addressing motivation issues: autonomy & purpose

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Addressing Motivation Issues:Autonomy & Purpose

Stacy L. Nonnemacher, Ph.D.Clinical Director

Bureau of Autism ServicesOctober 5, 2017


HOW CAN WE BETTER SUPPORT SOMEONE TO ENGAGE AND REAP THE BENEFITS FROM THE SUPPORTS AND

SERVICES AVAILABLE TO THEM?

Don’t we usually establish reinforcers or incentives??


"IF YOU TAKE A GROUP OF PEOPLE WHO ARE INTRINSICALLY MOTIVATED AND START

INTRODUCING ALL SORTS OF INCENTIVES FOR ACCOMPLISHING DIFFERENT GOALS, THEN THEY FOCUS ON THE INCENTIVES AND LOSE TRACK OF WHY THEY ARE IN THE PROFESSION IN THE FIRST

PLACE"

>www.dpw.state.pa.us >www.dhs.pa.gov 6

You are at a sit down lunch with work acquaintances to lead a discussion in your ideas to encourage efficiencies in the workplace. You skipped breakfast and are famished. You decide to get the burgers and fries. You are last to order and every else ordered a salad. When the waitress comes to you, you order…

What Would You Do?


ADDRESSING AMBIVALENCE


Engaging Intrinsic Motivation


• Engaging – talking about issues, concerns and hopes, and to establish a trusting relationship

• Focusing – narrow the conversation to habits or patterns that person wants to change

• Evoking – elicit motivation for change by increasing person’s sense of the importance of change, their confidence about change, and their readiness to change

• Planning – used to develop the practical steps person wants to use to implement the changes they desire

Motivational Interviewing


Milkman, et. al. (2013) “Temptation Bundling”

Carefully aligning incentives (external) with a foundation of internal

How to do this strategically?


Setting the Stage for Motivation


“Accounts of autonomy within liberal philosophy stress self-

determination and the dignityof all individual persons, but have excluded people with intellectual disability from moral and political

theories by denying their capacity for individual autonomy,

seen as a chief marker of moral personhood.”Davy (2014)

AUTONOMY


Optimal Choice Conditions

CHOICE

Information

Interests

Exposure


How do we support autonomy? (Nonnemacher & Bambara, 2011)

Expanding options & experience to

encourage choice

Supporting access to people of

authority

Being approachable &

accessible

Listening without judgment

Providing support for follow through


• Set small, measurable goals• Develop a mantra• Routine & Rituals• Commit publicly/”Mere Measurement”• Visualize the goals• Taking Risks

Motivation Muscle (Cohen, 2013)


• She applied for waiver services (with minimal support from her parents) after she lost her job 6 months prior

• Sometimes during scheduled times for supports, she won’t answer the door or may not leave the house to work on goals/skills

• Staff report it is difficult to “motivate” Adon to work on her goals despite the fact that she attends all her planning meetings and always agrees to parents goal ideas or offers her own

WHAT CAN WE DO?

How can we support Adon?


Reason Direction

IntentFunction

GoalMission

RelevanceBenefit(s)

PURPOSE


“Successful employers and parents land on a system of progressive but attainable incentives that keep targets motivated without discouraging them”

It can be all of this…and more!

“”


• The goals that she chose for herself at her last planning were: getting a job and getting her driver’s license

• The goals that her parents chose for Adon at her last planning meeting were: hygiene and keeping her apartment clean

Remember Adon?


www.MyODP.org

Scroll down on the home page to find How To Create an Account

Navigation Bar with Drop-down Menus

Training Drop-down Menu

Phone and email Help Desk options

Chat Feature


to provide information and support to families to facilitate connections between individuals, families, professionals, and providers throughout

the Commonwealth

ASERT Statewide Resource Center

• Statewide Toll-free Number: Offering live assistance from ASERT’s Resource Center Specialists

• Website:

• ASERT Outreach Specialists Available to attend conferences,

support group meetings and community events to promote autism awareness and provide resources

http://www.paautism.org/

addressing motivation issues: autonomy & purpose

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