How can people be motivated to make better health choices?

The National Institute for Clinical Excellence (Nice) is considering ways to persuade people to take better care of their health, due to the considerable impact that unhealthy habits are having on the NHS.

The NICE study examined a series of proposals, including one in Kent which pays dieters up to £425 for losing weight and another in Scotland which gives pregnant women shopping vouchers worth up to £650 for quitting smoking.

According to the proposals being considered by the health watchdog for England and Wales - people could be given cash incentives to encourage them to give up smoking or to lose weight.

• Can cash incentives motivate people to make better health choices?
• Are there better ways to encourage people to take care of their health or we are now at our last resort – hard cash?
• Would offering money as an incentive to improve health be cost-effective for the NHS or would the money be better spent elsewhere?
• Is it the right way forward?

You, as one of those professionals who work in the front line of helping people, are qualified better then anyone to answer these questions on the basis of your experience. Your opinion is invaluable and needs to be heard. We have created a simple poll were you can make your view known in two seconds: http://www.surveymonkey.com/s/5WWMS39

Please vote – we will make sure that your answers are known to those who make decisions on the matter.
Please feel free to send us your views on the matter as well as to post comments in the comments box of the poll or on our Psychology & Psychotherapy Blog.

This is an important topic closely linked to our training on Motivational Interviewing and Beyond (http://www.skillsdevelopment.co.uk/seminars.php?courseid=5) and we will definitely address this issue as part of our course discussion. However, we would like to give all of you the opportunity to express your opinion whether you are taking part in the course or not.

Looking forward to hearing from you.

Change your life in 66 days ?

Phillippa Lally and her colleagues at UCL (Lally et al (2009) How are habits formed: Modelling habit formation in the real world European Journal of Social Psychology) has been involved in addressing a fascinating question that is pressing for any practitioner who is trying to help their client change - namely how long does it take - not only to make a change but to ensure it is well established...in other words has become a new "habit" in their lives which they do automatically without thinking.

The average time taken was 66 days, although the spread ranged between 18 and 254 days. Not surprisingly, establishing new behavioural health habits (like doing sit ups every morning) took longer.

The good news from this study is that missing a single day's practice isn't of crucial importance. However, the bad news is that if a typical period for establishing a change is over two months (AFTER the change is learnt) brief interventions that are withdrawn as soon as a change is initiated are likely to lead to high relapse levels.

Our services (and ourselves as professionals) are forever overly preoccupied with clients at a Action Stage (in the Cycle of Change) and pay insufficient attention to Maintenance. Interventions for weight loss for example are well evidenced, but the containing failure at the maintenance stage continues to create problems. The issue is even more pronounced within mental health, where the preoccupation with acute problems remain just that - acute. Even when the issue of relapse is examined (as in depression) and its prevention through the use of mindfulness skills, there is little that looks at how long it takes a client to regularly and automatically use such new skills.

Whatever field we work in, if we were to keep the figure of 66 days in mind more frequently, it might substantially increase our long term effectiveness with our client and avoid the "hit and run" mentality that is currently so common.