4
Chapter
Chapter contents
General considerations 27
Practical measures 28Motivation and cognitive-
behavioral intervention strategies
General considerations
Health care practitioners frequently find that
patients react skeptically to advice. Sometimes we
need to persuade patients into behavioral change,
such as taking more exercise. Patients seem not
to like being told what to do. Despite this, pub-
lic health campaigns often try to increase individ-
ual risk perception through emotional messages
based on fear appeal theory, for example, the
graphic warnings on cigarette packs. Such warnings
are rarely successful – although fear is an impor-
tant factor in human perception, we need strate-
gies to deal with this fear. Practical research has
demonstrated that, although some patients react
favorably when given advice, success rates are not
very high, according to brief intervention studies
(Mason & Butler 1999; Marcus et al 2000; Lawlor &
Hanratty 2001).
This leads to the question: which type of interven-
tion would be successful in therapeutic practice? A
word of warning: studies researching the effective-
ness of different interventions have found inconsis-
tent results. For instance, in their review Lewis et al
(2002) state that definitive conclusions could not
be reached, because of measurement error, lack of
importance of a particular variable, or unsuccessful
interventions with changing variables.
We can still ask: how it is possible to enhance
our patients’ motivation and guide them to self-
motivated, responsible behavior? In this ideal state,
patients act autonomously, changing their unhealthy
habits into healthy ones.