What Is a Nudge in Counseling?
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Behavioral economists Cass Sunstein and Richard Thaler coined the term nudge in their 2008 book Nudge: Improving Decisions about Health, Wealth, and Happiness. Sunstein and Thaler recently updated the concept of nudging in their 2021 book Nudge: The Final Edition. Sunstein describes a nudge as a way of steering people in a particular direction while maintaining freedom of choice.
Nudges can be distinguished from more formal demands, such as travel bans or vaccine mandates because the latter do not involve choices. Instead, warnings about dangerous behavior can be nudges such as a sign that says no lifeguard is present and you’re swimming at your own risk. This sign provides information that “nudges” the person not to swim there but does not take away the ability to do so.
A nudge works by manipulating choice architecture, which includes the physical, social, and psychological environment in which a choice is made. Behavioral economists have long argued that despite our considerable abilities to make rational decisions, choice architecture can intervene in negative ways. We might not have the information, time, attention, or physical ability to make choices that are in our best interests.
By using a nudge intervention, people with less-than-ideal decision-making habits can still be moved in a positive direction. Nudges work by designing environments and anticipating barriers, allowing people to see clear differences between their options.
In an interview with McKinsey, Sunstein notes that government programs providing free school meals for poor children were not used optimally. Parents were required to opt into the programs—a process that might have seemed intimidating. When the government switched to opt-out, only requiring parents to turn the opportunity down, many more eligible children were served.
Nudges can also reinforce choice behaviors. Thaler and Benartzi (2004) increased the saving habits of employees from 3.5 percent to 13.6 percent by having them commit in advance to saving for their retirement.
The Ethics of Nudging
I attended a recent presentation by artificial intelligence (AI) ethicist John Sullins. During the Q&A, Sullins was asked where he stood on a question posed by Pew Research, asking participants if AI was exciting, terrifying, or a combination of both. In his response, Sullins remarked that one of the potential risks of our rapidly improving AI that concerned him was the possibility of nudging people without their awareness. He stated that the ability to do so was already here.
Sunstein and Thayer anticipate the “dark side” of nudges by proposing a nudging bill of rights. They argue that nudges should be transparent to the target, not hidden, as Sullins fears. Nudges should maintain human dignity by being in the interests of the people being nudged and consistent with their values. Sullins spoke of the need for “guardrails” for AI, which can also be true for nudges. Nudges should be consistent with constitutional law, and people should be able to reject them.
These guardrails sound like a good idea, but they are not in place nor even more than a blip in contemporary conversations. We would like to believe that people would not take advantage of the power of nudging, but it’s probably a good idea to work on those guardrails as soon as possible. Nudging has also been widely criticized as paternalistic—someone else is deciding what is in our best interests for us.
What types of nudges can we use? Mertens and her colleagues (2021) outline several useful strategies from a meta-analysis of the nudging literature. They identify barriers to sound decision-making, suggest possible types of interventions, and then provide examples.
The first barrier is limited access to information needed to make a good decision. This barrier can be overcome by improving information availability, clarity, or personal relevance. One intervention technique in this category is to provide social normative data. For example, how do people evaluate their power use? Providing information from “similar neighbors” helps to clarify whether you are typical or an outlier, in which case you are “nudged” to reduce your usage.
A second barrier is the limited capacity for evaluating choice options. This can result from a lack of time, bias, or expertise, as well as loss aversion or inertia. Nudges of this type focus on the ways options are presented.
The earlier example of having parents opt out of school meal programs instead of opting in represents this type of strategy. I regularly enroll in auto-ship programs for household items and pet supplies I use regularly, which represents a genius approach to retail marketing. The items are purchased with little active investment of time and effort on my part. All I have to do is review what has been ordered.
A final barrier is limited attention and self-control. Interventions of this type aim to boost self-regulation. This can be accomplished by regular reminders, possibly through an individual’s cell phone or fitness watch, and public commitment to goals.
Nudging in Counseling
Can nudges be useful in counseling? While reading through the previous description, many counselors could likely see the advantages of the nudging strategy and think of examples where it might be particularly useful.
Most of us know that telling another person to engage in behavioral change is rarely effective. The person has to want to make that change for it to work. What if we could use nudges to help make that happen? Remember that our efforts along these lines must be transparent, and the client’s dignity must be top of mind.
The importance of personal relevance of information cannot be overstated. I recall reading that interventions designed to discourage teen tobacco use usually fell flat. The interventions often focused on the 15 years or so of lost life expectancy associated with tobacco use. Unfortunately, dying at 65 instead of 80 has little personal relevance to many teens. When the message was changed to emphasize the negative effects of tobacco on personal attractiveness (yellowed teeth, bad breath, premature aging of skin), the teens sat up and took notice.
Changing default choices can help clients overcome inertia. Instead of asking a client to make a new appointment after each visit, appointments could be scheduled automatically unless the client opted out. Be creative about reducing physical and financial effort on the part of the client. Perhaps offering a telehealth session when a client is experiencing difficulty commuting to an office will be just what is needed. A financial equivalent to auto-shipping might be helpful. If you automatically enroll in a regular schedule of visits, with payment information saved, you get a discount.
In all likelihood, the most salient of the barriers addressed by nudges to counseling is the boost to self-regulation. So many problems presented to psychotherapists revolve around the need for more self-regulation, whether talking about substance use, anger management, or depressed mood. Although counselors have many items in their toolkits to address self-management, we can all learn new things.
The idea of regular reminders, especially using technologies like cell phones, already forms the basis of apps that present Marcia Linehan’s dialectical behavior therapy directly to clients. Throughout the day, clients are asked about their current state of mind, and suggestions for coping are offered. In my personal quest to maintain a sizeable weight loss for the last 16 years, I know that stepping on the scale every morning without fail is the most important part of my strategy. The numbers allow me to adjust my eating patterns that day or not, and I usually opt for adjusting.
There is something compelling about publicly committing to a plan of action for our social species. One has to wonder if this isn’t one of the driving forces behind successful self-help groups, such as AA or Weight Watchers. It’s one thing to make a commitment to yourself in the form of a New Year’s resolution, but it’s entirely different to let others know that’s what you’re trying to accomplish. We don’t want to let them down.
This aspect of human behavior can certainly be leveraged gently by counselors, who help clients make reasonable goals. Even if the goals are known only to the client and therapist, they’re still there.
Nudges, thoughtfully applied with beneficence, have the potential to help counseling clients make choices in their best interests. We have only scratched the surface of this potential here. Interested readers might engage in their own search for specific applications and ideas for nudging, such as in instances of major depressive disorder, encouraging routine health screens, and improving education.