Behavioral Health Minute

November 2008 - Link health values with life values

The short summary

Speak with patients about how their life values… what matters to them about what they wish to be doing… relate to their health values and choices about health behavior.

The modestly longer reflection

Why should I care what my A1c is or lipid profile looks like?  Why should I stop smoking, drinking, chewing, snorting, spitting or anything else like that?

I have thought for a long time that health has relatively little inherent value for people.  Health values (health status and related practices and behaviors) are important, I believe, insofar as they allow people to pursue the life values that are important to them.  Stopping smoking, for instance, is important not for some amorphous health reasons, but because someone would be able to be a better example to a child, or to play with a grandchild, or to work in the garden and grow flowers next summer, or to put food on the table, or to walk in the woods in the fall.

This is important for patients because focusing on life values can create energy and motivation. It is important for clinicians because patients know that you are really interested in who they are and how potential changes would fit into their lives.

As a practical matter, you can approach the connection between health values and life values from either end.

Life values > health values.

• What are the things that are important to you in your life?
• What do you care about being able to do, and why?
• If I were to take a snapshot of you doing in the future what you care the most about, what would I see?

Then…

• Given what you are describing to me, what is your sense about what you will need to be focusing on with your health to be best able to pursue these things in the future? 

Health values > life values

• We’re touching today on smoking (drinking, chewing etc)… how do you see it making a difference in your life as you are able to make changes with this?
• How would you describe why it would be important to you to be able to make a change with this? 

Follow-up

Ask patients to describe how possible changes in health behaviors could tie in with life values that are important to them.

Fred Craigie, PhD, 11/08