Lifestyle Factors and Mental Health PDF

Lifestyle factors and mental health Associate Professor Michelle Jongenelis Deputy Director, Melbourne Centre for Behaviour Change Senior Clinical Psychologist, Lawson Clinical Psychology [email protected] 1  Lifestyle factors and mental health Lif...

Lifestyle factors and mental health Associate Professor Michelle Jongenelis Deputy Director, Melbourne Centre for Behaviour Change Senior Clinical Psychologist, Lawson Clinical Psychology [email protected] 1  Lifestyle factors and mental health Lifestyle factors play an important role in mental health Eating healthy food Physical activity Smoking cessation Alcohol and other drug abstinence Sleep Social connections 2 3  Behaviour change The universe doesn’t give you what you ask for with your thoughts; it gives you what you demand with your actions – Steve Maraboli Wellbeing is not something we just have; it requires deliberate, considered, and repeated action on our part to foster and maintain positive experiences It is something we need to work for and we do this by taking action and engaging in behaviours that help us live a healthy and fulfilling life 4  Why don’t people change their behaviour? They may: 1. lack knowledge and/or hold incorrect beliefs (e.g., “Vaccines cause autism”) 2. be concerned about others’ approval if they change (e.g., “My smoking friends won’t like me if I quit”) 3. lack motivation/emotional involvement (change isn’t that important to them) 4. have too many other priorities (the time isn’t right) 5. lack belief in their ability to successfully change their behaviour (“I’m not capable”) 6. lack planning skills (don’t know how to plan change; e.g., goal-setting skills) 7. lack performative skills (don’t know how to enact change; e.g., implementation of plans, monitoring) 8. face difficulties overcoming existing habits and/or building and maintaining new habits (give up when it gets too hard) 9. live/work in an environment that facilitates current maladaptive behaviour 5  Behaviour change Taking action to change behaviour therefore involves a number of processes and skills. Many of these processes are within our control and many of these skills can be taught. These include: Motivation – desire/intention to engage in a behaviour Self-efficacy – belief in one’s ability to execute the behaviours necessary to achieve a goal Goal setting – setting a defined goal that will guide behaviour Planning – determining how one intends to achieve their goal Self-monitoring – examining and recording thoughts, feelings, and/or behaviour in relation to the goal Self-evaluation – assessing the extent to which one has succeeded in reaching a set goal Goal review – reconsidering a goal in light of evaluation 6  Behaviour change model Environment Knowledge Self-efficacy Attitudes Self- Motivation Goal setting Planning Action monitoring Normative beliefs Self- Identities and Goal review evaluation values and feedback 7  Key behaviour change questions 1. How can we build confidence in achieving successful outcomes (i.e., self- efficacy)? 2. How can we foster motivation? What are the drivers/determinants of motivation for this particular individual and how can we change/promote these? 3. What are the properties of goals most likely to lead to action? 4. How can we facilitate and optimise self-monitoring? 5. What types of evaluation and feedback are most useful in maintaining motivation and self-efficacy and optimising goal review? 8  What about you? Pick a behaviour from your own life that you would like to change to improve your wellbeing. Common examples include: Reducing alcohol intake Quitting smoking Increasing physical activity Eating healthily Improving sleep habits Spending more quality time with family and friends Reducing procrastination 9  Where to start? Environment Knowledge Self-efficacy Attitudes Self- Motivation Goal setting Planning Action monitoring Normative beliefs Self- Identities and Goal review evaluation values and feedback 1. Carver, C. S., & Scheier, M. F. (1982). Control theory: A useful conceptual framework for personality–social, clinical, and health psychology. Psychological Bulletin, 92(1), 111-135. https://doi.org/10.1037/0033-2909.92.1.111 2. Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50(2), 179-211. 10 3. Fisher, J. D., & Fisher, W. A. (1992). Changing AIDS-risk behavior. Psychological Bulletin, 111(3), 455-474. https://doi.org/10.1037/0033-2909.111.3.455  Motivation An individual’s desire/intention to engage in a behaviour Do they want to do it?  If yes, great! Move on to goal setting  If no, stop! Need to increase motivation first 11  Motivation is critical to behaviour change  Motivation is pre-requisite to behaviour change.  It is a function of the extent to which we want to act in a certain way and believe we should act in a certain way  Behaviour change is challenging when there is conflict between what we want to do and what we should do  For example, when what we want to do (smoke, drink, eat junk food) is not in our best interests 12  Determinants of motivation  Knowledge  Attitudes  Normative beliefs  Identities and values  Self-efficacy  Motivation is based on some form of story clients have developed that includes some or all of the above 13  The motivation ‘story’ For example: I don’t know how to change, change will be awful, my friends won’t like me if I change, this new behaviour isn’t ‘me’, I don’t have the skills to change Vs I know how to change, change will be hard but it will feel good, my friends will still like me and if they don’t they weren’t true friends to begin with, this new behaviour is consistent with my values, I have the skills to change 14  Work with clients to change the story Evidence from the following areas of research shows that changing these determinants results in increased motivation and behaviour change:  Smoking cessation  Alcohol  Cancer screening  Sun protection  Exercise  Diet 15  Increasing motivation  Knowledge  Ensure people are aware of (and understand!) relevant information  What do people need to know about a new behaviour they need to enact or old behaviour they need to stop enacting?  For example:  “Taking this medication may reduce your cholesterol by X”  “Going on a 30 minute walk every day may improve your heart health by X%”  “Within 2 days of quitting smoking, your sense of taste will improve” 16  Increasing motivation  Attitudes  People must believe the advantages/benefits of behaviour change outweigh the disadvantages/costs of performing the behaviour (i.e., they hold a positive attitude to behaviour change)  For example:  “It will feel good to quit smoking/increase my physical activity”  “Taking my medication/wearing my hearing aids/doing my rehabilitation exercises will reduce my pain/prevent illness/increase my physical strength” 17  Increasing motivation  Emphasise personal relevance – what are the benefits of change for this person? What is their story?  For example, be able to run around with their kids/grandkids, see them grow up  Provide many arguments and repeat as needed  Provide people with substitutes or alternatives to behaviour if they are giving something up that brings them pleasure  For example, low fat alternatives to liked foods 18  Increasing motivation  Normative beliefs  Others’ approval/liking is a powerful motivator  Motivation will be higher if one perceives more social (normative) pressure to perform the behaviour than not to perform the behaviour or vice versa  For example, eating fruit and vegetables – there is more social pressure to consume than not to consume  For example, smoking – there is more social pressure NOT to smoke than there is to smoke  “Others will approve of me/like me more if I quit smoking/reduce my alcohol intake/take my medication” 19  Increasing motivation  Changing normative beliefs is difficult when the behaviour people need to enact contradicts the behaviour patterns of their in-group  For example, getting smokers to quit smoking when their family and friends smoke  Work with people to overcome these norms  When in the first few weeks of behaviour change, can they avoid people who trigger old behaviour patterns?  Can they shift the location of social events from the pub to a café?  Discuss with client the concept of ‘enabling’ and how others benefit from the status quo, which is of detriment to the client 20  Increasing motivation  Identities and core values  People perceive performance to be more consistent than inconsistent with self-image/their values  Core values and identities determine priorities  Weaken current wants/desires by explaining to people  What we want is not necessarily aligned with who we want to be  For example, someone may want to be a present parent but their alcohol intake prevents this. Highlight this discrepancy to them 21  Increasing motivation  Values-based work can help clients to identify what their values are and  How their current behaviour isn’t aligned with their values  How behaviour change is aligned 22  REFLECT Rate motivation regarding the behaviour in your life that you wish to change: 0 – very low 10 – very high If