Positive Consequences for positive health outcomes

Rather than looking at the negative outcome of behavioral choices people make, Dr. Jane Bluestein examines a more positive alternative, one a shift in focus that is far more effective in generating the kinds of behaviors you want—and in a climate you and your patients can enjoy.

Over the years, one of the biggest challenges I have faced in my work involves selling the importance of switching our emphasis from negative consequences to positive outcomes. This shouldn’t come as a surprise, I suppose. In most instances, even the word consequencesignals something negative or punitive, leaving little room for the reality that positive consequences are almost always available as well. Nearly all discipline programs emphasize the negative outcomes, although there are some clear benefits to stressing positive outcomes—what the kids get or get to do when they do what you ask. I’ve talked about the drawbacks of depending on the threat of negative consequences, as well as positive ways to ask for what you want, so hopefully, this particular pump is primed.

One of the nice things about thinking in terms of positive outcomes you can offer is that it allows you to require certain behaviors or a certain amount of work from the patients in order for them to earn, or continue to enjoy, these benefits. In a culture in which far too many kids are growing up with an unnerving sense of entitlement and without limits or accountability, this is not a bad thing. And it’s easier to get people, especially children,  to respect limits and buy into a sense of accountability when offered outcomes they perceive as positive and meaningful.

This is where the whole bribery argument comes up, so once again, let me remind you that there is no such thing as unmotivated behavior. It really comes down to whether we’re going to use positive bribes—including work-related options and earned advances—in place of the negative ones on which we currently depend. We connect desired behavior to consequences one way or the other, so why not focus on the good stuff? Because frankly a reward-orientated classroom that emphasizes the payoff for cooperation —rather than punishment for non-compliance— is not only a cornerstone of win-win classrooms, but it’s also a lot easier to manage and generally a whole lot more fun. It doesn’t take long for even the most cynical, well-defended patients s to start seeing your office as a place where “good things happen when…” And therein lies the incentive to execute your doctor’s guidance on time.

Once you get comfortable with the idea of positive consequences, it’s time to start thinking of what you can offer. This is where those interest inventories and conversations will come in handy.

Everything overlaps and interrelates with everything else, which is why it’s so important to maintain a big-picture perspective in a win-win context for everything you do with your patients.

This could be as simple as taking a minute at the end of a visit to ask the patient about their expectations and listen.

And keep in mind that simply being able to make certain decisions about things like exercise, diet, or what is happening at work, for example, offers a host of positive consequences, and in many cases will be all you need to engage some, if not most or all of your patients.

About Dr. Jane Bluestein

Dr. Bluestein specializes in programs and resources geared to provide practical and meaningful information, training and hope in areas related to relationship building, effective instruction and guidance, and personal development.

Much of her work focuses on interactions between adults and children, especially children at risk.

Her Web site is http://www.janebluestein.com/

forward to a friend