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The 3 Factors of Motivation PDF Print E-mail
Written by Jason Parker   
Monday, 08 January 2007
In our last article, we discussed the three factors that determine return-to-work motivation: the value a person places on work, expectations of recovery, and the perceived or real cost of returning to work.  A comprehensive review by Hunt et al (2002) underlines the importance of motivation to return-to-work outcomes.  It found little consensus on predictive medical factors.  Hunt writes that “no medical factor was linked to work disability strongly enough to emerge across all time frames.” Clearly, understanding what motivates people to go back to work is critical to effective return-to-work planning.

But we also need to understand the more general factors that motivate people.  In their book Motivational Interviewing, Miller and Rollnick focus on understanding what causes a person to change.  As you read through this newsletter, keep in mind the following story:   

There once was a man who, every day after work, would drive over to pick up his children from school.  Each day, he would use the drive as an opportunity to unwind from the day’s stresses, and each day on his drive over he would have a cigarette.  One day, the man left work after an especially stressful day.  The meetings had been grueling, the deadlines tight, and he’d had a disagreement with his manager that was not yet resolved.  On his way to pick up his children, he reached in his pocket for his badly needed cigarette.  His wife had been after him to quit, but today he felt he really needed to unwind with a ‘relaxing’ cigarette.  As he reached for the familiar pack, he realized his pocket was empty.  He had run out of cigarettes earlier and he’d been too busy to buy a new pack.  He decided to stop at a corner store on the way to the school, even though he was running late.  He thought he could just run in and get a new pack of cigarettes and his children would only have to wait five or so minutes for him.  No big deal.  After the day he’d had, he deserved a cigarette.

This first instalment of the story illustrates that motivation is influenced by many naturally occurring interpersonal factors.  It is also influenced by specific interventions, which will be dealt with in future newsletters because it is important to understand the difference between the two, but for now, the focus is on naturally occurring factors.  As you become more aware of what drives motivation, you will begin to see how you can apply your new skills to facilitate changes in behaviour.

Miller and Rollnick break motivation down into three categories: willingness, ability, and readiness, in no particular order.  Keep in mind that each is not dependent on the other.  For example, a horse might be thirsty and willing to drink but can’t get to the water. 

To get at willingness, you have to ask the question, Why is it important to change?  Why is it important for the horse to drink?  What is important to them? Closely tied to the notion of willingness is the “self-regulation theory,” which can be thought of in terms of a self-correcting thermostat. If all is fine, then there is no change.  The minute that it gets cold, the heat kicks in, or conversely, the minute that it gets hot, the heat shuts off or the air conditioning goes on.  Our job is to find out how to initiate the change in temperature.

Ability has to do with confidence.  Does a person believe he or she CAN change?   Do they believe there is a way to change?  When it comes to the ability factor, it is important not to be the hero.  Imposing all your own ways someone can change is not motivating.  The secret to unlocking ability is to reinforce the fact that the responsibility to change is theirs; we can only help facilitate it.

Readiness is not about whether a person is able to start something; it has more to do with his or her hierarchy of priorities or values.  What is most important to that individual right now?  What are their priorities?  Back to our story to illustrate:

The man parked outside the store where he normally bought his cigarettes.  It was pouring rain, one of the heaviest rainfalls of the year according to the news.  He noticed that he had been making good time.  If he doesn’t go in the store he could actually pick up his children on time. If he decides to buy his cigarettes, he would only be five or 10 minutes late, which wasn’t that bad.  His children were old enough and they had waited for him before without any problems.  He was just about to get out of the car when he remembered that it hadn’t been raining that morning and his children didn’t have umbrellas or coats.  He doesn’t get out of his car, drives away, and never smokes again, because he realized that he never wanted to be the type of father that leaves his children out in the rain for a pack of cigarettes.

The central lesson of the story is this: The secret to motivation is that people will change only when something is, or becomes of value to them.   When it comes to being motivated to return to work, people will be motivated only when it is of value to them, they perceive they are able to return successfully, and that it is a priority for them.  A  critical part of your job is to find these factors out.  Once you accomplish this you have now improved the odds of that person successfully , and more importantly having a sustainable, durable return to work.

References

Hunt D, Oonagh A, et al.  Are Components of a Comprehensive Medical Assessment Predictive of Work Disability After an Episode of Occupational Low Back Trouble?  Spine 2002: Volume 27, Number 23 pp 2715-2719

Miller and Rollnick.  “Motivational Interviewing”

Last Updated ( Sunday, 18 March 2007 )