to change health behavior. Applied Psychology: Health and Well-Being.
• Oettingen, G., & Mayer, D. (2002). The motivating function of thinking about the future. Journal of Personality and Social Psychology, 83(5), 1198.
• Deci, E.L., & Ryan, R.M. (2000). The “what” and “why” of goal pursuits: Human needs and the self-determination of behavior. Psychological Inquiry, 11(4), 227-268.

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This article is from: Online Behavior Guidelines (PDF)

Published by the Lifestyle in Healthcare Coalition, February 2025