3-2-1: The Four Tendencies of Patient Compliance

I. Not all “noncompliance” is created equal
If a man isn’t following his exercise plan, it is rarely about laziness. Motivation has types.
An Upholder is like a Captain. Thrives on structure, clear goals, and measurable milestones.
A Questioner is like a Professor. Needs logical answers and evidence before committing.
An Obliger is like a Champion. Shows up for others but struggles alone, thriving with partnership and accountability.
A Rebel is like a Maverick. Resists rules but engages when given choice and autonomy.
Identify the type and you can stop fighting the wrong battle.

II. Boundaries reduce anxiety for you and your patient
The over-questioning patient is not trying to waste your time. They are looking for certainty to calm their nervous system. For a Professor, offering structure such as “Let’s tackle your top three questions today” and providing written resources helps them relax and engage.

III. For some, choice is the therapy
A Maverick does not want you to push them harder. They want you to hand them the steering wheel. Lay out the exercises, frame the outcomes, and let them choose what is doable. Autonomy is the hook, not the obstacle.

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I. Gretchen Rubin, author of The Four Tendencies:
“What we do every day matters more than what we do once in a while.”
(A reminder that for many patients, the real win is building a system they will keep using.)

II. William Glasser, psychiatrist:
“You can’t control another person’s behavior, but you can control your own.”
(And in doing so, you can create an environment where change feels possible.)

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If this patient never changed their personality, how would you adapt your approach so they still succeed?

With care,

Team IPC