moving beyond the behavior change trap with rosie ward, phd

MOVING BEYOND THE BEHAVIOR-CHANGE TRAPHP LiveApril 12, 2013

Rosie Ward, Ph.D., MPH, MCHES, BCC, Certified Intrinsic Coach®Health Management Services Manager

RJF, a Marsh & McLennan Agency LLC company

Minneapolis, MN

MARSH & McLENNAN AGENCY LLC

ORGANIZATIONAL CULTURE


THE CRISIS OF CAPACITY

• Humans are NOT Computers!– Continuously, at high speeds, for long periods of time,

running multiple programs at the same time.

Source: Tony Schwartz (The Energy Project, www.theenergyproject.com)


A CULTURE OF BELIEF: Exponential Engagement

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Engaged

Enabled

Energized

A work environment that supports

productivity & performance

Attachment to the company & willingness to

give extra effort

Individual physical, social

& emotional well-being at

workSource: Adrian Gostick & Chester Elton, All In: How the Best

Managers Create a Culture of Belief and Drive Big Results (2012)


THE IMPORTANCE OF ENERGYThe New Values Exchange

Values• Physical: Quantity of energy;

renewal for sustainability

• Emotional: Quality of energy; how you feel influences how you perform– Core emotional need = to feel

valued

• Mental: Capacity for focus (myth of multi-tasking)

• Spiritual: Serving a mission/purpose bigger than yourself

How to Renew Each Value:• Physical: food, exercise,

sleep, rest

• Emotional: managing triggers, cultivating positive emotions

• Mental: Flexible focus, quieting the mind

• Spiritual: connecting to a purpose (leaders inspiring others)

Source: Tony Schwartz (The Energy Project, www.theenergyproject.com)


COMPETITIVE ADVANTAGE OF E + E + E

9.9%14.3%

27.4%

Operating Margin

6Source: Adrian Gostick & Chester Elton, All In: How the Best

Managers Create a Culture of Belief and Drive Big Results (2012)

3x Higher


SHIFTING FROM BEHAVIOR CHANGE TO CULTURE

“Behavior change is really the mantra of wellness, but if a person achieves a lifestyle behavior change, only to return to the same unhealthy environment, what can we expect will happen? We set up wellness for failure if we don’t work on improving the environment and culture before we work on individual behavior change.” (Dee Edington, Ph.D., The Art of Health Promotion, Sept./Oct. 2012)

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Section 1

THE REALITIES OF MOTIVATIONThe Limitations of “Behavior Modification”


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)


WHY WE DO WHAT WE DO

Autonomy & Authenticity:

• Actions come from true sense of self

Control & Alienation:• Actions come from being

pressured• Acting without sense of

personal endorsement• Behavior isn’t expression of

self

10Source: Deci, E. (1995). Why We Do What We Do: Understanding Self-Motivation


INCREASING COST OF INCENTIVES

• 73% of companies used incentives in 2011 in health-improvement programs

• Average Incentive Values Increasing: 2011: $460 2010: $430 2009: $260

11 Source: National Business Group on Health (2012)

Heavy Use of Extrinsic Incentives → It costs more over time to get the same result.


MOTIVATION IS NOT ENOUGH!

Behaviors that change quickly also change back quickly!

12Source: Paul Marciano, Ph.D., Carrots and Sticks Don’t Work, (2010)


INCENTIVES & RISK REDUCTION

• Higher behavior change program completion rates– No changes in risk– No increases in health improvement

• Progress-based incentives???

13Source: Gingerich, Anderson & Koland (2012); American Journal of Health Promotion


THE FLAWED PATH TOWARDS OUTCOMES-BASED INCENTIVES

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WORDS OF WISDOM…

“After 35 years studying wellness as an economic strategy, I …challenge and engage organizations and populations to move wellness to a more mature field and to a higher level of purpose, values, mission and vision. Wellness is too important for all populations to reside at the level of economic gain and the use of incentives, which are built on the belief that "health can be bought."

~Dee Edington, Ph.D. (Jan. 24, 2013)

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CHANGING THE QUESTION…

How can we motivate others to…?• Take their medications• Exercise• Do their chores/homework• Eat healthy• Etc.

How can we create CONDITIONS within which

others will motivate themselves?

16Source: Deci, E. (1995). Why We Do What We Do: Understanding Self-Motivation


FOSTERING INTRINSIC MOTIVATION

• Occurs when learning activity & learning environment elicit motivation in a person.

• Key to organizational effectiveness = empowered & intrinsically motivated employees.

• Individual thoughts central to intrinsic motivation & self-leadership– Organizations need to create an environment that

fosters developing and maintaining constructive thinking.

