The Habit Factor: Why Clinicians Must Consider Patient Behaviours for Effective Treatment

Introduction

When it comes to treating patients, it's easy to assume that providing them with information and advice is enough to help them achieve their goals. But the truth is, success often comes down to something much simpler: habits. Whether a patient needs to start a new exercise routine, eat a healthier diet, or break a bad habit, the key to success is creating sustainable habits that support their goals.?

In this newsletter, I’ll explore the influence of habit on poor treatment outcomes and offer strategies for supporting patients as they create and maintain healthy habits.

Understanding Patients' Habits

Before you can help your patients create new habits, it's important to understand their current habits and how they may be impacting their treatment outcomes. For example, if a patient has never exercised before, they may struggle to establish a new routine without the proper guidance and support.?

Similarly, if a patient has a history of unhealthy eating habits, they may need extra support to break those habits and develop new, healthier ones. By taking the time to assess your patients' habits, you can create a more tailored treatment plan that's better suited to their individual needs.

Helping Patients Create New Habits

Once you understand your patients' current habits, the next step is to help them create new, healthier ones. This can be challenging, especially for patients who are resistant to change or who have a history of failed attempts at habit change.?

One effective approach is to work collaboratively with your patients, providing guidance and support while allowing them to take ownership of the process.?

For example, you might help a patient create a specific, achievable goal (like walking for 10 minutes a day) that is important to them and then ask how you can support them in creating this new habit that is part of an overall goal.

Taking the time to find out what they feel would best support their change may be very worthwhile. If they don’t know what they need, then you could suggest other strategies like offering encouragement, accountability, positive reinforcement and breaking down larger goals into smaller, more manageable steps.

Adapting Treatment for Resistant Patients

Unfortunately, not all patients are equally receptive to habit change. In fact all of us show some resistance to habit change at some time in our lives.?

Some patients may be resistant to change, either because they don't believe it's necessary or because they've tried and failed in the past.?

In these cases, it's important to adapt your approach to better engage the patient and support their needs. One effective approach is motivational interviewing, a technique that involves helping patients identify their own motivations and reasons for change, rather than simply telling them what they should do.?

Other strategies might include offering personalised feedback and support, addressing any underlying psychological barriers to change, and emphasising the importance of taking small, achievable steps towards long-term change.

Understanding the natural resistance to change

Brian Moran's book "The 12 Week Year" provides valuable insights into the emotional stages of change.

Moran highlights that the emotional stages of change are not a linear progression, but rather a cycle that individuals may go through multiple times during the change process.?

Here is a summary of his cycle from the perspective of your patient:

1. Excitement or uniformed optimism- patients are motivated and energised about the possibility of making a change. This is when they are sitting in your office agreeing to your suggestions?
2. Denial or uninformed pessimism- where patients may minimise the need for change or underestimate the effort required
3. Resistance or ‘The Valley of Death”- patients experience feelings of anxiety, doubt, and fear of failure. During this stage, it's common for them to procrastinate or sabotage their efforts. They give up and end up back in your office feeling defeated or guilty. You discuss options with them and they go out with ‘excitement/uninformed optimism’. The cycle starts all over again
4. Exploration and commitment or informed optimism- individuals begin to explore and experiment with different strategies for making the change. This stage may involve some trial and error and may result in setbacks or failures, but it's an essential part of the process. The commitment stage is when individuals have made a firm decision to change and are actively taking steps to make it happen. During this stage, individuals may experience a renewed sense of energy and purpose
5. Transformation- this stage is when the change has been successfully made, and individuals have integrated it into their daily lives. This stage may involve feelings of pride, satisfaction, and a sense of accomplishment

Understanding the emotional stages of change can help patients anticipate and manage the emotions that may arise during the change process. By recognising and navigating these emotional stages, they can increase their chances of success and achieve their goals more effectively.

This is the last in my three-part series on ‘Keeping Patients On Track’.