Compare and contrast two main motivational theories of your choice, which you think may have practical

application for lifestyle medicine. Include the following in your analysis: why you have chosen these theories (~200 words) a brief summary of the theories (~300 words max)) the practical value of each for application in lifestyle medicine (~500 words) the major similarities and differences between the two theories and (~500 words)

Introduction
A health professional too often deals with compliance issues to help patients achieve optimal physical and systemic health. This may require motivating them for lifestyle changes with weight loss, tobacco cessation, or high blood pressure reduction. Motivational theories can assist the health professional in the overall strategy of obtaining compliance and modifying existing behaviours. This requires an understanding of the basic concepts of human motivation to help patients achieve their goals. The Psychoanalytic Theory by Freud (1900-1930) has a novel approach in recognizing that neurotic behavior is not random or meaningless but goal-directed. There is some meaningful information associated with the purpose behind behavioural patterns which can be used to motivate the individual. Another theory of motivation which will be discussed is the Flow Theory propounded by Csikszentmihalyi in 1979 and is based on how an intrinsically rewarding experience feels. According to Freud, people are driven to satisfy these needs (mostly the physiological needs or instincts that arise from the Id) to reach a state of homeostasis. In absence of a socially acceptable way to satisfy the need, the ego usually plans an alternate strategy or suppresses the need. Milhayi suggested that pure intrinsically motivated behaviors involve enjoyment and complete immersion in the activity. This may also require a detailed focus, feelings of competence and loss of conception of time. He stated that the enjoyment from the flow experience further motivates the individual to seek additional challenges (1988). A lifestyle program such as a weight loss intervention or smoking cessation may benefit from a targeted experience or flow where high challenges are matched with high skills. A skill/challenge imbalance leads to less than ideal emotional states: when challenge is higher than skill, anxiety will be experienced; when challenge is low and skills are high, boredom will result; when both skill and challenge are low, apathy will be experienced.

All activities (e.g., leisure activities) have the potential for creating a flow and people may increase challenge in more mundane tasks by trying to do them more creatively or more efficiently). However, flow cannot be sustained unless challenge and skill continue to complexify (Brophy, 1998). Cognitive dissonance Laboratory demonstration Cultural differences Using dissonance to motivate change Extended dissonance: identity theory Causal direction: you are what you do? Acceptance and commitment

References
1. Egger, Binns and Rossner, 2008) is available from the library or can be purchased from Amazon.com. Other recommended texts are:

2. Reeves J (2005). Understanding Motivation and Emotion. (4th Ed). NY. John Wiley and Sons.
3.

4. Miller WR, and Rollnick S. (2002). Motivational Interviewing: Preparing People for Change. The Guilford Press, NY. 5. Smith S, and Norton K. (1999). Counselling Skills for Doctors. Open University Press, Buckingham 6. Silva et al (R02.01), and consider how the nature of the balance between
motivational states could alter the outcomes of a lifestyle change program

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