Self-determination theory (SDT) is a framework for understanding human motivation. It gained a great deal of popularity as a possible explanation for the effects of motivational interviewing (MI), although MI's primary creator William Miller has said that his understanding of MI is atheoretical. It is certainly the case that MI came about long before SDT was used to explain it. And it's also true that SDT was an established model with its own body of research before it was ever linked to MI. But Stephen Rollnick, Miller's co-author in his most important works on MI, has specifically said that he considers SDT to provide the theoretical explanation for MI's success.
Deci and Ryan (2000) propose six "mini-theories" or propositions that together make up SDT:
1. intrinsic motivation is a strong predictor of behavior, and is related to feelings of competence and autonomy. The intrinsic/extrinsic motivation distinction is an old one in psychology, reflecting the difference between behavior that someone does for rewards and behavior that is engaged in "for its own sake." Edward Deci (one of the two authors of SDT) proposed a distinction between intrinsic and extrinsic motivation as early as 1975, in a model called cognitive evaluation theory that was later incorporated as one of the mini-theories that make up SDT. Quite a bit of evidence suggests that providing someone with external rewards can undermine their intrinsic motivation, and theories such as flow or gamification are closely tied to the idea of intrinsic motivation.
2. extrinsic motivation can be converted over time to intrinsic motivation, through a set of mechanisms that Deci calls "organismic integration theory." These include adopting or internalizing the goals and belief systems of the people who provide the external rewards. In this way, a motivator that started out as extrinsic can become intrinsic eventually.
3. causality orientation theory builds on a basic social psychology principle around attributions, pioneered by Fritz Heider in the early 1900s. In Deci's view, there are three types of people who differ in the values that they apply to decision-making. People who are autonomy oriented care most about the task itself and their ability to perform it. People who are control oriented focus on rewards, gains, and approval from others. And people who have an impersonal orientation are motivated by anxiety and worried that others will discover they are not competent to complete the task.
4. basic psychological needs theory suggests that people in general are motivated by feelings of autonomy, competence, and relatedness. These are similar to the higher levels in Maslow's hierarchy of needs, such as self-actualization. Clearly this proposition fits best for people who have the "autonomy orientation" identified above under point #3, but these mini-theories might operate semi-independently of one another. The three elements of motivation are often seen as the most important components of SDT, as shown in the diagram at the top of the page.
5. goal contents theory again differentiates between intrinsic and extrinsic motivation, but has some connection to the economics literature, in which people are happier when they focus on "the good life" instead of "the goods life" (i.e., external rewards). This brings a "happiness" variable into SDT as well as motivation for behavior.
6. relationships motivation theory is again tied to Maslow's hierarchy, and suggests that people are highly motivated by close relationships, social perceptions, and interactions with others over time. Relationships are closely connected to the three basic components of motivation, with Deci and Ryan suggesting that "Indeed, the highest quality personal relationships are ones in which each partner supports the autonomy, competence, and relatedness needs of the other."
I agree with SDT's overall focus on motivation as an important predictor of behavior. Social motivators, such as those emphasized in Deci's "relationships motivation" mini-theory, are important Intuitive-Mind predictors of behavior; as I have written previously, people are acutely attuned to social expectations and consequences, and social support is an important predictor of behavior change. Feelings of autonomy and perceived control also likely operate at the level of the Intuitive Mind. And if feelings of control over one's own behavior are accurate, they could also serve as a metric for willpower or ability to change. A sense of autonomy has been identified as important for behavior change in other theories as well, such as Larry Beutler's integrative model of psychotherapy.
Although the intrinsic-extrinsic motivation distinction is well-established in the literature, I'm less sure that I agree with the cognitive emphasis that suggests decision-making at the level of the Narrative Mind. As usual I see motivation as a function of the Intuitive Mind, perhaps with the different motivational goals identified in Deci's "causality orientation" component as between-person differences that result from genetics or past history. When it comes to motivational interviewing, I have suggested that the Narrative mind produces social understandings (based on Intuitive-level social perceptions), and that the "relational hypothesis" for MI can be accounted for largely through these factors, a perspective that seems to align relatively well with SDT. However, I have also suggested that MI's "technical hypothesis," focused on skills like reflective listening and open-ended questions, operates more directly at the level of the Intuitive Mind. The efficacy of MI is likely due to a combination of these factors, rather than MI's support for Narrative-level perceptions of autonomy and control alone.
Overall, I see SDT as a valuable theory that particularly calls attention to the patient-provider relationship in health care settings, and that urges providers to act in "autonomy-supportive" ways that do not undermine patients' intrinsic motivation to take care of their own health. Where I think this model doesn't go far enough is in detailing the Intuitive-level forces that also affect people's motivation to take care of their own health.
Comments
Post a Comment