Perceptions and Actions

Introduction

Social cognition models emphasise an individual's learning directly or indirectly from observing others through social communication, interaction, and experiences (Conner and Norman, 2015). It shows that better practices can be motivated through social participation and incorporated within self-practice that can eventually create self-development of physical and mental health. The following needs assessment report will focus on a case study of a hypothetical patient suffering from obesity, high cholesterol, and probabilities of severe heart attack to determine target behaviour alongside related socio-cognitive theories and models.

Risks outline based on history.

From the case study, Jeff is a 46 years old male with 5'7" height. He is 110 kg and has a BMI of 37.8. This range of BMI index falls in the morbidly obese level, presenting a high risk of severe heart disease, with life-threatening implications. Some of condition associated with this lifestyle and high BMI includes cardiovascular diseases related to heart and blood circulation, gallbladder diseases, high blood pressure, osteoarthritis, colon cancer (Tabarés, 2017). Similarly, obesity and overweight are frequently linked to emotional problems like melancholy, anxiety, and depression. According to Tabarés (2017) obese adults had a 55 percent higher risk of acquiring depression over the course of their lives than non-obese people. Furthermore, the patient's lifestyle is very unhealthy, considering his improper diet with no physical exercise. Also, Tabarés (2017) reveal that healthy diets have even been shown in studies to aid with sadness and anxiety symptoms. On the other hand, dietary habits that are unhealthy have been related to an increased risk of dementia and stroke. Furthermore, he reports having barely performed any physical exercise in the last 10 years. Other than mental issues, his lifestyle is also linked to high blood pressure, high cholesterol, and increased risk of heart disease and various cancers (Chen et al., 2019). His lifestyle can greatly impact his working life and hinder his prospect of earning through the business thus impacting his social economic ability. Besides, he has a motto of ‘enjoy life while u can’ which denotes a short sighted attitude towards his health.

Status of behaviour

The current behaviour of Jeff does not advocate for healthy mental and physical health. His personal and professional life incorporates the least physical efforts alongside unhealthy junk food that follows no schedule. Therefore, his daily life includes eating junk food and less physical exercise which can be termed as unhealthy behavior. In his job, he is driven to various construction sites and his ideal work involve supervising employees. Therefore, he is rarely involved in physical work or exercise. Similarly, he consumes his daily meals without being concerned about the calorie measurement and without following any schedule. As part of his social life, he meets with his friends and drinks alcohol in pubs in excessive units. He does not include any variation of his behaviour in self-management that can create better effects on his health. However, with self-management and psychological counselling his life can change for better.

Social-cultural context

Jeff’s socio-cultural context consists of his work environment and his friends, who he socializes with over the weekends. Jeff’s work environment is the construction industry. Therefore, his close friends are all working in the construction industry as masonries or casual laborers. However, regardless of hard work, his diet and eating habits are still poor. In the morning, Jeff joins his colleagues for breakfast, which consists of unhealthy fried foods. However, though Jeff has bad eating habits, he enjoys a nice social life with his friends. His friends are always available. However, his health and age now cut from social life and this forces him to join his friends at the pub on Fridays and Saturdays. However, it is a matter of concern that he is degrading his health condition while his socialization revolves around this drinking behavior. These drinking habits may be difficult for Jeff to change and this means that his economic and financial level are negatively affected.

According to his BMI level, he is already overweight and morbidly obese. Similarly, taking more alcohol frequently and some health condition seem to endanger his social and economic stability. The drinking behavior is not only dangerous to his health but also to his social-economic life. Instead of the drinking behavior, Jeff should take healthy meals and get positive motivations.

Psycho-social factors that relate to the behaviour

Psycho-social factors refer to the characteristics that influence an individual from his psychological or social perspective (Trist, 2016). From Jeff behavior of excessive drinking, he risk losing his financial status and this can be liked to psychosocial impact including divorce and loneliness. According to Martino et al., (2019) money disputes are the second most common reason for divorce, after infidelity. The findings suggest that excessive debt levels and a lack of communication are important contributors to household financial stress and anxiety. Jeff’s present behavior is shaped by the motivation of enjoying life to a large extent. Also, his social engagements are limited to his colleagues and friends. Furthermore, his unhealthy eating habits endangers his health and this in turn risk being fired from job due to absenteeism and hospital permission. in case of such circumstance, he would be forced to stay at home lonely and his social life completely disrupted.

