Helping People Change
In discussing compliance or adherence to treatment recommendations, be they drugs, exercises or instructions to cease smoking, one of my colleagues, Stephanie Kincaid, observed the distinction between information and contingencies. We had just heard a colloquium on the topic of personality, lifestyle choices, and longevity in which one of the presenter's conclusions seemed to be that telling people how important something was to their well-being would bring about a change to the more healthful alternative behavior. It was as if saying "it is really, really, really important that you [take this drug, lose weight, stop smoking] NOW" might be sufficient to bring about, and sustain, that alternative behavior. I don't mean to single out our speaker, for we all do it. People who have achieved in a business (or any other setting) often are loquacious in their advice for success to the minions on lower rungs of the workplace ladder. When students ask me how they might improve their next exam score, I am full of helpful, hopefully friendly advice. Am I optimistic that it will be followed? … Need I really answer that question? And even if they did, would it work out for them?
There is a plethora of research suggesting that advice, no matter how good, does not systematically or regularly control behavior. So, how can we help people whose health is in need of shoring up or who wish to improve their lot in business or academe or anywhere else? Advice is worth what you pay for it, or less. Time and time again, however, it has been shown that behavior changes when environments change. These changes can be brought about by the person whose behavior is in need of change or by some other person. What is needed is a careful analysis of the antecedents to and consequences of the behavior. Sometimes it is as simple as providing more explicit feedback and at other times the contingency management system, as it sometimes is called, needs to be more elaborate. But both are do-able.
A recent report in the New York Times noted that people who weigh themselves daily are more likely to be in the normal weight range than people who don't. This is, admittedly, a sweeping conclusion that requires further research to determine its validity and limits (it may be, for example, that weighing oneself is not pleasant if one is overweight). But weighing daily as a means of weight control makes sense from what we know about antecedent control of behavior. Weighing in the morning every day can (it may not, but it can) provide a guideline for the day's exercise and eating activities. Obviously more than just the act of regularly weighing is involved in weight management, but it is a factor to be considered, and one that is easily implemented. And there is the matter of getting people to do this, a response which may itself require a behavior management program. My point is that doing something to actively intervene in a systematic way to help better a person's life sure beats providing “useful advice” in the form of instructions, or nagging or berating people for what they are not doing.
Trying to build behavior change through the latter methods is not productive. If we want people to come to behave in new and more healthful or helpful ways, we have to help them find and use effective antecedents and consequences of the behavior in need of change.
