Module 3b - Self-Determination Theory

Self-Determination theory

Focuses on the processes by which a person develops quality motivation for initiating a new health behaviour or maintaining one over time

What is Critical for Self-Determination Theory?

Developing a sense of autonomy leads to internalization and integration so the person can better self-regulate their behaviour

Quality of Motivation Overview

Amotivation - no motivation at all 

Controlled - doing it for a reason outside of themselves 

Autonomous - reasons that you have identified in wanting to do something 

Types of Regulation (“reasons why”)

Non-Regulated - off switch

External - Actions are performed to fulfil an external demand, achieve a reward, or avoid punishment

• Doctor

Introjected - Activity is engaged in to avoid negative emotions

• Gym in morning because otherwise guilt

Identified - Activity is linked to important and valued goals  

• Getting vaccinated so I stay healthy during winter

Integrated - Activity is consistent with a person’s identity 

• Tied with your identity, therefore act consistently with personality

Intrinsic - Activity is undertaken because it is enjoyable, interesting, stimulating or self-rewarding 

• Purest form of motivation, joyful, think of kids

Types of Psychological Needs

1. Innate: born with them 

2. Fundamental: can not be broken down into anything else

3. Essential Nutrients: necessary for optimal psychological functioning 

**can be satisfied or frustrated 

• impacted by social environment, personality differences in autonomy, and life aspirations 

Autonomy

Acting in accord with your own desires rather than through external or internal pressure; being true to yourself; fully integrating oneself

Competence

Feeing as though you can successfully complete optimally challenging tasks

Relatedness

Feeling a sense of belonging with important others

Changing Autonomy Satisfaction

Tough because health behaviours are not inherently fun

Most people start health behaviour because of external pressure

Can still be valued: provide meaningful rationales for change, do not apply external pressure

**provide support as people identify pathways to health and barriers

STRATEGIES:

• Support agency

• Provide options

• Ask for their perspective

Changing Competence Satisfaction 

Provide effectance-relevant feedback 

Help them find the skills and tools for change 

Do not over challenge

Help establish mastery in small steps

Find behaviours they are good at

Changing Relatedness Satisfaction

Provide input and guidance to facilitate a good relationship with patient

Respect, understand, and care for patient

Enhance connection and trust

Encourage activities with friends and family

Social Factors

People can affect your perceptions of psychological needs

1. Autonomy Supportive Health Care Climate

2. Controlling Health Care Climate

Autonomy Supportive Health Care Climate

A treatment atmosphere that encourages individuals to engage in health-conducive behaviours for their own reasons, facilitates success in dealing with barriers to change, and conveys feelings of acceptance and respect

Leads to more psychological satisfaction

What are some things to try in an Autonomy Supportive Health Care Climate

Provide relevant information and meaningful rationales for change

Supporting patient decisions and interests

Understanding patient perspective

Controlling Health Care Climate

A treatment atmosphere that controls people’s behaviour through means such as offering tangible rewards or externalizing pressuring them toward practitioner valued behaviours or outcomes

Leads to psychological need frustration

Controlling Health Care Climate Avoid: 

Incentives 

Using authority 

Rewards

Contingent approval 

What do you target to change behaviour?

Try to enhance the satisfaction of psychological needs and reduce the frustration of needs

How do you change psychological needs?

Change the social environment

Help people set intrinsic life goals

Help people internalize the behaviour and be more autonomous

Problems with SDT

Not the best for predicting behaviour

• Hard to test/implement

• Assumes innate tendency for growth, development and intrinsic motivation

• All three needs don’t equally predict behaviour as hypothesized

Evidence on SDT

Effect sizes were MODERATE

Overall pattern of results supported theoretical model

Autonomy supportive climates enhanced psychological need satisfaction which in turn impacted biopsychosocial outcomes

Evidence on SDT - Experimental studies only 

Effect size SMALL MODERATE in magnitude 

Need satisfaction not related to behaviours 

Need support and autonomous motivation associated with change in health behaviours