Does this experience sound familiar? You educate a patient on the importance of nutritious foods, you provide them with an abundance of supportive resources, and you help them set goals. They leave the appointment seemingly motivated and ready to take action. Success! … Or so you think. However, when you see them again in a few weeks or months, they have not made any significant progress toward their goals.
Keeping patients motivated and on track is arguably one of the most challenging pieces of the behavior change process. For most people (including healthcare providers!), implementing new habits is a cycle of two steps forward and one step back and requires consistent intention. Luckily, there is a lot we can do as clinicians to better support our patients and bolster their success in this process. Here are a few of my favorite strategies.
1. Identify barriers
Helping patients identify and remove obstacles is key to keeping them moving forward. Since everyone’s experience is different, you should strive to approach each patient with a beginners mind, allowing them to fully share their fears and barriers. Something that you consider to be “easy” may be a significant barrier for someone else, so ask open-ended questions such as: what has prevented you from making changes related to your health in the past? What do you predict might be hard? What is one thing that would make it easier for you to meet your goal? Learn more about motivational interviewing principles to help build trust and support patient progress.
2. Crystallize their deeper “why”
Self-Determination Theory, a popular behavior change model, emphasizes moving beyond a patient’s level of motivation to also consider the quality of their motivation. For motivation to be considered high quality, it must be autonomous and intrinsic. For example, a desire to feel good so one can keep up with grandchildren is a higher quality motivator than a desire to achieve a certain number on the scale. Help patients crystallize their “why”, their deeper reason for working toward new habits, and keep that reason front and center in all interactions.
3. It takes a village
Identify who can support your patients through their change work, whether it is family, friends, or a group of people with similar goals. Help patients establish their support network so they feel connected and accountable, especially in moments when you aren’t there to cheer them on. Examples include scheduling a standing walking date with a friend, enlisting family members to help with weekly meal prep, or joining a support group you’ve established with other patients. And remember, you are part of their village too! LighterPRO provides an easy way for patients to feel supported by you in between visits.
4. Cultivate mindfulness
The mental ‘muscle’ that allows someone to respond instead of react to life’s circumstances can be a patient’s most valuable tool in staying on track, and this muscle can be strengthened through cultivating mindfulness in day-to-day life. This daily "workout" could take the form of a morning meditation practice, a commitment to focus on the breath while washing dishes or taking a shower, or a weekly routine of sitting down to plan meals and exercise in advance. In a study comparing those who practiced mindfulness and those who did not, the researchers concluded that individuals who practiced being in the present moment were more motivated to make positive health changes. Help patients find ways to sprinkle in mindful moments.
For further reading on motivation techniques, check out Motivational Interviewing: Helping People Change by William Miller. You will learn how to improve your interview style to get at the root of what motivates individual patients and how to give them deeper insight into their own desires to change. Another book, Switch: How to change things when change is hard by Chip and Dan Heath also gives valuable perspective on how to change habits. If you missed my post on habits, be sure to check that out too.