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by ScottAS 2735 days ago
Encouragement is not a bad idea, and there’s nothing stopping doctors from doing that today.

But the idea of “prescribing” an activity that is meant to be intrinsically motivated seems misguided.

It reminds me of those kids growing up who’s parents forced them to do every extra-curricular activity. They ended up -hating- everything they were made to do. And from my anecdotal evidence, kind of miserable.

Creative activities require a real intrinsic desire to participate in them in order to be joyful. Forcing them spoils them, and can make the participant feel even more down on themselves (I’m practicing, why don’t I like it?).

I think the better alternative is for the dr to flesh out what things the person really wants to do already, and continuously encourage them to go for it.

Maybe what I’m missing is that by making it a prescription, medical insurance will cover it? I guess that would be pretty great, as long as the person has an intrinsic desire to do the thing.

7 comments

> But the idea of “prescribing” an activity that is meant to be intrinsically motivated seems misguided.

Social prescribing doesn't mean the patient is forced to do something they don't want to do, it means the patient who may struggle (because motivation, health, money) to access something gets some support to access an activity.

That support might be financial. Here's a scheme to give free access to a slimming club for epople with a BMI over 25: https://www.slimmingworld.co.uk/health/swor/how-does-it-work...

It might be motivational, or a stepped approach from a supported activity into a mainstream activity.

> But the idea of “prescribing” an activity that is meant to be intrinsically motivated seems misguided.

But what if the evidence shows than it works? Because this stuff is evidence-based.

The thing about illness is, when you feel crappy you don't want to do anything. Which of course leads to less activity, to exacerbation of associated health problems and then back to not wanting to do zilch.

You can only break that circle by getting your body and brain busy with anything at all.

And with any creative activity, you figure out as you go whether you're any good at it or you prefer to switch to something else. Only you need motivation to do that.

Parents do it all the time.

Nobody wakes up wanting to play the oboe.

Oddly enough, my daughter did. No idea why at all.
As a Former high school oboeist I can confirm that the oboe is F*ing hard to play.
It may work better in helping to get people to start doing something, rather than keeping their routine.

There's nothing that says people may not start liking the activity that is good for them later, and keep doing it regardless of whether they started doing it on prescription or with encouragement/friend recommendation. But there's usually some initial hurdle to get over, and anything that helps is probably good.

The proposed better alternative is more the role of a counselor than a doctor IMO which makes me think they should be encouraging the use of counselors instead. That being said, many people find things like counseling as superfluous or taboo so maybe it is in our best interest to delegate this responsibility more towards general practitioners.
Part of the GPs job is to be a general counciler on their health and lifestyle habits. They certainly shouldnt be diagnosing mental health issues if they don't have the expertise but encouraging to have good habits before referring them to an actual therapist is definitely warented in most cases.
I think a lot of these people fall into a pit which they can't get themselves out of. They probably just need a push to get them going again.