Overview: Self-Determination in Health

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.

In Practice: Health

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.

Suggested Readings & Research

(2021) Health Psychology Review

A meta-analysis of self-determination theory-informed intervention studies in the health domain: Effects on motivation, health behavior, physical, and psychological health

Ntoumanis, N. Ng, J. Y. Y. Prestwich, A. Quested, E. Hancox, J. E. Thogersen-Ntoumani, C. Deci, E. L. Ryan, R. M. Lonsdale, C. Williams, G. C.

(2019) Health Psychology Review

A meta-analysis of techniques to promote motivation for health behaviour change from a self-determination theory perspective

Gillison, F. Rouse, P. Standage, M. Sebire, S. Ryan, R. M.

(2017) Psychology & Health

Predicting dental attendance from dental hygienists' autonomy support and patients' autonomous motivation: A randomized clinical trial

Halvari, A. Halvari, H. Williams, G. C. Deci, E. L.

(2014) Health Psychology

Autonomy support, self-regulation, and weight loss

Gorin, A. A. Powers, T. A. Koestner, R. Wing, R. R. Raynor, H.

(2012) Perspectives on Psychological Science

Self-determination theory applied to health contexts: A meta-analysis

Ng, J. Y. Y. Ntoumanis, N. Thogersen-Ntoumani, C. Deci, E. L. Ryan, R. M. Duda, J. L. Williams, G. C.

(2008) The European Health Psychologist

Facilitating health behaviour change and its maintenance: Interventions based on self-determination theory

Ryan, R. M. Patrick, H. Deci, E. L. Williams, G. C.

(2019) Frontiers in Psychology

Effects of a mental health intervention in athletes: Applying self-determination theory

Shannon, S. Hanna, D. Haughey, T. Leavey, G. McGeown, C. Breslin, G.

(2019) Mental Health & Prevention

Predicting student-athlete and non-athletes’ intentions to self-manage mental health: Testing an integrated behaviour change model

Shannon, S. Breslin, G. Haughey, T. Sarju, N. Neill, D. Lawlor, M. Leavey, G.

(2021) Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity

Development and cross-cultural validation of the Goal Content for Weight Maintenance Scale (GCWMS)

Encantado, J. Marques, M. M. Palmeira, A. L. Sebire, S. J. Teixeira, P. J. Stubbs, R. J. Heitmann, B. L. Gouveia, M. J.

(2020) Motivation Science

A classification of motivation and behavior change techniques used in self-determination theory-based interventions in health contexts

Teixeira, P. J. Marques, M. M. Silva, M. N. Brunet, J. Duda, J. L. Haerens, L. La Guardia, J. G. Lindwall, M. Lonsdale, C. Markland, D., Michie, S., Moller, A. C., Ntoumanis, N., Patrick, H., Reeve, J., Ryan, R. M., Sebire, S. J., Standage, M., Vansteenkiste, M., . . . Hagger, M. S.

(2020) Journal of Consulting and Clinical Psychology

Self-determination theory interventions for health behavior change: Meta-analysis and meta-analytic structural equation modeling of randomized controlled trials

Sheeran, P. Wright, C. E. Avishai, A. Villegas, M. E. Lindemans, J. W. Klein, W. M. P. Rothman, A. J. Miles, E. Ntoumanis, N.

(2020) PLoS Medicine

A gender-sensitised weight-loss and healthy living program for men with overweight and obesity in Australian Football League settings (Aussie-FIT): A pilot randomised controlled trial

Kwasnicka, D. Ntoumanis, N. Hunt, K. Gray, C. M. Newton, R. U. Gucciardi, D. F. Thogersen-Ntoumani, C. Olsen, J. L., McVeigh, J., Kerr, D. A., Wyke, S., Morgan, P. J., Robinson, S. Makate, M. Quested, E.