Self Determination Theory and Potential Applications to Alcohol and Drug Abuse Behaviors (2011)

There are several new behavior change theories that have come up in recent years. One theory is the self determination theory (SDT). It is an metatheory (Ryan & Deci, 2000) grounded on the foundation that humans have an innate tendency toward growth, integration and health. SDT proposes that humans have three basic psychological needs of autonomy, competence, and relatedness that must be satisfied in order for growth and well-being to be achieved (Fortier, Williams, Sweet, & Patrick, 2009). Self-determination theory is particularly focused on the processes through which a person acquires the motivation for initiating new health-related behaviors and maintaining them over time. SDT argues that developing a sense of autonomy and competence is critical to the processes of internalization and integration through which a person comes to self-regulate and sustain behaviors conducive to health and well-being. Equally important is relatedness, as people are more likely to adopt behaviors promoted by those whom they trust (Ryan, Patrick, Deci & Williams, 2008). This theory presents itself through two mini-theories, organismic integration theory (OIT) and cognitive evaluation theory (CET). OIT focuses on the motivational difference between autonomous and controlled behaviors, as situated on a continuum, and the degree to which behaviors are elective. This continuum includes behaviors that are intrinsically regulated, integrated regulated, identification regulated, introjection regulated and externally regulated. Behaviors that are the least controlled and most autonomous are intrinsically regulated, meaning they are performed out of interest and enjoyment. Integrated regulation behaviors are executed due to congruence with other personal goals. In the middle of this continuum are less autonomous forms of regulation: identification, and introjection, with identification referring to behaviors that are done out of importance and are personal, and introjection behaviors that are engaged in out of sense of guilt or punishment. The most controlled and least autonomous are referred to as externally regulated behaviors, which are only performed to satisfy a demand or gain a reward. OIT suggests that positive outcomes are achieved by more autonomous forms of motivation verses those forms that are less autonomous. A final component of OIT is the process of internalization by which an individual takes on greater autonomy for self-regulation over time (Fortier, Williams, Sweet, & Patrick, 2009). Cognitive evaluation theory (CET) is the piece of SDT that suggests the essential needs of autonomy, competence, and relatedness for growth and well-being. Autonomy relates to the desire to be the regulator of one's actions, and that behavior is volitional; competence describes the experience of feeling able to achieve a desired outcome; and relatedness refers to experiencing care and concern from and trust in important individuals and feeling connected and understood by others (Williams et al., 2011). In addition to the needs of autonomy, competence and relatedness, CET considers the role of a social context in regard to internalization and self-regulation. Individuals are more likely to regulate behaviors on their own, and thus engage in lasting behavior change, if there is social context support for autonomy, competence and relatedness. Contexts can have a unique effect on whether behaviors are internalized, specifically contexts delivered by health care professionals in a position to prescribe positive health behaviors (Fortier, Williams, Sweet, & Patrick, 2009). Self-determination theory has been utilized with a variety of health behaviors, including tobacco abstinence, physical activity, weight loss, medication adherence, diabetes management, and cholesterol reduction (Fortier, Williams, Sweet, & Patrick, 2009). Williams, Niemiec, Patrick, Ryan & Deci (2009) evaluated the effectiveness of a tobacco-dependence intervention based on self determination theory using a randomized cessation-induction trial. …