The chosen target behaviour of the client and proposed outcome

For treating the health condition of Jeff, the first duty is to incorporate self-motivation in both his personal and professional lifestyle. According to Geller (2016) self-motivation is vital because it prevents individual from relying on others and encourages them to use their strengths to achieve their objectives. It also ensures that individual work on their flaws rather than allowing them to derail their ambitions. This self-motivation will lead to better self-development and achievement of set goals including reducing weight and changing drinking behavior which poses a risk to his health, economic status and social life. similarly, Barnes and Cassidy (2018) reveal that studies linking self-determined motivation to weight reduction shows a beneficial relationship between emotions of autonomy about healthy eating and, in particular, physical activity, and enhanced weight loss in the short and long term. Therefore, self-motivation is critical to Jeff especially promoting physical exercise and changing his lifestyle. According to Teixeira et al., (2012) a person's drive to succeed in weight loss is well-documented, especially among those who work with obese patients and their loved ones. The study add that internal motivation to lose weight and self-motivation have been discovered as predictors of successful weight control. Therefore this behaviors can be critical in weight loss and control of drinking habit.

Theories that predetermine the target behaviour

From the case study, Jeff has problem with drinking and eating unhealthy foods. His behavior of living a sedentary lifestyle, drinking alcohol and eating unhealthy life seem to originate from is motto of ‘enjoy life while u can’. Therefore, to achieve positive outcome of reducing weight and being motivated to eat health lives and sometimes exercise, Jeff need change in his thoughts. Therefore, cognitive Behavioural therapy.

Cognitive Behavioural therapy (CBT) is aimed at modifying thought and habits frequently impact individual life (Robertson, 2018). In CBT, the goal is to change a person's unhealthy habits and attitudes into more realistic and healthy ones. For example, from the case scenario, Jeff habits of eating unhealthy foods and drinking excess alcohol are affecting him. The theory is based on idea that our ideas influence our actions (Robertson, 2018). Coping skills for dealing with current issues and changing unhelpful cognitive or behavioral patterns are the primary goals of Cognitive Behavioral Therapy (CBT). However, despite the vast amount of evidence that supports CBT's usage, there are still questions regarding how successful it is and how useful it will be long after therapy is finished (Kew et al., 2016). Aside from depression, CBT has been used to treat anxiety disorders, substance misuse disorders, personality disorders, and eating disorders. CBT's basic assumption is that one's thoughts have a significant role in determining one's emotional and behavioral responses to life's challenges. Psychotherapy in which a patient learns to identify and change their own self-destructive and counterproductive thinking patterns. For example, Jeff perception of enjoying life is impacting his health status and might impact his social life. Positive and realistic beliefs can be substituted for negative ones using the model's assistance in pinpointing the source of the issue (Kew et al., 2016). With CBT, you learn how to cope with problems and how to feel better about yourself in the process. It can help those with panic disorders, sadness, and other health issues.

Hetrick et al. (2016) reveal that cognitive behavioral therapy is an effective treatment for low motivation. Changes in thinking and action are necessary to break the cycle. Individual has a greater sense of purpose and accomplishment as a result of making these changes. Therefore, through this model, Jeff can achieve self-motivation leading to reduced weight and reduced drinking habits. Also according to Kew et al. (2016), using cognitive behavioral therapy (CBT), people in recovery from a substance use disorder are encouraged to establish connections between their thoughts, feelings, and actions and to become more aware of how these things affect their recovery. Anxiety and other co-occurring conditions are also addressed by CBT, which is why it is so effective. The advantage of CBT is that it helps individual become aware of their erroneous or negative thinking so that they may better understand and respond to tough circumstances (Kew et al., 2016). However, In order to obtain the greatest benefit from cognitive behavioral therapy, you must be willing to put in the time and effort. A therapist can guide and counsel you, but you must also be willing to participate.

