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What Do Intrinsic And Extrinsic Motivation Have To Do With Behavior Change

Posted by Siobhan Bulfin on Apr 23, 2019 4:28:10 PM

When it comes to behavior change, patients face countless influences - both from within and from without. These external and internal factors create a wide spectrum of challenges in developing better habits.


Over the course of a long-term illness, people’s motivation to manage their health will naturally fluctuate. How can we help support patients to stay motivated and withstand pressures in the long run for improved wellness?

Social psychologists have developed various theories to explain human behavior change - what drives it and what builds endurance. While many theories exist, psychology as a whole remains divided on what makes the biggest difference - extrinsic or intrinsic motivation.

Defining the terms

In a discussion as complex as human motivation, definitions are important. In this context, we’ll define extrinsic desire as momentum for change that’s derived from outside of the patient. Intrinsic motivation, on the other hand, refers to desire that comes from within.

That’s the core difference between theories. Does motivation begin within or without? Before jumping to conclusions about which is better, let’s take a brief look at each theory and allow them to rise or fall on their own merit.

Extrinsic motivation


Extrinsic motivation has proven effective in achieving short-term engagement. Examples include retail reward programs or immediate benefits to signing up to a website such as a coupon code. Or rewarding children with a cookie if they tidy their room. It can also motivate new skills and knowledge.

Let’s look at a health example. Take an employer who encourages employees to lose weight by offering incentives such as a fitbit or a financial reward on the basis that the goal weight loss be achieved. This external motivation (motivated by receiving something externally) can help encourage people to sign-up to the weight loss program and receive the Fitibit, and for some people the extra motivation of a financial benefit will also be motivation enough for them to achieve their goal weight.

It’s important to note that extrinsic motivation isn’t always a circumstance or an object. Sometimes it’s psychological - meaning that sometimes people are motivated by praise or recognition. This, too, is can be a positive external influence on human behavior.


However, motivation from external factors isn’t usually sustainable. Take, for instance, the employer weight loss example. What happens after the employee has signed up and received the fitbit which is their motivation for joining. Or for others - what happens after they lose weight and achieve the financial reward?  Research suggests that once the source of the motivation expires - so does the action the motivation resulted in.

Known as the overjustification effect, using outside force doesn’t tend to be best for long-term behavior improvement. When it turns a fun activity into work, extrinsic factors can extinguish established intrinsic desires.

Patients with chronic conditions may already possess a desire to change, yet they struggle to establish better lifestyle habits. In many cases, patients don’t need external motivation. Instead, they need support to tap into ‘their why’ and fulfill their internal drivers for wanting to get well.

Intrinsic motivation

While intrinsic motivation is typically viewed as the most effective and sustainable form of motivation, practically speaking, it’s not always possible to solely rely on it.


Intrinsic desires have many positive benefits, but there are a few challenges as well. For instance, new skills may be avoided by those who have no intrinsic desire to learn.

Perhaps, an employee has no interest in learning how to use new software installed by management. With only intrinsic motivation, how can they ever develop interest? In this instance, they may need some outside factor to encourage necessary growth such as job security.

It’s important to note as well that some psychologists think that describing human motivation with two terms is an injustice to the complex nature of humanity. These scientists raise the question: Can all of humanity’s impetus be summed up with two categories? Regardless of the weaknesses of this framework, however, it does create structure in discussing the topic of motivation and how it impacts patients with chronic conditions.

Despite these caveats, the concept of intrinsic motivation has a far-reaching impact for much of human existence and medical conditions. Internal desires play a major role in creating long-term habits. In addition, ambition from within has staying power even in difficult times.

Another benefit of intrinsic motivation is that it can inspire creativity and innovation. When applied to behavior change, patients can develop improved solutions for symptoms by leveraging their intrinsic motivation.

Are extrinsic and intrinsic motivators exclusive?

In all of this, it’s safe to say that motivational theories that rely on controlling human behavior rather than developing human potential will most likely implode in the long run. Since whole-person wellness is a long-term concept, patients need an approach that gives them staying power if chronic illness becomes more difficult.

While extrinsic motivation can decrease intrinsic desires, external factors (when not used to bribe or coerce) can help patients develop intrinsic motivation that lasts. For instance, when peer groups or health coaches praise and recognize patient efforts to be more physically active, they can help those patients turn external factors into internal motivation. Or - when a patient helps another patient by sharing their experience or providing moral support. Gratification achieved as a result of helping someone else is one of the most powerful intrinsic motivators.

What will help patients in the long run?

Patients in the maintenance stage with chronic illness need to be enabled in whole person wellness. People at this stage benefit from being more physically active and being empowered in weight loss.

However, superficial changes won’t necessarily translate into long-term prevention. External change at some point needs to be guided by an internal desire to change. While some extrinsic rewards can enable some intrinsic change, for long-term success, it’s typically best to develop patients’ internal desires.

Patients who have a support group such as encouraging family members or peers are enabled to see more progress in developing internal desires. That’s why Melon focuses on creating interactive groups that inspire individuals to harness the power of human desire.

These groups don’t rely on tangible rewards for patient motivation. Rather, our goal is to provide patients with external encouragement, providing intrinsic motivation.

Part of our approach is to have health coaches assist patients in setting small, achievable goals that enable patients to get an early sense of achievement and habit development. These small lifestyle changes help them grow intrinsic motivation that can last for the long run.

Why does motivation matter in chronic illness?

Motivation isn’t just a theoretical discussion. It impacts the lives of those with chronic disease on a daily basis as they self-manage symptoms and complications. As patients strive for better health behaviors, they need support that encourages internal desires to change.

Here at Melon we want to enable patients to keep motivation going strong. So we provide online, easy-to-access support for patients. With skilled advice from health coaches and peers, patients can develop a motivational approach for change that will last in the long run.

Discover how to use intrinsic motivation for your patients. Schedule a call today.


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Topics: patient engagement, behavior change, emotional wellness, whole person care

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