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Building Motivation From Basic Needs

2017; Lippincott Williams & Wilkins; Volume: 21; Issue: 2 Linguagem: Inglês

10.1249/fit.0000000000000274

1536-593X

Janet Buckworth,

You may assume that clients who contact you for help to achieve fitness goals have overcome their first hurdle, but making that assumption may place a hurdle in your path to help foster their behavior change. Motivation to change can prompt a call to a fitness professional, but sources of this motivation can influence clients’ initial and long-term success. If a health care provider tells someone he or she must lose weight, he or she may begrudgingly contact a fitness professional but drop out of a fitness program when he or she does not see the numbers on the scale go down or his or her schedule gets busy. Let’s explore a practical model for understanding what drives your client and how you can use this information to implement strategies to promote adherence to healthy behaviors. More than 30 years ago, Deci and Ryan (1) proposed the Self-Determination Theory (SDT) as a theory of motivation for intentional behavior. The SDT frames motivation along a continuum from extrinsic (motivation for a task is determined and regulated by others) to intrinsic (motivation is determined and regulated by the person engaging in the behavior). The SDT also is based on several assumptions: Human beings are active in controlling their lives, We are naturally inclined toward growth and development, We have a set of three basic psychological needs that are universal (competence, autonomy, and relatedness), and Motivation results from efforts to meet the three fundamental human needs. Basic Human Needs Competence: The need to seek mastery. A client schedules an individual coaching session to improve his or her tennis skills. Autonomy: The need to be an agent of one’s own life, that is, the extent to which a behavior or course of action is endorsed personally and engaged in with a sense of choice or volition. The customized fitness class is full while the prescribed program is underenrolled. Relatedness: The need to interact, be connected to, and experience caring for others. You recruit your friends to sign up with you for a 5K training program. There is good evidence that behavior will be sustained if the consequences are pleasurable and enjoyable with positive experiences serving as important motivators (2). Engaging in activities that help meet the three basic needs will link those activities with enjoyment and foster intrinsic motivation. There are several strategies a fitness professional can use to help get those needs met (3). Providing information to help a client make informed choices will increase a sense of autonomy. Offering options from which to choose will allow that autonomy to be put into action, such as providing group classes, sessions with a personal trainer, time-limited sport programs, and self-directed workouts. Making sure that clients have guidance and feedback to improve skills and fitness components including strength, endurance, flexibility, and balance will increase a sense of competence. Providing social connections and support in person or through social media on a personalized level will help clients feel engaged with others. Ask yourself when working with a new client how you can give him or her choices, opportunities to experience improvement, and a sense of belonging and social engagement. Identifying where your client is on the motivation continuum also will help you decide how to customize your strategies. The SDT has a central and useful framework for distinguishing types of motivation that is based on the level of autonomy (or self-determination). Motivation is thus framed by the degree to which a person regulates or controls his or her behavior, from extrinsic to intrinsic regulation. External regulation of behavior typically is what we think of when we think of extrinsic motivation, or acting based on external rewards or punishments. External regulation governs behavior that is prompted by external sources of control, such as coaches and health care providers. When the external pressure is removed, so is the reason for the behavior if that is the only motivation. One useful approach to promote adherence in someone motivated through external regulation is to help identify additional reasons for adopting the behavior. If a health care provider has instructed your new client to lose weight, you can brainstorm about other personally meaningful reasons to eat a healthier diet and be more physically active. There may still be some external regulation of the weight loss behavior, but it will not be the only reason for your client to take and sustain positive actions.Types of extrinsic motivation based on different levels of self-determination External regulation means behavior is totally controlled externally, and the only reason for the behavior is to prevent penalty or gain rewards. Introjected regulation is more internally controlled, but the regulation of the behavior is external to the person and is not self-determined. The reason for the behavior is to avoid guilt, shame, or anxiety, or to enhance pride or ego. In the case of identified regulation, the importance of the behavior is recognized, and the value of the behavior is accepted. Integrated regulation is the most autonomous motivation among these four. In this case, the behavior is integrated fully with the organization of the self. Motivation to stick with a walking program may be to comply with your health care provider’s requirement, but also to avoid feeling guilty from giving up. This introjected regulation is characterized by internalized reasons for actions, but is based on self-imposed pressure. Avoiding guilt can be a powerful motivator, and introjected regulation can govern adoption and maintenance of behaviors for many people. Someone may attend an early morning workout to avoid feeling guilty later in the day, even if he or she doesn’t enjoy the workout. If the motivation to finish the workout is based on the value placed on exercise for health, even if it is early in the morning and not a lot of fun, the motivation is considered self-determined. Behavior driven by identified regulation is chosen and is highly valued. You might not like a 5 a.m. spin class, but you know it is good for you, and staying active is important. Helping your clients understand and accept the personal benefits of healthy behaviors, especially when linked to something they already value, such as physically keeping up with children or grandchildren, can go a long way to foster identified regulation. The next step on the motivation continuum is self-determined. Integrated regulation is characterized by engaging in the behavior by personal choice. Importantly, the behavior is integrated with the organization of the self, and choices are coherent with other aspects of the self. Someone who identifies as a good pet owner will walk his or her dog on a regular basis, even if it is unpleasant weather or he or she is tired after a long day at work. One of my favorite community programs was designed to target overweight dogs through walking clubs for the owners and the dogs. You guessed it — the dogs and the owners lost weight — and stuck with it! Intrinsic motivation is the most autonomous or self-determined motivation. It embodies enjoyment, engagement, competency, and choice. Behaviors that meet the three basic needs will be more likely to be sustained through intrinsic motivation. Having clients in a cooking class pick healthy recipes to learn how to prepare and serve to friends and family members provides autonomy (choosing recipes) and opportunities for mastery (learning new cooking skills) in a social setting. These strategies will likely keep clients engaged in preparing and eating a healthy diet. Motivation to begin, motivation to take action, and motivation to continue can be different and can change over time. How does motivation become more intrinsic? A patient required to participate in cardiac rehabilitation before being released from the hospital is motivated extrinsically to participate in rehab, and this behavior is regulated by external forces. There is little or no choice if he or she wants to gain the reward of leaving the hospital. However, as the patient begins to experience less fatigue and more independence, this initially externally regulated behavior becomes more valued and may eventually become integrated with how he or she sees himself or herself rather than something he or she has to do. Helping him or her to recognize improvements and how his or her options expand the more fit he or she becomes targets the need for competency and autonomy, and puts him or her on the road to more self-determined motivation. Using concepts from SDT, your goal is to move clients along the continuum to develop motivation that is more intrinsic through identifying how they are motivated now and what you can do to help them meet the basic needs through healthy behaviors. When trying to identify their sources of motivation, keep in mind that they probably have multiple motives that emerge based on the situation. For example, someone may enjoy playing soccer (intrinsic motivation), but he or she may be motivated to play harder when there is someone in the crowd he or she wants to impress (introjected regulation), and spend extra time practicing because he or she identifies as an athlete (integrated regulation). He or she has multiple reasons for playing soccer, which increases the likelihood he or she will stick with it despite challenges. Self-Determination Theory is a useful framework for identifying what is driving your clients to seek your help and guidance and for implementing strategies that will help them become more intrinsically motivated. Determining which strategies will be most effective starts with discovering what your clients want to do and why they want to do it through smart goal setting and identification of the real drivers of their behavior.