In addition, Jeff has a motto of ‘enjoy life while u can’. This motto is limiting his ability to reduce weight and eat balanced diet and quit drinking alcohol. Therefore there is need to predict and understand Jeff behaviors. To understand and predict his behaviour including is behaviour outcome, Theory of planned behaviour is very critical. Ajzen (2020) reveal that human behavior can be predicted and understood using the concept of planned conduct. Behavioral intentions, according to this theory, are immediately decided by a combination of three factors: attitude toward the behavior, subjective norms, and the perception of behavioral control (Ajzen, 2020). It also demonstrates that people's acts are influenced by their intentions, which are influenced by attitudes, subjective norms, and their sense of control over their actions, which are all influenced by their sense of agency. This theory suggests that an individual's behaviour is highly influenced by the ethics and beliefs with which individual has grown up with (Ajzen, 2020). Therefore, this model would be effective in identifying and effectively changing Jeff believes to help him reduce weight and abandon alcohol taking. The theory reveal that most of the beliefs and practices of a person are obtained from childhood. Therefore, this theory would be effective in determining what chsilhood though led Jeff to be less concerned with health and focusing on enjoyment. In childhood, factors like family, friends, and schools play a significant role in shaping people's beliefs (Ajzen, 2020). However, over time, the beliefs get modified with the change of socialisation. In each of the cases, the behaviour changes correlate with the beliefs. For example, in the case of Jeff, he believes that life should be enjoyed to its greatest extent. For that reason, his behaviour has been indulging towards a lifestyle that is entirely unhealthy and cost him his present physical complexities.

Theory of planned behavior (Gao et al., 2017).

From the model, Jeff behavior are closely linked to motivation. Therefore changing his motivation can result to positive behavior (action) thus creating positive outcome. The theory is advantageous since it allows individual to forecast how likely an individual is to engage in a particular action. It sheds light on the circumstances that lead to a particular course of action (Ajzen, 2020). However, the model is not perfect in all cases. The approach doesn't take into consideration the difference between an individual's intentions and their actual actions. Does not explain how to identify actions that lead to behavioral change

Furthermore, from Jeff lifestyle, he has no goals and no objectives concerning his health. Therefore there is need for him to evaluate, realize and observe himself to create positive outcome. to achieve this, Social cognitive theory is very crucial. Social cognitive theory suggests that the observation of others highly influences the acquisition of knowledge by an individual through social interactions, experiences, and outside media influences (Schunk and DiBenedetto, 2020). Schunk and DiBenedetto also reveal that self-observation, self-evaluation, self-reaction, and self-efficacy are all part of the Social Cognitive Theory. As a whole, the four components influence motivation and goal attainment. The theory also add that people do not learn new behaviour by themselves and their beliefs; instead, their own beliefs and understandings become integrated with their social interactions to generate certain behaviours. Therefore, through observation, Jeff can learn new ehaviour other than what he has learned in his workplace and the habit of drinking. The social observation process needs to include attention towards others, retention of the necessary components, production of own behaviour linked with the social learning, and motivational process to continue such behaviour. Though this model, Jeff motivation to reduce weight and stop drinking alcohol can be increased thus a positive outcome.

At the same time, research reveal that social cognitive theory is an important theory of motivation (Schunk & DiBenedetto, 2020). According to the concept, internal processes lead to behavioral outcomes. On shifting reciprocal relationships, the conceptual framework is based. Social cognitive theory emphasizes the primary importance of self-beliefs in human cognition, motivation, and behavior. Social cognitive theory emphasizes the importance of the self-system that allows individuals to exert some control over their thoughts, feelings, and actions (Usher & Schunk, 2018). Therefore the model is critical not only in understanding Jeff believes but also creating a self-system that will help him control his emotions and believes.

Another critical model is the Self-determination theory. To be self-determined, a person must set and work toward their own goals, take part in life's decisions, speak up for their own interests, and take responsibility for their actions (Vasconcellos et al., 2020). Contrary to popular belief, self-determination has nothing to do with exercising power over one's own life. This theory suggests that people are motivated to grow and change through the influence of three psychological needs: competence, connection, and autonomy (Adams, Little, and Ryan, 2017). Therefore the theory would be effective in promoting competence and autonomy in determining to reduce weight for Jeff. This theory focuses more on people choices that are not influenced by any external factors. Similarly, intrinsic motivation for Jeff would be very critical for positive outcome. People need to feel the need to control their behaviours for their betterment (Vasconcellos et al., 2020). Also people need to learn new knowledge and skills. This influences the behaviour as people tend to take the actions more seriously, making them accomplish their intended tasks. Though this theory provides awareness, it's difficult to envisage a self-determined or motivated human (Vasconcellos et al., 2020).

