The role of self-determination theory and motivational interviewing in behavioral nutrition, physical activity, and health: an introduction to the IJBNPA special series.

Abstract

On the occasion of the 9 Annual Meeting of the International Society of Behavioral Nutrition and Physical Activity (ISBNPA) in Lisbon (2009), a satellite meeting was organized in Sintra entitled Self-Determination Theory and Motivational Interviewing in Behavioral Nutrition, Physical Activity, and Health. The organizers of this small meeting (about 100 people attended) were interested in stimulating a focused discussion around the similarities, differences, and complementary of selfdetermination theory (SDT; [1]) and Motivational Interviewing (MI; [2]). This gathering was spurred by both a recent growth in applied health behavior research based in SDT [3], and by a continuing interest in exploring the mechanisms by which MI produces results in practice [4]. The links between SDT, a well-established theory of human motivation and behavior, and MI, a popular clinical method for evoking behavior change are multiple and have been explored before [5,6], leading many to think that a formal “marriage” i.e., accepting SDT as “the theory of MI” and MI as the “intervention method of SDT” would be just a matter of time. Both models are explicitly person-centered and process-oriented, both emphasize that optimal behavior change must involve deep personal commitment and engagement, and both stress that a positive emotional “climate”, defined by genuine empathy and unconditional regard towards patients or clients is a necessary condition for the success of behavior change interventions, especially their long-term effects. Moreover, both SDT and MI appear to have at its center the concept of motivation, endorsing the development of “internal” motives and the need for patients to take responsibility for change, to the detriment of externally imposed goals, pressures, or a preponderance of reasons for change which are nor personally meaningful [7,8]. The interest in both MI and SDT has grown steadily over the past decades, with scholars and practitioners working in fields such as eating behavior (e.g., [9]), physical activity (e.g., [10]), and diabetes (e.g. [11]), becoming increasingly interested in exploring motivational dynamics. It is recognized that the motivation underlying patients’ behavior change attempts provides them the necessary energy to actually undertake change and plays a key role in successful long-term outcomes. In fact, the issue of behavioral persistence is a critical one in the era of behavioral, preventive, and “lifestyle” medicine, with individuals increasingly called upon to manage or “self-regulate” their own health [12]. Short-lived change, such as what results from so many weight loss programs, is not what health practitioners and their patients are usually looking for. According to SDT, although patients and clients might put some initial effort in change, lasting results are more likely to fail if it is not undergirded by the ‘right’ motives [13]. This implies that it is critical to move beyond merely considering a patient’s level or intensity of motivation but also consider the quality of their motivation. In fact, motivation is conceived by SDT as a differentiated concept and a distinction is made between different types of motivation (autonomous relative to controlled), with some motivational subtypes being more desirable because they yield more positive outcomes than other types. Specifically, SDT researchers maintain that patients can best self-endorse change such that they willingly or volitionally pursue it rather than feeling seduced or pressured to make those changes. Nevertheless, and despite recent progress (e.g., [14]), * Correspondence: pteixeira@fmh.utl.pt Interdisciplinary Centre for the Study of Human Performance, Faculty of Human Kinetics, Technical University of Lisbon, Lisbon, Portugal Full list of author information is available at the end of the article Teixeira et al. International Journal of Behavioral Nutrition and Physical Activity 2012, 9:17 http://www.ijbnpa.org/content/9/1/17