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Tuesday, February 19, 2008

Why can't everyone change unhealthy behavior?

What are the real barriers to positive lifestyle change? Why can't people "just" eat healthier, get more active, or quit smoking? These questions are at the heart of the challenges faced in the wellness industry.

Steve Beller, psychologist and author of the blog Curing Healthcare, has a good entry that explores some of these questions about the difficulty of healthy change from the perspective of a mental health professional (and an advocate for healthcare transformation to a more patient-centered model).

Beller writes [the emphasis in bold is mine]:

[U]sing incentives and disincentives fails to motivate many employees to live healthier lives. Wellness programs, therefore, ought to focus on providing the risk assessment, feedback and counseling necessary to deal with the emotional, attitudinal and resource blocks that prevent employees from making positive changes. Rewarding these people for participating in such counseling make sense, but punishing them for failing to improve their health is foolish and worthy of criticism by the Labor Dept. Not until these employees have attained a more positive psychological/emotional state will they be motivated to change. Only then does is make sense to reward them for achieving biologic benchmarks (e.g., weight, cholesterol levels, blood pressure, etc.) and behavioral goals (e.g., diet, exercise, non-smoking, reduced alcohol consumption, medication compliance, etc.).

Basically he argues for the importance of counseling as an integral part of behavior change programs. Tough to work into a program, but food for thought.

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