The most relevant cognitions

Cognitive Behavioral Therapy Model

Cognitive Behavioral Therapy Model (Kew et al., 2016)

As mentioned, to make changes in Jeff life, his involvement and self-motivation are very critical. Therefore CBT model is very helpful. CBT address wide range of mental health issues and behavior. Through CBT, one learns how to become more cognizant of one's own thoughts and feelings, as well as how to recognize and alter dysfunctional thinking patterns and behavior in order to improve one's emotional well-being (Robertson, 2018). This model is specifically chosen due to its ability to address various possible vulnerabilities (e.g., cognitive, behavioral and affective), as well as spanning multiple intervention pathways. Kew et al. (2016) reveal that preventing issues and enhancing patient self-control is an important part of cognitive behavioral therapy (CBT). Self-monitoring, self-awareness, and the development of coping skills are some of the techniques employed in the treatment of drug abuse. Thus the model would be effective to helping Jeff quit taking alcohol and also changing his eating habits. The CBT will be specifically focus on motivating Jeff to quit taking alcohol and maintaining healthy diet so that his weight reduces.

Session Procedure

Providing patient with information (this step would be critical in obtaining consent and securing confidence).

CBT treatment begin and run for 16 weeks (this step involve ideal treatment including self-guidance).

6 weeks follow up assessments (this step ensures that new behavior is put into practice).

Self-Determination Model

Jeff indulged in living life in unhealthy ways and was indifferent towards a healthy lifestyle. He is less concerned with his health. This situation has created a sense of protection and initiated self-determination. As the protection motivation theory made Jeff go to the health specialists with his concerns, a motivation of self-determination needs to be provided in this stage (Menard, Bott, and Crossler, 2017). The theory reveal that individual are able to become self-determined when their needs for competence, and autonomy are fulfilled. People's basic mental requirements and inherent growth inclinations are at the heart of self-determination theory (SDT). When we make decisions that aren't influenced by what's around us, we're using it as our inspiration (Ajzen, 2020). Goal-oriented acts can benefit greatly from this concept of inspiration. Taking into account the percentage of our habits that are both self-determined and self-motivated is an important part of the self-determination hypothesis. Therefore, through self-motivation, Jeff can create self-development goals which are effective in quitting alcohol drinking and reducing his weight.

Session Breakdown for the Target Behavior

Reducing alcohol intake. This step will includes intense training of the impact of alcohol thus moving Jeff to quit from personal decision. Another step is incorporating self-care behaviours – exercise and diet. In this step, I will include training on benefits of health diet and exercise as a way to motivate Jeff to undertake the challenge of training and taking health diet. The last step is motivating him to be assertive to resist social influence of his colleagues and friends.

As a counseling expert, I will offer counseling where behavioural homework will be provided to Jeff that will include putting down regularly updated data of behavioural change in a personal diary and monitoring the logbook once a week, cooking healthy meals with different recipes every day, and performing regular physical exercise for at least 30 min a day. Besides, medications from the healthcare specialist also need to be maintained to obtain a better result within the optimum time.

Take a deeper dive into People Management Strategies in the National Health Service with our additional resources.

References

Adams, N., Little, T.D. and Ryan, R.M., 2017. Self-determination theory. In development of self-determination through the life-course (pp. 47-54). Springer, Dordrecht.

Ajzen, I., 2020. The theory of planned behavior: Frequently asked questions. Human Behavior and Emerging Technologies, 2(4), pp.314-324.

Barnes, M.S. and Cassidy, T., 2018. Diet, exercise and motivation in weight reduction: The role of psychological capital and stress: Diet, exercise and motivation in weight reduction. JOJ Nurse Health Care, 9(5), pp.1-6.