Sources: Brandt (1999); Chance (1992); Lahiry (1994); Neck & Manz (1992)

FOSTERING INTRINSIC MOTIVATION


Section 2

MOVING BEYOND BEHAVIORSThe Critical Role of THINKING


REALITY OF HUMAN DEVELOPMENTWhy Behavior Modification Isn’t Sustainable

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BRAIN: FRIEND OR FOE?

Prefrontal Cortex Basal

Ganglia

THE ROLE OF THE BRAIN IN CHANGE


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)


WHY DON’T WE ACT IN OUR OWN BEST INTEREST?

“Leaders don’t have time for the future because they’re too busy with the present.” ~ Muhammad Yunus

“To transform the world, we must first transform ourselves.”

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Source: Tony Schwartz, “Why Don’t We Act in Our Own Best Interest?”, Harvard Business Review (Jan. 2012)

MARSH & McLENNAN AGENCY LLC Source: Chip Heath & Dan Heath, Switch: How to Change Things When Change is Hard

CHANGING WHEN CHANGE IS HARD…

CHANGING WHEN CHANGE IS HARD


THE HABIT LOOP

24 Source: Charles Duhigg (2012), The Power of Habit


LESSONS FROM CLAUDE C. HOPKINS


MARSH & McLENNAN AGENCY LLC 26


REPLACING HABITS



IT ALL COMES DOWN TO LEADERSHIP…

Organizational Effectiveness & Health Determined by:

• Who leaders are BEING, not what they’re doing.

• Cohesive leadership teams

• Leaders recognizing when their thinking isn’t serving them

• Leaders being intentional vs. habitual in their thinking and actions

• Leaders recognizing the importance for their ongoing development.

28Sources: The Arbinger Institute, Leadership and Self Deception (2010); Patrick Lencioni, The Advantage (2012


Section 3

THE ROLE OF INTRINSIC THINKINGA Road Map for Sustainability


DEFINING & ASSESSING EFFECTIVE THINKING PATTERNS

ROBERT S. HARTMAN, PH.D.

Life Question:“Why is evil so

easy to organize, while good is

not?”

Life Purpose:“I dedicate

myself to finding out how to

organize good.”

Good Defined:A thing is good

when it has all its properties


VALUES THINKING / VALUING

Hartman’s Hierarchy of Values:• Intrinsic (I) – valuing individual uniqueness• Extrinsic (E) – valuing function• Systemic (S) – valuing concepts/ideas; ought/should

• I > E > S – people are more valued than things; things are more valued than mere ideas of things or people.

Sources: Hartman (1967) & Pomeroy (2005)


I, E & S IN ORGANIZATIONS

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Policies & Procedures

Mission, Vision, Values

Systemic

Roles/Job Functions

Operational Tasks

Extrinsic

I Want to be fully alive at

work

I have unique gifts & talents

Intrinsic


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SYSTEMIC (S) vs. INTRINSIC (I) THINKING / VALUING

•S > E > I:

• Values OUR thinking

• Conclusive / Evaluative

• Only sees content

• Habitual (i.e., basal ganglia)

• Narrowing, analyzing

• Quick, no pause, no new thinking

•I > E > S:

• Values OTHER person’s thinking

• Expansive, NEW thinking

• Takes a little longer

• Recognizes there’s more than what’s merely apparent to us.

Source: WELCOA, “Changing the Game of Health Coaching” (2010)


APPEARANCE OF VALUE

Why so much of the good we want to do doesn’t happen:

• Intrinsic Valuing of People

• Extrinsic Valuing of People People as Things (predictable, replicable, and comparable – Why

can’t you be like your cousin?)

• Systemic Valuing of People People as Ideas (Imagined – You should sit and be quiet, do what I

think, etc.)

34Source: Christina Marshall, Marshall-Hartman Synthesis (Intrinsic Solutions Group

International, 2012)


PROGRAMS FAIL BECAUSE THEY ARE PROGRAMS

• Programs are nearly always designed to accomplish a specific goal in a relatively short time period.

• Programs fail because people view them as something to be done for a period of time and not as something that needs to be incorporated into their lifestyle.

• What organizations want are employees who work hard all the time and not just when they are chasing carrots.

• “Programs don’t fundamentally change employees’ beliefs or commitment to their job; they just change their behavior during the course of the program.”

35 Source: Paul Marciano, Ph.D., Carrots and Sticks Don’t Work, (2010)


PROGRAMS ARE TOO NARROWLY FOCUSEDAvoiding the Reductionist Trap…

36Source: Christina Marshall, Marshall-Hartman Synthesis (Intrinsic Solutions Group International, 2012)


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WHEN WE ONLY WORK WITH WHAT IS APPARENT TO US…

• Jumping to conclusions• Judgment• Impatience• Frustration

Without the Capacity and Ability to work with more than what is merely apparent, you can never

be anything other than my ideas about you…


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“I wish my parents would see me for all that I AM instead of all the things that I haven’t become!”


