You Oughta Know Jennifer La Guardia

In this episode, we focus on mental health and behavior change. Our guest is the wonderful Jennifer La Guardia, a behavioral scientist and clinical psychologist from an organization called Brightline.

We talk about Digital Health in the mental health space. Specifically in the context of child and family care. What it is, how it works, and more. For example, many don’t have access to the care they need, whether that is due to time, money, distance, or even the stigma sometimes- unfortunately- associated with mental health.

We allude to nudge and some of the research issues associated with that behavioral modification approach. Matt references the validity and reliability issues/ scandals around the theory. Jennifer discusses the SDT issues with it— how it can be paternalistic and undermining. We do discuss how certain aspects of nudge can potentially be supportive of the psychological needs, but often, in how it is utilized, it can be leveraged punitively.

Independently of SDT, here is an article discussing the ethical issues of nudge: https://journals.sagepub.com/doi/epub/10.1177/10434631231155005

NPR did a great podcast episode on the publication scandal associated with nudge. https://www.npr.org/transcripts/1190568472 

We briefly explore the ties between emotional regulation and motivation and the “why’s” for “eating the cookie” or getting that other reward. The key is to get people to make thoughtful, more controlled, and autonomous decisions regarding their health.

We discuss competition, specifically things like having “accountability buddies” when losing weight or other “motivating” health goals. When one doesn’t win, or one is losing, this feeling also can undermine. Rather, having shared, collaborative goals is more effective over the long run. 

Matt references Edward Deci, one of the founding thought leaders of SDT. Competition can be great, if the focus is on the activity itself and the win/lose aspect of the competition is a natural outcome of that activity.

We talk about introjection, a concept in SDT where the catalyst for motivation is based in ego, obligation, or other internalized controlling factors. We use introjection as a basis to discuss why people struggle with weight loss, or body image, or even just feeling bad if one doesn’t live up to standards from those around them.

We discuss how parents can support their children more effectively in lifestyle and health development. There is a mental health crisis, made worse since COVID began. We tend to wait for the problem to happen, rather than early prevention. 

This is where coaching comes into play. Jennifer defines and explains how coaching fits into the greater process of care. She talks about how difficult behavior change is… how stressful it can be. 

Finally, if you are looking for a behavior modification program, Jennifer shares some pointers.

More about Jennifer.

Jennifer has 20+ years experience promoting motivational approaches to health behavior change, management of chronic illness (e.g., overweight/obesity, diabetes, cardiovascular disease), and improving personal well-being. She is an expert in SDT, and has designed, implemented, and evaluated large scale health behavior interventions (‘live’, web-based, mobile health). Her work brings practical solutions for implementing best healthcare practices within employee and community populations. She earned her Ph.D. at the University of Rochester under the supervision of Dr. Richard Ryan, one of the creators of SDT. She has worked as a consultant with workplace and community organizations, the National Cancer Institute, and international groups. Currently, she is the VP Care Innovation for Brightline.

And her organization, Brightline, can be found here: https://www.hellobrightline.com