Healthcare

Motivation plays a central role in both health and health behavior change. For example, leading causes of death such as cardiovascular disease and many forms of cancer are determined at least in part by people’s behaviors and lifestyles. Yet, diminishing health-compromising behaviors like smoking, abusing alcohol, overeating, or being sedentary can be hard. So can engaging in health-promoting behaviors such as exercise, controlling glucose levels, or following a medication regimen. SDT research demonstrates that to make meaningful behavior changes, experiences of both autonomy and competence are essential. One must value the behavior change being implemented and experience a sense of volition around this change, and also have the knowledge and skills necessary to implement the desired change.

Health-care providers play an especially important role in supporting patients’ autonomy and competence. By listening to patients’ perspectives, providing opportunities for choice in how treatment plans are enacted, and providing clear explanations and rationales, practitioners increase the likelihood that patients will be successful in their behaviour change attempts. Importantly, SDT intervention studies suggest that training in providing autonomy support can help physicians provide greater support and better care to their patients.

SDT health research and clinical trials have examined both patient motivation and provider autonomy support in a wide variety of health areas, including weight loss, glucose control, tobacco cessation, medication adherence, increasing activity/exercise, healthy eating, dental hygiene, and others. This work supports the SDT health-care process model (see Figure below) showing that individuals’ own autonomous motivation as well as support from the health-care environment facilitate wellness (physical and psychological) through the satisfaction of basic psychological needs.

The types of wellness goals individuals set also determine wellness outcomes. For example, healthy eating that is motivated by the aspiration to increase one’s physical attractiveness (extrinsic aspiration) is likely to be less successful than when this same behaviour is undertaken with the goal of improving health and increasing vitality (intrinsic aspiration).

Finally, SDT scholars are also examining motivational processes and wellness among practitioners. Articles here include studies of the role of basic need supports in both professional training and practice, as well as studies of factors affecting practitioner-patient relations.

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Gillison, F.Rouse, P., Standage, M., Sebire, S. (2019) A meta-analysis of techniques to promote motivation for health behaviour change from a self-determination theory perspective. Health Psychology Review, 13(1) ,110-130

Halvari, A., Halvari, H., Williams, G. C., Deci, E. L. (2017) Predicting dental attendance from dental hygienists’ autonomy support and patients’ autonomous motivation: A randomized clinical trial. Psychology & Health, 32(2) ,127-144

Gorin, A. A.Powers, T. A., Koestner, R.Wing, R. R. (2014) Autonomy support, self-regulation, and weight loss. Health Psychology, 33(4) ,332-339

Williams, G. C., McGregor, H. A.Sharp, D., Levesque, C. S. (2006) Testing a self-determination theory intervention for motivating tobacco cessation: Supporting autonomy and competence in a clinical trial. Health Psychology, 25 ,91-101

Ryan, R. M., Patrick, H., Deci, E. L., Williams, G. C. (2008) Facilitating health behaviour change and its maintenance: Interventions based on self-determination theory. The European Health Psychologist, 10 ,2-5

Ng, J. Y. Y., Ntoumanis, N., Thogersen-Ntoumani, C., Deci, E. L. (2012) Self-determination theory applied to health contexts: A meta-analysis. Perspectives on Psychological Science, 7 ,325-340