ABSTRACT
This chapter explores Accountability in health behavior change. The notion of accountability is deeply embedded in behavior change of many types, including health behaviors. In this context, a person is often encouraged to “report” their progress to someone, as a means of remaining committed to the change process. More recent thought on accountability conceptualizes a continuum – from entirely extrinsic through to deeply internalized accountability.
The Supportive Accountability model highlights the central role played by relationship and therapeutic alliance in the success of any effort toward accountability. Critically, the notion of accountability must also incorporate “modifiability” – ensuring that a person is only accountable for behavior within their sphere of control. This perspective supports the practitioner to ensure that social determinants in behavioral change are not conflated with personal responsibility for change.
Goals as a means of managing accountability are examined, as are the notions of psychological safety, compassion, and measurement of progress in health behavior change.
