Intrinsic: The Key to Sustainable Change Health Promotion LIVE July 15, 2010 Rosie Ward, Ph.D., MPH, CHES Certified Intrinsic Coach® Health Management Services Manager RJF Agencies, Inc.How People Make Behavior Changes Changing the Change Paradigm
“Insanity: doing the same thing over and over again and expecting different results.” ~Albert Einstein Traits of Human Nature• To be curious• To be active• To initiate thought and behavior• To make meaning from experience• To be effective at what we value Sources: Brandt (1999) & Chance (1992)
What Comes To Mind??? Intentional Change Theory• Idea of smooth, continuous change not a reality for most people.• Change process is often non-linear and discontinuous.• Change process stems from a set of discoveries or epiphanies.• Adults learn what they want to learn! Source: Boyatzis (2006). Journal of Management Development, 25(7)
Intentional Change Process• Must begin with a person wanting to change. – Desire does not have to be conscious or within scope of awareness.• Discovery of who one wants to be (ideal self) – Not to be confused with the ought self• Accurate assessment of the real self. Source: Boyatzis (2006). Journal of Management Development, 25(7) Theory U• New model for understanding & conducting profound change and deep learning.• What & how we pay attention are key to what we create.• Blind Spot – inner “operating center” – Becoming aware of blind spot critical to change (individually and systemically)• Shift in awareness to connect to our essential self via presencing and learning from future as it emerges Source: Theory U, Otto Scharmer (2009)
Paradigms of Change• Helping• Fixing Both paradigms assume the client / employee has something wrong and needs external assistance to get somewhere.• Serving The Role of Motivation What Works for Long-Term Change?
Types of Motivation• Intrinsic Motivation: – “People doing an activity because they find it interesting and derive spontaneous satisfaction from the activity itself.” (Gagne & Deci, 2005)• Extrinsic Motivation: – People are driven to do something due to pressure or tangible rewards rather than for the fun or interest of it.” (Petri, 1991)
Extrinsic MotivationDo Extrinsic Rewards Undermine Intrinsic Motivation? We can’t motivate others; we can get compliance, but the desire has to come from within. Businesses Ignore the Evidence• Carrot & Stick (especially $$$) not only ineffective but HARMFUL• True Motivation = Autonomy; Mastery; Purpose. Results in higher EE satisfaction and stronger results
Baseline Rewards• Baseline Rewards must be adequate & equitable. – Salary, contract payments, benefits, a few perks, etc.• Without - focus will be on the unfairness of the situation and anxiety over the circumstance. – No motivation at all.• Removing barriers increases actions. Source: Drive, Daniel Pink (2009) When Incentives Work • Algorithmic Tasks - follow a set of established set of instructions down a single pathway to one conclusion (i.e., there’s an algorithm for solving it). • Heuristic Tasks - no algorithm exists; have to experiment and find a novel solution. • External rewards and punishments (both carrots and sticks) work nicely for algorithmic tasks only. Source: Amabile, T. (1996), Harvard Business School
What About the Stick?• Do negative consequences reduce undesired actions?• Shift from moral obligation to purely transactional. – People start weighing the consequences of sticks to determine if the punishment is worth it. Source: Gneezy & Rustichini (2000)
Principal-Agent Theory• Principal – the motivator (i.e., employer, teacher, parent)• Agent – the motivatee (i.e., employee, student, child)• Once reward in place, need contingent rewards in order for behavior to continue. Escalating Zero Point2002 HA Participation: 2006 HA Participation:• $50 = 50-60% • $100 = 50-60%• $100 = 60-70% • $200 = 60-70%• $200 = 80% • $400 = 80% Heavy Use of Extrinsic Incentives → It costs more over time to get the same result. Source: StayWell Health Management (2002, 2006)
Negative Motivation• Heart Patients (double or quadruple bypass operations) – 2 years post operation, how many actually stick to new habits? – Only 10%!• Dr. Dean Ornish program – Patients taught to appreciate life rather than fear death. – 2 years post operation, how many actually stuck to new habits? – 70%!
