This week I'm looking at another concrete tool in the behavior-change armamentarium, social support. I have written previously about the Narrative mind's strong focus on social cues, and indeed perhaps the Narrative system evolved specifically to help us coordinate our behavior with groups of other humans. As a behavior-change strategy, social support can be used in several different ways.
Instrumental Social Support. The most basic form of social support is instrumental, the type of help that a neighbor gives in loaning you a tool or that a friend provides in bringing you a meal. This type of concrete support can be helpful for diet change -- e.g., here are some fresh vegetables from my garden -- or exercise -- e.g., you can borrow my tent for your camping trip. Although instrumental support is particularly powerful because someone is actually doing something for you or giving you resources that you don't have, it is also usually short-term (I probably don't want you to keep my tent forever, and I won't be bringing you vegetables every week). Nevertheless, it can help someone to start or try out a new form of healthy behavior. And in some cases perhaps it can be long-term, if for example a neighbor gives you old gear that they are no longer planning to use, or invites you to use their swimming pool while they are on a trip. Because instrumental support is context-specific (it depends on where you live, who you know, and what resources they have), it's hard to tap into systematically. It also probably flows more readily to people who already have more resources (another example of social capital, sometimes pessimistically stated as the Matthew principle: "to everyone who has, more will be given" [Matt. 25:29]). Nevertheless, behavior-change professionals can promote instrumental support by asking a client if they know a friend or acquaintance who has previously made the type of lifestyle change that the client is considering, by asking them to survey their friends to identify potential sources of support for a planned change, or simply by asking "who can help?"
Affective Social Support. Another type of social support takes the form of encouragement or empathy. This type of support is more readily offered remotely, although in-person connections may be particularly meaningful. People sometimes solicit affective social support by posting their behavior-change plans on social media accounts (e.g., "I'm trying to lose weight this year!"), although there's a risk of embarrassment if the behavior-change plan doesn't last. Having a specific buddy or mentor to support behavior-change efforts may be more effective, as in the peer-sponsor model used to great effect by Alcoholics Anonymous. A client will likely feel more accountability to a single person than they would when announcing their behavior-change intentions to a broad group. Behavior-change apps are increasingly building in a social networking component, where users can connect with other people who are also trying to change and send each other encouraging messages or reminders. And for in-person behavior change programs like the Diabetes Prevention Program, a classic strategy is to encourage clients to exercise or cook meals with a group. A group format creates social pressure (a) to show up, and (b) to have good progress to report, both of which help people stay focused on their goals.
Affiliative Social Support. People like to be part of a group. Even if group members don't provide you with any specific instrumental support, and aren't particularly emotional or empathic, it can feel supportive for someone just to be part of the group. (A lot of the old-school Lutheran churches were like this!) In the context of health behavior change, joining a team can be a particularly strong motivator for exercise -- if you don't show up for practice, your team members will be mad. People also like to advertise their group memberships, e.g. through items with logos or slogans on them that are meaningful to the group. In the Denver metro area, for instance, you can identify runners by the Bolder Boulder slogans on their reusable lunch bags, which are given out every year at the massive Memorial-Day race. Wearing group-themed gear can also help to build instrumental or affective forms of support, if fellow group members see you wearing it and reach out to make a connection.
Friendly Competition. It might be strange to think about competition as a form of social support, but for many people this is a powerful motivator. When we're directly competing we may want to get the best of our opponent, but when we step back we recognize them as a fellow enthusiast who shares our goals, who we probably like, and who perhaps even has something to teach us. In fact, as long as the level of competition doesn't get out of hand or have too many extrinsic consequences, we often have very warm feelings toward our competitors. Competition therefore has two different benefits: In the moment, the desire to win motivates us to try harder and exert ourselves more strongly. And afterwards, the friendly feeling toward our competitors gives us some of the same benefits as affiliation with a group. Sometimes the two things co-exist, as in a formal group like a baseball or bowling league. Behavior-change professionals often capitalize on competition by providing metrics like leaderboards, or rewards like first-, second-, and third-place medals. They might also encourage the "friendly" part of friendly competition by providing ways for competitors to connect with each other and share information outside of the contest itself. Both aspects are likely to help people stay engaged with behavior-change efforts over the long term.
Negative Social Support. It's important to acknowledge that not all social support is necessarily positive. Some groups or relationships create stress. Some might have unspoken rules that inhibit healthy activities like exercise. Others might have traditions involving unhealthy food. At the extreme, some shared-interest groups are centered mainly on drug or alcohol use. In a recent research project, one of our nursing honors students found that negative social relationships were a significant contributor to students' stress. Behavior-change professionals often need to help their clients determine when a social relationship is interfering with their goals rather than promoting them. The question then becomes whether the relationship can be modified in some way, or whether the client needs to seek social support elsewhere. Although social support can be a very powerful motivator for behavior, we need to be attentive to the ways in which it can also inhibit or act against our clients' goals.
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