Keeping Motivated Living with Diabetes
Beth M. continues to toss out intriguing issues to address. In her most recent blog discussing her son's indifference to exercise and efforts to motivate him to move, she expressed hope for a "motivation potion" to enable desired behavior. Needless to say, I have yet to discover a motivation potion for everyone; however, through many years of experience, I have created several potions that seem to work for many different types of characters!
The key to discovering a successful motivation potion is to make it unique for the individual--an extraordinary key to open the latch and "turn on" the desired behavior. I believe that the major challenge for professional psychotherapists is to find out what works for their patient.
I have written extensively about the different developmental stages as a child transitions from infancy into young adulthood. Therefore, based on my experience with these diverse age groups, I have fashioned different motivating potions depending on the developmental stage and individual personality. Therapists often use "motivational interviewing" to hone in on goals. This form of therapy takes a great deal of time and is useful if you can get the child, teen, and parents to agree to several well-selected goals. The trick is to get the kid to actually adhere to the desired tasks!
1. Infant/Toddler: A motivation potion for a toddler is incredibly difficult since a typical toddler will say "no" to something he/she desperately wants, just to be oppositional. During this phase, they are learning to separate from parents and caregivers. This is why toilet training and feeding time may be so difficult. The child is actually "training you" to behave in a certain way. Indeed, when the caregiver finally learns that he/she is being manipulated by a 2-4 year old, the "aha" moment arrives! Thus, my motivation potion for the toddler and family is actually "limit setting" by the caregivers. "Jonny, you may choose between these three snacks: a, b, or c (not which of the 10 snack choices would you like today). " Jenna, meal time is over in 20 minutes. If you are not finished at that time, we will save your dessert for tonight." Parents might say the child will go low if he doesn't eat! Thus, in these situations, I sometimes suggest giving insulin after the meal (especially with rapid acting insulin). In summary, motivation for a toddler is actually limit setting along with major positive reinforcement for desired behaviors and no reinforcement for undesired behavior. In other words, they do not get what they want most-your attention.
2. School-Aged Elementary Children: The motivation potion for this age group is the understanding that they want to please their caregivers and receive praise and rewards. "Megan, you have been sitting watching television for two hours. For each hour of TV, you must ride your bike for 30 minutes outside." School age kids love for things to be fair. They are learning to follow the rules. You have to make the rules and allow them to win. And, in so doing, you win as well. Be creative: some of my kids are so into video games that I actually encourage families to purchase games emphasizing fitness (Wiifit, or Dance, Dance, Revolution are typical examples). Creativity works and your kid will be impressed with your brilliance. The trick is to keep finding cool activities to entice your child. My idea is to attach a treadmill to the television set. Activity will be necessary to keep the TV on! So, if the kid wants to watch an hour of TV, they will need to walk an hour on the treadmill!
3. Tweens and Teenagers: Require the toughest motivation potion of all! Once again, we are dealing with the same developmental issues of toddlerdom--setting limits. These kids are really into their peers and social life. They also love material things (cell phones, ipods, portable DVD players, car keys). Once again, the key is to be creative and go where the kid lives. Set limits, develop consequences for actions, and set rewards for positive behavior. Don't set up a situation where you cannot possibly win. I have taken cell phones away if my kids won't check blood sugars (if they can text their friends every five minutes, they can check their blood sugars four times/day.) Driving is big. Driving is not a right, it is a privilege. The biggest motivation potion for teens is setting the rule that if there is no blood glucose checking, there are no car keys! Forgetting night time Lantus dosage: no sleepovers. You have to find what matters to your kid and set-up the equation: if ....., then..... The key to remember in these situations is that you are the caregiver and source of all goodies (money, car keys, ipod, itunes, laptop computers, DVDs, CDs, clothes, jewelry, etc.
I do not recommend telling your teen that "if you don't take care of your diabetes you will lose your eyesight (or any other body part) when you are 35." That is an old age to your teen and "it will never happen" to them as teens think they will live forever (which is why they engage in high risk behavior).
In conclusion, most of the motivation potions described today live inside you! It is necessary is to think creatively and find out what is most important to the child to have the right ingredients!
Please send your ideas so that everyone can benefit from your creativity.