Chen, Y., Peng, Q., Yang, Y., Zheng, S., Wang, Y. and Lu, W., 2019. The prevalence and increasing trends of overweight, general obesity, and abdominal obesity among Chinese adults: a repeated cross-sectional study. BMC Public Health, 19(1), pp.1-18.

Conner, M. and Norman, P., 2015. EBOOK: Predicting and Changing Health Behaviour: Research and Practice with Social Cognition Models. McGraw-Hill Education (UK).

Gao, L., Wang, S., Li, J. and Li, H., 2017. Application of the extended theory of planned behavior to understand individual’s energy saving behavior in workplaces. Resources, Conservation and Recycling, 127, pp.107-113.

Geller, E.S., 2016. The psychology of self-motivation. Applied psychology: Actively caring for people, pp.83-118.

Hashemzadeh, M., Rahimi, A., Zare-Farashbandi, F., Alavi-Naeini, A.M. and Daei, A., 2019. Transtheoretical model of health behavioral change: A systematic review. Iranian journal of nursing and midwifery research, 24(2), p.83.

Hetrick, S.E., Cox, G.R., Witt, K.G., Bir, J.J. and Merry, S.N., 2016. Cognitive behavioural therapy (CBT), third‐wave CBT and interpersonal therapy (IPT) based interventions for preventing depression in children and adolescents. Cochrane Database of Systematic Reviews,

Kew, K.M., Nashed, M., Dulay, V. and Yorke, J., 2016. Cognitive behavioural therapy (CBT) for adults and adolescents with asthma. Cochrane Database of Systematic Reviews, (9).

Martino, G., Langher, V., Cazzato, V. and Vicario, C.M., 2019. Psychological factors as determinants of medical conditions. Frontiers in psychology, 10, p.2502.

Menard, P., Bott, G.J. and Crossler, R.E., 2017. User motivations in protecting information security: Protection motivation theory versus self-determination theory. Journal of Management Information Systems, 34(4), pp.1203-1230.

Norman, P., Boer, H., Seydel, E.R. and Mullan, B., 2015. Protection motivation theory. Predicting and changing health behavior, pp.70-106.

Robertson, D., 2018. The philosophy of cognitive—behavioural therapy (CBT): Stoic philosophy as rational and cognitive psychotherapy. Routledge.

Schunk, D.H. and DiBenedetto, M.K., 2020. Motivation and social cognitive theory. Contemporary Educational Psychology, 60, p.101832.

Sun, M., Feng, W., Wang, F., Li, P., Li, Z., Li, M., Tse, G., Vlaanderen, J., Vermeulen, R. and Tse, L.A., 2018. Meta‐analysis on shift work and risks of specific obesity types. Obesity reviews, 19(1), pp.28-40.

Sussman, R. and Gifford, R., 2019. Causality in the theory of planned behavior. Personality and Social Psychology Bulletin, 45(6), pp.920-933.

Tabarés Seisdedos, R., 2017. Health effects of overweight and obesity in 195 countries over 25 years. New England Journal of Medicine, 2017, vol. 377, num. 1, p. 13-27.

Teixeira, P.J., Silva, M.N., Mata, J., Palmeira, A.L. and Markland, D., 2012. Motivation, self-determination, and long-term weight control. International Journal of Behavioral Nutrition and Physical Activity, 9(1), pp.1-13.

Trist, E., 2016. Culture as a psycho-social process. In The Social Engagement of Social Science, a Tavistock Anthology, Volume 1 (pp. 535-545). University of Pennsylvania Press.

Usher, E.L. and Schunk, D.H., 2018. Social cognitive theoretical perspective of self-regulation.

Van Zyl, L.E., Roll, L.C., Stander, M.W. and Richter, S., 2020. Positive psychological coaching definitions and models: a systematic literature review. Frontiers in psychology, 11, p.793.

Vasconcellos, D., Parker, P.D., Hilland, T., Cinelli, R., Owen, K.B., Kapsal, N., Lee, J., Antczak, D., Ntoumanis, N., Ryan, R.M. and Lonsdale, C., 2020. Self-determination theory applied to physical education: A systematic review and meta-analysis. Journal of Educational Psychology, 112(7), p.1444.