The relationship between health and wellness practitioners and their clients is built on a foundation of motivation. As practitioners, it's incumbent on us to do everything possible to keep clients motivated. To do this effectively, we must be deeply invested in understanding each client’s unique health history, challenges, and goals. And our clients must be committed to following their treatment plans to experience meaningful change. This, of course, describes a perfect-world scenario. Since practice is never perfect, you’ll inevitably always have some clients who require the extra push.

We see it all the time: A client "forgets to take their supplements," or doesn't follow their prescribed nutrition plan, or resists doing their daily stretches. And we might be inclined to think that this type of person can't be helped if they aren't willing to help themselves. Some people are naturally more motivated to change than others and — scientifically speaking — it’s not their fault; Scientists have unearthed a chemical connection showing that highly motivated individuals have increased levels of dopamine in the reward and motivation portions of the brain. 

You don’t have to become an expert dopamine hacker to light a motivational fire under a non-compliant patient. But you do need to meet each client where they are, understanding which unique drivers will personally motivate each individual. This article is a great place to start.

Keep reading to better understand the psychology of motivation, discover key signs that a client is lacking motivation, and learn proven strategies for shifting even your most non-compliant patients from passive to passionate.

How Motivational Psychology Impacts Client Engagement

Motivation is the desire to act in service of a goal. It's a crucial element in setting objectives and then bringing them to fruition.

The psychology of motivation traditionally looks at motivation through two lenses: intrinsic and extrinsic.

• Intrinsic motivation - According to the American Psychological Association (APA), intrinsic motivation is “an incentive to engage in a specific activity that derives from pleasure in the activity itself rather than because of any external benefits that might be obtained.” In other words, with intrinsic motivation the drive to change comes from within. Evidence also suggests that dopamine is a key substrate of intrinsic motivation.
• Extrinsic motivation - In contrast to intrinsic motivation, the drive behind the action here is outside the person. The APA defines extrinsic motivation as “an external incentive to engage in a specific activity, especially motivation arising from the expectation of punishment or reward.” So, for example, with extrinsically triggered exercise motivation, a client may be motivated by the many pictures they know will be taken on an upcoming beach vacation with friends. 

It’s important to note here that motivation can be fluid. Your job would be much easier if every client showed up channeling Buzz Lightyear, intrinsically motivated to follow their prescribed health plan “to infinity…and beyond!” More realistically, many come to their intake appointment eager to get started, fueled by their expectations that they will see quick results if they put in the effort. In other words, they show up extrinsically motivated to succeed. Fast forward six weeks and you find yourself sitting across from a non-compliant patient who seriously lacks the motivation to keep going. 

The key to pushing through the peaks and troughs of client motivation lies in accepting that they are normal, knowing how to recognize signs of an unmotivated client, and having a toolbox of strategies you can implement to convince every client to remain an active participant in their health and wellness journey. 

Signs Your Clients Might be Unmotivated

The reasons why patients are non-compliant with their health plans are as varied as the patients themselves. Some may suffer from perfectionism or self-sabotaging fear and doubt. Others may need more specific goals than are typical for others in their place. Still, others may get discouraged if they feel that their progress is too slow.

No matter the underlying reasons, here are some signs that a client lacks the motivation they need to succeed:

• They have a history of being a non-compliant patient
• They cancel or stop booking appointments entirely
• They seem disengaged in 1:1s
• They have decreased attendance in group sessions
• They have an unsupportive home environment or lifestyle that doesn’t support compliance
• They make excuses for lack of progress and get defensive when asked about it
• They don’t seem to trust you as their practitioner

Understanding the Different Types of Motivation

Although motivation psychology tells us that intrinsic and extrinsic are the two main types, there are subtypes that fall within each of these two categories. Here are a few that may come into play with clients on their health and wellness journeys.

Real-Life Examples of Different Types of Motivation

Motivated Clients are Better For Business

A motivated client is an engaged client, which makes them far less likely to cancel appointments last minute or, worse, ghost you entirely. Your clients need to show up consistently to ensure continuity of their treatment (and your revenue). 

Engaged clients are also more likely to refer others to your practice (an average of almost three), which is also great for your practice’s financial health. According to the Wharton School of Business, the average value of a referred client is 16% higher than other types of clients. 

Motivation aside, there are proven strategies that can help with client retention, so make sure you’re employing them in your practice.  

Checklist for Inspiring Every Client’s Success

How do you keep all your clients moving forward on their health and wellness goals when some are motivated by achievement and others are triggered by something else entirely? Here are five strategies you can put to use in your practice to get–and keep–every client on the right path. 

1. Start with Motivational Interviewing

Motivational interviewing is an approach used in the field of medicine to help people feel more invested in their own wellness and build their confidence to make lifestyle changes. There are four basic elements of motivational interviewing:

• Ask open-ended questions. Questions that elicit yes or no answers won’t get you very far. Giving your client lots of space to answer means they are more likely to lead you to the places where the true insights lie.
• Make affirmations. It’s validating for clients to hear positive statements that demonstrate your appreciation or understanding of their situation.
• Use reflections. This helps clients arrive at answers on their own rather than you prescriptively telling them, so they can uncover their own “why” behind seeking treatment.
• Summarize. Repeating back what you’ve heard helps to keep you both on the same page while reinforcing their motivations.

