Reframing Behavior holly kretschmar, Gretchen Wustrack

Sustainable change requires the right mental model

Almost everyone wants to change something. Perhaps it’s a major change, like quitting smoking or shedding unhealthy pounds. Or it might be a smaller lifestyle decision, such as starting to take vitamins, selecting a new phone, or walking to work. Big or small, changing one’s habits can require significant physical and mental effort.

Designers have traditionally focused their energies on physical objects, seeking to optimize their functionality, usability, and desirability. But helping people make needed changes in their lives requires more than physical objects. People import mental models to new experiences, and if they are to change their habits, they must first change the attitudes on which they rest. Designing for sustainable change means finding the right mental model.

Designing around a mental model can help people overcome obstacles to successful, sustainable change. Reframing helps them envision their efforts in a new way, increasing the likelihood of success and building loyalty toward the products, services, interactions, and communications that show them the way.

The Evidence — Stories from around the globe

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From me to us

Bill and Kathy have had a great life together, but for the last five years their attempts at sex always ended with Bill turning over and pretending to sleep and Kathy staring at the ceiling.

Eventually, Bill talked to his doctor and learned about erectile dysfunction. They had both believed that the little pill would be the silver bullet, but they weren’t prepared to address the damage done to their relationship over so many years. Rather than solve the problem, the expectations raised by the promise of medical therapy exacerbated it.

In response, a major pharmaceutical company developed a starter kit that focuses on the couple’s relationship rather than the man’s medical condition. It includes materials to increase empathy and rekindle the romance.

What if we design tools that address the relationships in our lives that can inspire and sustain change? Can we design tools for the people around the individual who wants to change?

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From should to want

A plus-size athlete, Jennifer doesn’t fit the typical mold of a personal trainer, but this is fine with her clients. Jennifer trains many different types of people including those who are obese and whose goals may be as simple as walking around the block.

Over the years, Jennifer realized that focusing on diet and exercise is the wrong approach. Many of her clients swore off exercise after a humiliating experience during PE class, so she helps people change by tapping into “their innate desire to move.”

By framing activity in terms of pleasure rather than exercise, Jennifer motivates her clients so that they can take on the challenge of shifting their habits. She measures her success by a lengthy list of referrals from her longstanding customers.

What if behavior change were described in terms of pleasure rather than pain? What if behavior change tools unleashed our innate desires and encouraged small, first steps?

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From steady state to dynamic

Sean and Rachel had always expected that their financial life would steadily improve as they got older. As they fell deeper into debt, the mismatch between their expectations and the reality was adding significant stress to their relationship.

Rachel tried to “freeze their assets” by putting her credit card in a block of ice in the freezer, and the couple decided to put off getting married in order to save on insurance. Despite these desperate measures they fear they may never recover a feeling of financial stability.

If they could reframe their situation as expected bumps in the road to financial health, they would feel less guilt, less shame, and less tension in their relationship.

What kinds of tools might help people understand dynamic change as a fact of modern life? Can we design tools that help people view lean times as part of a life well lived?

The National Campaign

The National Campaign, a nonprofit organization with a mission to reduce unplanned pregnancy, found that women generally only consider long-term birth control in the context of an ongoing relationship. This leaves plenty of gaps in contraception use, so the National Campaign is launching a program to reframe contraception as the default mode for women until they are ready to have a child: “If you’re not using contraception, you’re trying to get pregnant.”

Letters to an ex

Smoking cessation programs often encourage people to realize that success is not about willpower, but about breaking an emotionally dependent relationship. As part of changing the mental model of willpower, successful quitters wrote breakup letters to their cigarettes: “You made me feel like I couldn’t do anything alone; you took my money; you made me feel great and then terrible about myself….” Framing change in terms of a negative relationship helped people understand the nature of their habit and prepared them for the difficult journey ahead.

Empowering heart patients

Dr. Dean Ornish, founder of the Preventive Medicine Research Institute, believes that patients who attribute exaggerated power to their doctors become passive in managing their own care. In a study of high-risk heart patients, Dr. Ornish required them to eat a vegetarian diet and do yoga, meditation, and exercise for three hours a week. After five years, 99 percent had stopped or reversed the progress of their heart disease. By teaching them to take control of their own heath, Dr. Ornish helped them commit to lasting change.

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The Small Plate Movement

The Small Plate Movement has found a simple way to decrease the amount of food people eat. The organization has found that plate size determines the amount of food people serve themselves. A two-inch difference in plate diameter—from 12 inch to 10 inch—results in 22 percent fewer calories served, yet doesn’t seem to affect feelings of satisfaction. If a typical dinner has 800 calories, a smaller plate would lead to a weight loss of approximately 18 pounds per year for an average-size adult.

Discussion

Graham

November 6, 2009

I have been thinking about how a designer would tackle a problem as intangible as the American inner model, which leads to overspending and over expectations with regards to health care.

While there are possible political solutions for health care overspending, I don’t see as much concurrent focus on moving the average, individual behavior model to a more sustainable point (probably because of all the rhetoric about it being a purely market based, rational choice theory problem… because people don’t directly pay the cost, monetary motivations don’t apply.) Maybe it is possible to help people internalize the real costs/benefit analysis of health care without making it a market based decision. This would remain an important challenge if we had the good fortune of moving towards a single-payer system.

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Tomaz Aquino

January 29, 2010

the right mental model?

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Tracy Slotin

February 3, 2010

I agree that people need to change their mental models to change their habits but what you left out was the source of those habits and mental models stem from about 2 months before we are born to the age of 2.5-3 years old. These habits and mental models were created as safety patterning in the organism to help it survive. Which means these are very deeply held habits that are in bedded in our subconscious brain. Only using something like Neuro-Linguistic Programming are you going to be able to sustainably change those habits (that is Neuro-Linguistic Programming at a belief, identity and systematic level). You are better off spending your energy trying to learn about exactly what those habits are. Rather worry about changing people’s mental models think about progression of change through giving them what they are familiar with (use the habits they already have - creating their critter brain to relax rather than go into fight-flight-freeze response) already and add to it. You’ll be more successful and get a larger market since most of the market (75%) like change to be progressive rather than instant or not at all.

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Tracy Slotin

February 6, 2010

Change is not good or bad, it just is. There is just a preference timing system for everyone. There is a portion of a population that likes things to stay the same, and there is portion of the population that like things to change progressively and there is portion of the population that likes things to change immediately. If you were to say have a conversation with any of these types of individuals the language that they would use would indicate their affinity for change… if they use words like, more, better, less (gradation words) in describing relationships they like change to be progressive. If they use words like switch, shift, change, different they like change to be instant and if they use words like same, constant, consistent they don’t like change, they like things to be the same. If you are planning to help them change, you would want to know what type of change preference you are working with. Additionally these link to internal timers that range from about 6 months to life in which they cycle through different relationships in their lives.

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Lillian

August 10, 2010

I absolutely agree in regards to the smaller plate concept. However, letters to an ex, I don’t know.  My relationship with cigarettes is more than an emotional bond. I believe it is a drug addiction.  But you are so correct there certainly is a strong emotional addiction there also. This is such a health hazard if it takes writing letters then I am all for it. Thank you, thank you.

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