In our last article we introduced the concept of predictive coding or predictive planning. As highlighted it is the concept of we behave in the world is based not on the objective reality, but on how we perceive our world. And accordingly, we make predictions about how we and our physiology should behave and adapt to that perceived world. Now this concept may appear overly esoteric when it comes to working in a professional setting. Does this mean that we can implement anything, even low value interventions and expect successful outcomes if the subject believes that the intervention is good?

In short, no. There continues to be no substitute for a well investigated and effective intervention, however the way in which it is delivered, and the way in which the individual you are working with is involved in that process is a key factor in their motivation and belief in the process that they are undertaking. We have all been involved in professional relationships whereby one party does not have faith in the approach which leads to limited input and ultimately less than ideal outcomes. 

So how can we approach the problem?

There are a few factors that influence how some one perceives a situation and in this article I would like to explore some of the concepts that are associated with motivation. We know that motivation is a key driver of behaviour, and the more motivated someone is, the more likely they are to believe in the direction that they are going. But what exactly will make them more motivated?

To understand motivation, we will lean on one such understanding of what motivates individuals. This concept is called Self Determination Theory. The term has become popular since the first descriptions in the early 1980’s by researchers Deci and Ryan. The concept highlights that the three key influences on motivation are autonomy, competence and relatedness.  

Autonomy relates to the involvement of the individual in the decision making process. For those that listened to the podcast involving Kiely, you will remember that including the people that you are working with in the decision making process was a key step in the building of trust and faith in the intervention that is being implemented. It may seem difficult to establish autonomy, but its much easier than you may think. Giving the people that you are working with choice opens up their engagement in the process and provides them with faith that their thoughts, ideas and values are being considered in the decisions being made about the intervention that they are involved in. The key factor in this is that the professional needs to pitch the decision making at a level that is commensurate with the individuals level of understanding and competence (we will come to this in a moment). So if you are dealing with a child, you will not ask them their thoughts on the periodisation of a training plan. But you may give them a couple of choices when it comes to a skill task. Do they want to work on short or long passing today for instance. By giving them some choice you are opening their opportunity to understand some of the planning process and be comfortable with the approach. Similarly if you are dealing with someone that has enormous experience in an area such as a veteran baseball athlete with shoulder pain, who has had numerous bouts of shoulder pain, injuries and surgeries, they are likely to have significant knowledge and experience in what the best course of action may be to settle their latest bout of shoulder pain in time to play in next week’s game. Your approach with them may be to ask them openly, how do you think we approach this latest niggling injury. And more often than not they will have a very good understanding of what steps are valuable and even the most appropriate, evidence based approach is for them. You can see that the degree to which you involve the subject in the decision making process varies widely, but providing some level of autonomy at all times increases trust, motivation and likely the perception the person has on the benefit of the intervention that they are undertaking. 

The next factor that drives the motivation, and faith in the process, is termed relatedness. This refers to the relationship factors within a group or between an individual and professional/coach/parent etc. This will often refer to the quality of such a relationship and common areas of interest, value structures or similar or desired behavioural traits. Whilst this may seem obvious, the link is clear that the better the relationship between the parties involved, the higher the level of trust and therefore the faith that the actors in the situation are acting in the best interest of the group. Kiely does caution this throughout the podcast, whereby he suggests that the phenomena of athletes moving to a successful coach or successful team often see a jump in performance initially. This may present a faith in the desired outcome exhibited by the coach or team, which can fade as the view behind the curtain reveals that such behaviours are not what the individual is seeking and thus their faith in the environment diminishes. Relatedness in the realm of sport or health, is the process of developing rapport, common ground and establishing shared values. By doing this or being open to discussing such areas throughout your interactions there is room to develop rapport that will assist in the belief that a patient or athlete has in the interventions being applied.

The last area is one in which we all know. That is the factor of competence. I am sure that we have all been in the situation whereby we try something new and when we find we have a natural aptitude for it, decide to pursue spending more time at it. Conversely when we have tried something and find that we have very little capability, we are often discouraged and sometimes fatally. This is competence. When we feel competent, or that we are becoming more competent we will be motivated and believe that the process is the correct one. It is a unique individual that is able to pursue something in the presence of repeated lack of capability and improvement. In the context of our professional settings this applies to the design of our interventions and how we must look to pitch the intervention at a level that demonstrates that the outcomes are heading in a positive direction. This may come in setting an exercise or training session that may be difficult but within the bounds of possible. If we are inconsiderate of developing and nurturing this growth of competence, we place ourselves in a position to detract from the belief of the individual. This only shifts their motivation lower and is likely to detract from their long term progression. 

We have only skimmed these areas of motivation and how they relate to belief and predictive planning, but we hope that it has created some questions for professionals, patients, and athletes alike about their environment and whether it is working to enhance their faith in what they are working towards or setting up the situation for reduced motivation and poor results.