Using behavioural science to promote better adherence to rehab or post-treatment advice

Behavioural Science 

Behavioural science is the systematic study of human behaviour.  The tenets of behavioural science could offer great value to your professional practice given the challenges you may experience in your day-to-day roles. For example, you might be challenged by poor client adherence to their rehabilitation programme. An understanding of the antecedents of human behaviour could help you to provide a service which is targeted and tailored to your client's needs, and in turn enhance your clients' health, wellbeing, and performance. 

Adopting a Behaviourally Informed Approach 

The important first steps in utilising behavioural science in practice are: 

• Identify the target behaviour(s) that you want to enable (e.g., the client performs rehab exercises twice a day). 

• Undertake a behavioural analysis to understand the barriers and enablers to the target behaviour(s).  

Identifying What Needs to Change  

A behavioural analysis is when practitioners take time to understand clients' thoughts, feelings and experiences of doing the target behaviour(s) and identify the barriers that need to be targeted through a behavioural intervention to increase the likelihood that the target behaviour(s) will be performed consistently over time, as advised.   

If we take the target behaviour “client performs rehab exercises twice a day”, the capability, opportunity, and motivation behaviour ( COM-B) model [1] recognises that for a client to enact this behaviour they must have: 

• The capability to do the exercises twice a day (e.g., knowledge of what the exercises are and how to do them, the physical skill to execute the exercises as advised, and the memory and attention to decide to do the exercises when presented with two or more alternative options). 

• The opportunity to do the exercises twice a day. Including the social opportunity (e.g., support from others) and the physical opportunity (i.e., the necessary equipment and/or facilitates).  

• The motivation to do the exercises over other competing behaviours that day. Motivation is the brain process that directs our behaviour and can be reflective (e.g., the client is confident that doing the exercises twice a day will help them achieve their personal and/or professional goals, and they are confident in their ability to do the exercises twice per day as advised), and automatic (e.g., the client has a positive emotional response when thinking about doing the exercises twice a day)  

All three component are essential for behaviour to occur. Figure 1 is a schematic representation of the COM-B with illustrations of potential barriers to performing rehab exercises twice per day.