How do you define motivation? MOTIVATE ME TO COMPLY How do you define motivation? How do you define compliance? It might be worth having clarity.

A DEFINITION OF MOTIVATION Motivation can be defined as a concept used to describe the factors within an individual which arouse, maintain and channel behaviour towards a pre-defined goal.

BEHAVIOURAL CHANGE OCCURS WHEN FIVE FACTORS ARE PRESENT:- I want to do it. I can do it what is asked of me. (Self efficacy.) It will be an advantage to me to do it, or i can avoid a disadvantage. I will work at it. (Effort) I will persist at it. (Time.)

COMPLIANCE IS RECOGNISABLE IN:- Orientation to the problem. Recognising it as a PERSONAL problem. Searching for a solution. Applying the solution. Maintaining the gains.

Let us understand the five factors.

What are the reasons for the person to do what you require of them? WANT TO? What are the reasons for the person to do what you require of them? BECAUSE, BECAUSE! Use the freakin word!

BECAUSE PROVIDES REASON, AND REASON IS IMPORTANT IN MOTIVATION.

SEASON OF REASON People are much more likely to be motivated to be compliant when we provide them with REASONS for them to do so.

Never forget, the human brain tries to MAKE SENSE OF, to UNDERSTAND, to FIND MEANING. To motivate people often all we have to do is provide meaning.

You are subtly forcing them to think about it GOOD REASON You are subtly forcing them to think about it by giving them reasons to do so, and is especially powerful when we provide them with a GOOD REASON.

It is at its most powerful when the person is motivated by THEIR good reason.

(Strive for maximal congruence, i.e. same reasons) HIERARCHY. Person’s good reason to be motivated.   Your good reason. (Strive for maximal congruence, i.e. same reasons) Your reasonable request as to how it will be done.

Or, as soon as they hit an obstacle they give up. CAN DO IT. If a person does not believe that they can carry out the steps and influence the outcome they won’t even try. Or, as soon as they hit an obstacle they give up. S.F.P.

ADVANTAGES / CATASTROPHE. Help the person identify the advantages of being compliant and the catastrophe is in not being compliant.

ADVANTAGES OF COMPLIANCE People are motivated to be compliant (change behaviours) when they COGNITIVELY RE-EVALUATE the impact on their lives of NOT BEING COMPLIANT.

ADVANTAGES OF COMPLIANCE When the actual consequences of being non-compliant out weigh the perceived benefits of being compliant behavioural change is much more likely to occur.

People like the “no-effort” solution to life’s problems. EFFORT IS MINIMAL. People like the “no-effort” solution to life’s problems. Habits are efficient ways of doing things. Once a habit is established we have compliance. “Habits are at first as cobwebs, at last as chains.”

Our minds love habits and routines. KEEP IT UP. Our minds love habits and routines. Once your mind acquires a habit, it resists change irrespective of whether what you are doing is good or bad for you.

PERSISTENCE. By far the bulk of medication regimes are abandoned in the first twelve months, if not in the first thirty days! Follow up, remind.

To motivate a person to change BEHAVIOURS, RULE OF THUMB. To motivate a person to change BEHAVIOURS,   INCREASE THE REASONS FOR THEM TO DO SO.

To maximise compliance IDENTIFY AND REMOVE THE OBSTACLES. RULE OF THUMB. To maximise compliance   IDENTIFY AND REMOVE THE OBSTACLES.

REMIND THEM OF THE REASONS THEY CHOOSE TO DO IT, RULE OF THUMB. To keep them compliant   REMIND THEM OF THE REASONS THEY CHOOSE TO DO IT, DECREASE THE OBSTACLES.

AS IN REMOVING THE OBSTACLES. RULE OF THUMB. TWICE AS MUCH EFFORT SHOULD BE PUT INTO ESTABLISHING THE REASONS TO CHANGE AS IN REMOVING THE OBSTACLES.

Prochaska and Diclemente”s Transtheoretical Model of Change. Relapse Exit Entry Pre Maintenance Contemplation Action Contemplation Preparation

PRECONTEMPLATORS (definition) Unaware, underinformed, uninformed. They avoid thinking, talking, reading problem, not relevant. Obstacles to change dominate thinking. May lack “SELF EFFICACY”. May have “tried and failed” in the past. No plan to change in next 6 months. Not ready for ACTION. 40% of target group.

PRECONTEMPLATORS – to encourage contemplation. RAISE AWARENESS. Information - emphasise prevention. Educate - directly and other means. Explain issue and your concern. Interpret findings and results. Provide feedback on changes.

PRECONTEMPLATORS – to encourage contemplation. UTILISE EMOTIONAL LEVERAGE. Build it up, bring it down. It doesn’t have to be this way. 3C’s Cause, Consequence and Cure.

CONTEMPLATORS (definition) Acknowledge need to change, decisional balance not yet tipped. Receptive to information, not yet ready for action. Aware of advantages, focussed on costs. Stereotyped as “procrastinators”, often frustrated with self. 40% of target group.

CONTEMPLATORS- to encourage Preparation EXPLORE REGRET. Tempest does fugit UTILISE DISCREPANCY. Current v’s ideal self. Healthy v’s unhealthy behaviour. Values v’s behaviour.

CONTEMPLATORS- to encourage Preparation MOTIVATIONAL INTERVIEWING. Most applicable with contemplators.

PREPARERS – (definition) Decisional balance has tipped. Advantages of change out weigh costs. Attempts to implement recommendations. Usually have a plan to be implemented in next 6 months. No plan? Provide / negotiate one.

PREPARERS - to encourage Action. SUPPORT ANY CHANGES, -more likely to persist. BE ACTIVELY INVOLVED. Follow up! Remove obstacles. NEGOTIATE TREATMENT GOALS. -This makes success measurable, provides feedback. GIVE THREE CHOICES.

ACTION – (definition) Implementation of treatment plan. Not synonymous with PERMANENCY or COMMITMENT. Action is a learning phase. 20% of target group are in action.

ACTION – to encourage Maintenance. REMIND OF RISKS. Relapse is always possible ENCOURAGE SELF REWARD. This helps to maintain motivation. CONTINUE SUPPORTIVE CONTACT. Ain’t no substitute for that good ol’ therapeutic relationship.

MAINTENANCE – (definition) Continuation of negotiated treatment plan. Can take up to seven years to establish. Planned review essential.

MAINTENANCE – to avoid Relapse. RELAPSE PREVENTION. Identify high risk situations. Upskill. Problem solving. Relaxation. Read the road.

DESIDERATA “Speak your truth quietly and clearly, and listen to others, even the dull and ignorant, they too have their story.” Thank you for listening.