2. Work Together to Create Measurable Goals That Excite

A whopping 92% of people who set New Year's goals fail to follow through. That’s because feeling excited about making a change isn’t enough to fuel someone through showing up every day to do the work and make change happen. Here are some ways to make goals feel more achievable. 

• Attach the goal to a bigger value. Wanting to see quick results is  common. But if a client can attach their goal to a larger value–like being a healthy role model for young children at home for the long term–they are more likely to stay motivated. 
• Provide options. Suppose a client struggles to set aside a 15-minute block each day to complete their pelvic floor exercises. Can they achieve the same goal by breaking them into several shorter sessions they fit into activities they enjoy (e.g., complete a set while on the sidelines watching your child play soccer)? This is called “temptation bundling” and it’s a simple way to boost willpower.
• Keep them accountable. Think about what resources you can provide to help a client stay focused on their goals. For example, you can create meal plans they’re excited about attached to the expectation that they’ll follow them. You can encourage them to join an online challenge where they have to show up weekly to share progress. Or you can print out client-friendly daily supplement protocols that give them something tangible to refer to. Any activity that ignites a social contract will help to drive accountability. 

Check out this example of a protocol for getting started on a whole foods diet:

Dietary changes can challenge a client's resolve. Having easy-to-read nutrition materials close at hand can help support the chances of the client successfully implementing these healthy changes: 

3. Advocate Implementing Small Changes (and Quick Wins!)

Clients on a new health and wellness journey tend to focus on outcomes. This can be dangerous because there are no quick fixes when committing to a new program or lifestyle. Breaking entrenched habits requires commitment and making those commitments feel less daunting can help eliminate barriers to achievement motivation. Even subtle positive changes get the feel-good dopamine flowing, providing the motivational juice to keep clients motivated.

• Start small. Forming new habits should feel non-threatening, so start with behaviors that seem reasonable to complete. For example, motivation to exercise will quickly dry up if the prescribed plan demands two-hour gym sessions each day. Instead, you can keep clients motivated by incorporating more movement into their day by taking a certain number of steps.
• Celebrate all wins. Any progress should be applauded. Even something as seemingly small as a client drinking a liter of water when they typically only drink caffeine should be praised. 
• Tap tech to track progress. Wearables like a smartwatch are an efficient way to let clients track their progress as they go. Layer in journaling to make the progress feel more permanent and help trigger attitude motivation.
• Eliminate the sludge. Sludge is a marketing concept that refers to anything in a process that hinders the person taking the action. Sludge in your processes can prevent clients from following through. For example, a practitioner might make several recommendations for supplements with the onus on the client to visit multiple stores to find them. Virtual dispensaries like Fullscript and WholeScripts can remove this barrier, helping clients start their treatment protocol faster and with less effort.

4. Introduce the Power of Community

Tap into the power of social motivation by encouraging clients to join online group challenges or other peer groups you may offer. This helps clients communicate with individuals who may be experiencing similar challenges, emotions, and wins. 

Bonus: If a client can connect with an accountability buddy to help them problem-solve and focus on small victories, they are more likely to stick with healthy habits.

5. Follow Client Progress With Frequent 1:1 Sessions 

Checking in with your clients 1:1 lets you follow up on the goals you set together, keep them accountable, and celebrate progress together. Finding the right balance can be challenging. If you meet too frequently, they may not have had enough time to experience any wins. If you leave too big a gap, motivation killers can kick in.

Choosing the right 1:1 frequency will depend on a combination of what motivates the client, the intensity of their treatment plan, and even their own preferences and budget considerations. It may be helpful to schedule 1:1 meetings for the same day/time so they become an anticipated part of their routine. 

In follow-up sessions, be sure to use empowering language, such as using “we” to underscore that you are their partner in this transformation they are undertaking. 

How to Connect with Unmotivated Clients 

Non-compliant patients are those who intentionally refuse to follow treatment plans. Here are some tips on how to handle non-compliant patients. 

• Understand the nuance. Non-compliance has a less intentional cousin: non-adherence. The reasons behind non-adherence can be plentiful, from confusion around what needs to be done to concern over costs to a catastrophic life event that has nothing to do with your effectiveness as a practitioner. Tapping into your motivational interview techniques can help you understand what’s behind the behavior.
• Don’t make assumptions. Instead, ask them why to lead with empathy and uncover what matters to them. 
• Extend an olive branch. Offer a free follow-up consultation to identify why they lost interest or became unmotivated, or try to reignite interest by inviting them to a free online challenge. 

It’s important to acknowledge that you won’t be able to turn around every unmotivated client. This is perfectly acceptable. Do your best and know when to let them go. Much like the advice you’d give your clients, celebrate small wins, and don’t let the losses impact your motivation!

Final Thoughts 

Change isn’t easy. The health and wellness field often demands that clients abandon behaviors that don’t serve them well, even though those behaviors have been conditioned by cues in the environment and those pesky dopaminergic pathways in the brain to feel quite enjoyable. 

By recognizing the signs of lagging motivation early, and meeting each client where they are, you can better uncover the unique motivational drivers of each individual you’re treating and keep clients motivated. This is how you become a true partner in supporting clients in persevering with their health and wellness transformation, even in those inevitable moments when it feels hardest. 

Practice Better is the complete practice management platform for nutritionists, dietitians, and wellness professionals. Streamline your practice and begin your free trial today.

Editor’s note: This post was originally published on September 14, 2022, and has been revamped for accuracy and comprehensiveness.