For the past two months, the Motivate Forums have been crackling with amazing discussions about working with clients (Not a member? Why not? It’s free and there’s only mild hazing!). A lot of these discussions have centered on communication, and I have found myself teaching my fellow Motivators new words from my time in social science. I actually try really hard not to drop academic words all over the place because most of them are not any better than the words we use every day with our clients. But there is one word in particular that I think trainers, coaches, PTs, doctors, and practitioners of all helping professions need to know: “concordance.”
In the late 1990s, the scientists started looking at an epidemic problem in medicine: only 33-50% of patients take their medication as prescribed. It was called, “medication non-compliance” or “non-adherence” and it’s a really big problem. A $290 billion problem. So researchers began to examine the problem and possible solutions from a lot of different angles. Doctors, nurses, pharmacists, education, rewards, incentives, etc. And no matter what they tried, one psychological fact kept coming up: people hate feeling controlled.
The 40-year body of work called Self-Determination Theory has very convincingly determined autonomy to be a Basic Psychological Need that is universal. Motivation needs choice. Otherwise it’s just compliance. The more you try to control people, guilt people, and finagle them into doing something, even with rewards, the less likely they are to do it over the long haul.
You can’t put a dog collar on humans. We will always take it off eventually.
So the medical fields have started to change, and the first place they are changing is the words they use to describe the desired outcome. They have started looking for “concordance.”
The roots of “concordance” are two latin words, 1) con- “together” and 2) cor- “heart.” So the latin word concordia (where we get “concordance”) means “of the same mind” but literally translates to “hearts together.”
In practice, it means working with the client to determine the course of action and how the client and the practitioners invested in helping them can reach the best possible outcome. It means asking questions, listening empathetically, and letting the patient take the lead in their care. It means meeting people where they’re at by taking the time to actually find out where they’re at.
And it works. Better than guilt. Better than shame. Better than “because I’m an expert” and way better than “because I told you to.”
I think that everyone who works with clients, patients, humans needs to know the word “concordance.” We need to stop looking for “exercise compliance” and “diet adherence.” We need to start looking for how to help our clients stay on a mutually agreed upon path to the lives they want. We need concordance. Not just because it will change the way we talk, but because using it will change the way we, our colleagues and our clients, think about the problems we are facing together.