Enhancing motivation in others
We cannot motivate someone else. But we 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 to feel autonomously motivated to change their family’s lifestyle behaviours (which makes successful change more likely). Even if a parent 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 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 are more likely to feel autonomously motivated to change. This can be done be using a “guiding approach” and avoiding a “directive approach”:
A guiding approach (supports autonomy, competence and relatedness). This is where the clinician encourages the parent 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 clinician has the overall control of the direction of the consultation, but the responsibility and choice for change lies with the parent.
A directive approach (diminishes autonomy, competence and relatedness). Often health professionals believe their role is to tell parents what to do, and how to do it. This is called a directive approach and can reduce parents’ feelings of autonomy, competence and relatedness (thus reducing autonomous motivation). If a practitioner tells someone what to do with little consideration for the parent’s situation (i.e. a directive approach) parents are likely to generate barriers and feel reluctant to change their behaviour.
Read the two fictional case studies below to see how the doctor’s approach affects Nicola’s motivation to help her overweight son.
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 he is probably ill because he is overweight. He told her she needs to do something about this by forcing Jack to 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 BMI charts, explaining where Jack fits on the chart. Nicola was surprised and upset to see Jack was 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).