“We cannot solve problems by using the same kind of thinking we used when we

created them.”~Albert Einstein


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CHRISTINA MARSHALL

SHIFTING THINKING PATTERNS“Cracking Open the Intrinsic”


“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” (Intrinsic Solutions International)

• Shifts thinking to I>E>S:– Improves Resiliency and Work/Self Balance– Improves Communication– Improves Relationships– Teams: Get more done in less time

INTRINSIC COACHING®Strengthening Intrinsic& Overall Thinking


IC® = IMPROVED COMMUNICATION SKILLS

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THOUGHT PATTERN / BEHAVIOR

FROM… TO…

Listening • Talk more than listen.

• Interrupt people to provide own thoughts & ideas.

• Listen more than talk.

• Let people finish their thoughts.

Engaging Others in Conversation

• Give advice/tell people what I think they should do.

• Ask questions to elicit their best thinking so they can decide for themselves what they want to do.

Source: Rosalind Ward, Ph.D. (2008)


IC® = IMPROVED WORK RELATIONSHIPS

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FROM… TO…

Colleagues / Employees

• Get employees to do their jobs and tell them what to do.

• Impatient; jump in to fix problems for others.

• Allow employees to create own way of being effective in their roles.

• More patient; allow people to figure things out for themselves.

Customers • Lecture clients/ customers on what they should do based on my thinking about their situation.

• Let them talk; ask ?s about what they want and what is important and providing guidance from there.



IC® = IMPROVED RESILIENCY / COPING WITH STRESS

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FROM… TO…

Perception of Stress

• Overwhelmed by stressful situations & trying to figure out what to do.

• Focus on what is most important; gain clarity about situations before moving into action steps, resulting in less stress and not feeling overwhelmed.

Handling Personal Challenges

• Acting based on habits.

• Feeling like a victim of circumstances.

• Act based on what is most important.

• Recognizing I can make a difference in my life.



Section 4

LEADERS’ ROLE IN ORGANIZATIONAL HEALTH


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LEADERS’ ROLE IN WELL-BEING

• Leaders shouldn’t ignore well-being as if it’s beyond the scope of their jobs.

• People who agree their manager cares about them as a person:

– Are more likely to be top performers– Produce higher quality work– Are less likely to be sick– Are less likely to change jobs– Are less likely to get injured on the job

Source: Rath & Harter (2010), Wellbeing: The Five Essential Elements


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A “REBIRTH OF PERCEPTION”


SEEING MORE THAN OUR IDEAS ABOUT PEOPLE

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Section 5

PUTTING CONCEPTS INTO ACTIONThe Journey Towards Sustainable Well-Being


Yesterday’s Approach

HA

Biometric Screenings

Incent Behaviors

Limited in scope; lacking in sustainability

Biometrics Optional

Total Well-Being

Strengthen Leaders

Cognitive Stimulation

Increase I>E>S

Work Environment

Ind. & Org. Assessment

Engagement & Sustainability

Today: Organizational Well-Being

SHIFTING OUR APPROACH


CHANGING ORGANIZATIONAL HABITS


PAUL O’NEILL


I>E>S IN ACTION“Correcting” for Incentives

• “Now That” vs. “If/Then”


I>E>S CASE STUDYCity of Ames, IA

• Profile:– 560 employees, 1350 total insured members– 75% M: 25% F– Avg. age = 44– 5 unions environment

• Highlights:– 95% Retention Rate over 7 years– Started w/ 60% low risk, now 80% (maintained for 5 years)– Required IC® sessions– It’s about the message & approach, not the money!


I>E>S CASE STUDYFrom the Mouths of Employees…

• “The program is fabulous…the coaching is EVERYTHING!”

• “I’m continuing to learn more about myself…it’s not just about weight loss and exercise.”

• “Glad the City has this…it shows they care about me as a person and just as an employee.”

• “This creates such a great environment…I have pride in the organization.”

• “This would be one of the hardest things to let go of if I were ever to leave the City. It is a huge benefit that we have! My doctor finds that this is amazing that we have this!”


CONTACT INFORMATION

Rosie Ward, Ph.D., MPH, MCHES, BCC Certified Intrinsic Coach®, Certified Valuations Specialist

Health Management Services Manager

RJF, a Marsh & McLennan Agency LLC company

[email protected], (763) 548-8861

www.rjfagencies.com

www.DrRosieWard.com

mailto:[email protected]

http://www.rjfagencies.com/

© Copyright 2013. RJF, a Marsh & McLennan Agency LLC company. All Rights Reserved.

The content provided in this presentation is proprietary and confidential and not for distribution without written consent from MMA.

moving beyond the behavior change trap with rosie ward, phd

Health & Medicine

marsh mclennan agency

marsh mclennan agency

individual behavior

use of incentives

culture of belief

cost of incentives

lifestylebehavior change

energy project