Enhancing motivation in others
You cannot motivate someone else. But you can create an environment that enables others to feel motivated.
It is not possible to motivate someone else. However, it is possible for you, as a practitioner, to create an environment that enables parents/carers to feel autonomously motivated to change their family’s lifestyle behaviours (which makes successful change more likely). Even if a parent/carer comes to see you for a controlled reason (e.g. they feel pressured by other people) the way you interact with them can help them develop an autonomous motivation to change.
Guiding and directive approaches
It is possible to support a parent/carer to develop autonomous motivation during the time you spend with them. If you communicate in a way that supports the psychological needs of autonomy, competence and relatedness, parents/carers are more likely to feel autonomously motivated to change. This can be done by using a “guiding approach” and avoiding a “directive approach”:
A guiding approach (supports autonomy, competence and relatedness). This is where the practitioner encourages the parent/carer to generate their own ideas and make their own decisions based on their values and beliefs and listens supportively, offering their expertise when necessary. Taking this approach the practitioner has the overall control of the direction of the consultation, but the responsibility and choice for change lies with the parent/carer.
A directive approach (diminishes autonomy, competence and relatedness). Sometimes professionals believe their role is to tell parents/carers what to do, and how to do it. Being "directive" in this way can reduce parents/carer's feelings of autonomy, competence and relatedness (thus reducing autonomous motivation). The practitioner might use forceful language (e.g. saying a parent/carer “must” or “should” do something), or tell parents/carers that “if” they don’t change, “then” there will be negative consequences (e.g. their child's health will suffer). Such approaches may prompt defensiveness, increase resistance to change and have a negative impact on parents/carers' wellbeing.
Read the two fictional case studies below to see how the doctor’s approach affects Nicola’s motivation to help her son who is living with overweight.
Case study – Nicola (visit to doctor A – Directive approach)
Nicola recently took her 3-year old, Jack, to Doctor A as he had a bad cough. Doctor A looked at Jack and told Nicola the reason he gets ill easily may be because he is overweight. He told her she needs to do something about this by making Jack eat healthily and get him active otherwise he could get heart disease when he is older. This made Nicola angry because she doesn’t think Jack looks overweight and his friends are all the same size. Anyway, how is she meant to do those things living where she lives and with hardly any money?
Case study – Nicola (Visit to doctor B – Guiding approach)
Nicola recently took her 3-year old, Jack, to Doctor B as he had a bad cough. Doctor B was really kind-natured and high-fived Jack when they got there. He asked if he could ask Nicola some questions about Jack’s lifestyle. He then asked her to talk through a typical day and some typical foods Jack likes to eat. He weighed and measured Jack and talked Nicola through the Body Mass Index (BMI) charts, explaining where Jack fits on the chart.
Nicola was surprised and upset to see Jack was living with overweight so asked Doctor B what she could do about this. Doctor B talked through Jack’s physical activity with Nicola, carefully explaining how children of Jack’s age can increase their activity in fun ways. He then asked Nicola to come up with some ideas for doing this herself, which made her feel ‘actually there are some things I could do’.
Although the conversation was a bit of a shock, Nicola felt like the doctor cared and this left her wanting to do something about it. She agreed to go back and see him next month to talk through how she’d been getting on (and felt ok about this, because Doctor B had made clear not to worry if she struggled to do these things at first, it’s just about taking small steps).
The language we use when talking about weight matters. Referring to an “overweight child” or a “child who is overweight” defines the individual by their condition and can feel like it devalues who they are as a person.
Instead, it is good practice to use “person-first” language (e.g., “a child living with overweight” or “a child with obesity”, which puts the child first). This can help engage, respect and build trust with parents/carers.
This leaflet from Obesity UK contains some helpful guidance on talking about weight in a way that is collaborative and respectful.