ABSTRACT

Many clinical encounters revolve around patients’ decision-making: decisions around treatment, decisions around medication adherence, decisions to start or stop certain behaviors. Encourage healthy decision-making by continually lauding positive decisions, behaviors, and progress. The form of positive reinforcement depends on the situation. Positive reinforcement is powerfully motivating for changing behaviors. Even when punishment is an option, it is far less effective than positive reinforcement for changing behaviors. For example, parent management training is a behavioral therapy designed to help parents manage problematic behaviors in children. By necessity, clinical encounters center around illness and difficulty. In a study of clinicians who work with pediatric cancer patients, the sense of always delivering bad news and being at odds with patients and families led to decreased clinician satisfaction and greater burnout.