Typical Conversations• Notice who is doing the work.• Notice the energy and commitment from the person being “coached”.• What do you think the likelihood of success will be? The “Try Harder” Approach• Putting the employee in a passive role requires us to work harder. “If I could only find a different way to say this…” “Maybe if I had them try x…”• This leads to: Frustration Being stuck in a viscous cycle BURNOUT!
Intrinsic Motivation• Occurs when learning activity & learning environment elicit motivation in a person.• Key to organizational effectiveness = empowered & intrinsically motivated employees.• Self-leadership (Neck & Manz, 1992) – Recognizes intrinsic rewards – Increased self-efficacy and performance Sources: Brandt (1999); Chance (1992); Lahiry (1994); Neck & Manz (1992) Creating Intrinsic Motivation• Having goals and rewards that are meaningful to people.• Having learning/activity that is important to people.• When learning/activity helps people obtain valued accomplishments.• When learning/activity helps people integrate themselves with the world, with others, and promotes self-awareness. Sources: Brandt (1999) & Chance (1992)
On Second Thought… Understanding the Power of the Thinking Behind the Actions Who Am I?Person #1 Person #2• Lazy • Overwhelmed• Unmotivated • Grieving• Disengaged • Strong• Stressed • Loving• Alcohol/Drug Problem • Saintly SAME Person → Perspective / Judgment changes based on information apparent to us.
How Thinking Gets In Our Way• “I know I should…”• “I really need to…”• “I just can’t seem to get motivated…”• “If only ______ (person) would do …..” Behavior Change – who does the work? Being told what to do – does it work? Thought Self-Leadership• Individual thoughts central to intrinsic motivation & self-leadership.• Use of specific cognitive strategies to control own thoughts.• Organizations need to create an environment that fosters developing and maintaining constructive thinking. Sources: Manz & Neck (1991)
I,E,S in Organizations• Judgment Index™ (C. Stephen Byrum, Ph.D.) – Uses HVP to measure strength of judgment, stress indicators, burnout indicators, hiring, morale/engagement, etc. Outcomes Outcomes Part 1 – Vs. Part 1 – Work Side Work Side Part 2 – Part 2 Self Side Self Side www.judgmentindex.com I, E, S Systemic Extrinsic I Want to Have ↑ Insurance Limitless Energy Premiums for Incentives SmokersBehavior Change I Want to Be There for My Healthy Snacks in Programs Kids Vending Machines Intrinsic
The Danger of Assessment Labels What Happens When the Intrinsic is Missing?• Jumping to conclusions• Judgment• Impatience• Frustration Without the intrinsic, you can never be anything other than my ideas about you…
“I wish my parents would seeme for all that I AM instead of all the things that I haven’t become!” Behavior Change• Behavior change results from a shift in thinking.• Behavior change is not DOING differently. – Doing differently is the outward observable of the internal change.
Why People Relapse• Old behaviors met some greater need.• When old behaviors are eliminated, the need still exists.• New behavior has not been substituted or does not fully meet the need.• Too much focus on fixing rather than building on strengths???• Reduced intrinsic thinking??? Moving Upstream Thinking Skills Emotional State Behavior Wellness
Brain: Friend or Foe?Prefrontal Cortex Basal GangliaCognitive Challenges with Change• Change itself amplifies stress & discomfort.• Carrot & Stick don’t succeed in the long run.• Brains = pattern-making organs with innate desire to create meaningful connections.• People can detect the difference between authentic inquiry and persuasion efforts.• Change requires changing mental maps through creating moments of insight. Source: Rock & Schwartz, “The Neuroscience of Leadership”, Strategy + Business (2009)
Changing When Change is Hard• Successful change = – Change situation – Clarity of direction• Rational & Emotional Systems must align with surrounding environment When Engagement Occurs• Emotionally connected to others• Cognitively stimulated• Know what is expected of them• Have what they need to do their work• Perceive they are part of something significant with co-workers they trust• Have chances to improve and develop Source: Harter, Schmidt & Hayes, Journal of Applied Psychology (2002)
Brains Are Like RW CDs“Scientists estimate that the average person has 50,000 to 60,000 thoughts a day. 90% of those are repetitive. 85% of the repetitive thoughts are negative. If leaders have approximately 45,900 negative thoughts a day, and, their followers are doing the same, the most important skill that leaders can develop is training the mind to lead.” ~Suzanne Kryder, Ph.D. (www.themindtolead.com) Stop DOING, Start BEING • People know if being manipulated, coped with, etc….it’s not about skills but how leaders regard others. • Our thinking about others influences how they perceive our behaviors. • People respond not to what we’re doing but how we’re being.
