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Figure 11 Approaches to promoting treatment adherence commonly make use of techniques that involve external regulation, such as the use of incentives or external network support. An alternative motivational paradigm to such controlled behavior regulation focuses on attempts to promote autonomy by fostering greater intrinsic motivation. Health providers can foster this motivational process through a variety of steps, including promoting patient ownership over recommended behavioral changes (i.e., getting patients to voice their own reasons for initiating change), helping patients to find a meaningful purpose for suggested changes, formatting the specifics of behavior recommendations in a manner most consistent with patients' personal preferences, and recognizing what coping mechanisms were best served by the old adverse behaviors (e.g., eating to decrease a sense of tension) and finding alternative solutions. At the same time it is important to avoid ignoring a sense of conflict (which can occur if behavioral recommendations are made without considering the relationship of physician advice to patients' internal values and preferences), fostering a sense of coercion, or setting goals that are not readily achievable.
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