Increasing the Intrinsic: The Role of Coaching Sustained Behavior Change Cognitive Coaching Research (Stanford) New New Skill New Behavior Knowledge Developed at WorkInstruction Only 90% 25% 5%Add 90% 50% 5%Demonstration 90% 90-95% 5%Add Practice 90% 90-95% 5%Add Feedback 90-100% 95%Add Coaching 90-100%
Strengthened Intrinsic = Working Beyond What is Merely Apparent• Disabling the dominance of E and S thinking.• Listening with a Spirit of Service – vs. Listening to Assess – vs. Listening for Solutions How To Elicit the Intrinsic• Really listening to people without judgment.• Asking forward-moving questions that get to the core of what is most important to that person. “What do you want?” “What do you want that’s important to you right now?”• What? > How? > Why?
Intrinsic Capacity and Intrinsic Coaching® What Research Tells Us Intrinsic Coaching®“A paradigm changing approach to better results for, with, and through people” by “increasing people’s capacity to think better about choices, especially by increasing intrinsic thinking” (Totally Coached, Inc.)
2 Studies…So FarLifestyle Makeover Program: Doctoral Research:• Increased intrinsic capacity • Increased intrinsic capacity;• Improved life balance strengthened internal• Improved blood lipids & systemic glucose • Improved life balance &• SUSTAINABLE results! resiliency • Better outcomes at work and in life as a result of shift in thinking (I>E>S). Being>Doing>Becoming Outcomes Outcomes Vs. Part 1 – Part 1 – Work Side Work Side Part 2 – Part 2 Self Side Self SideSelf Side is critical to have I>E>S (Robert Hartman) Source: Byrum, Ph.D. / Judgment Index™
ress & rs: Work-side st 4 Stress Indicato stress & ability to ability to cope; Self-side IENCY) cope (i.e., RESILValue of Increased Intrinsic Capacity• Builds RESILIENCY – Stress / lack of coping and resiliency = #1 cause of poor judgment• Self-side coping / resiliency significantly related to job satisfaction and affective commitment.• Also strengthens internal systemic (clarity of life direction). Sources: Byrum, Ph.D. (2009) & Ward, Ph.D. (2008)
I>E>S in Action – City of Ames, IA• Population of Ames 52,000 (with college)• City municipality – 14 departments• Multiple sites - 16 locations• 560 employees, 1350 total insured members• 75% M: 25% F• Average age = 44• 5 unions environment I>E>S in Action – City of Ames, IA Program design is very intrinsic – “seeing” people in their lives vs. trying to change them.Systemic Components: I>E>S:• Required to complete annual • Focus on improving blood profile and HA. intrinsic thinking and clarity of goals – people & culture.• Other Required Criteria: – Preventive exams • Program linked to reduced – Consumerism modules health insurance premium, – Metabolic Measures but found it was about the – Participation in 4 programs message, not the money – 7 IC® coaching sessions/year
City of Ames - Results• After 3 years: – 70% participation rate amongst EEs; 100% retention rate (3 participants left organization) – 53% reduction in risk factors – 92% of participants satisfied – 84% of participants felt coaching making a difference – 97% of participants reported coaching was a positive experience• What’s Next? Leaders complete IC® training; weave into culture beyond EE wellness program. Summary of Key Points• Behavior change is complex; When using tools and resources, make the information second to the person.• Missing link is Intrinsic, but extrinsic and systemic are needed for support.• Sustained change results from eliciting new thinking, not being told what to do or given more information.
What new thinking have youhad today that you want toapply at your organization?Health Management Services Manager, RJF Agencies, Inc. www.rjfagencies.com; firstname.lastname@example.org Dr. Rosie Ward www.DrRosieWard.com; email@example.com