How Self-Determination Theory Can Transform Health and Disability Conversations at Work
- Elevation Occ Psy
- Jul 28
- 2 min read
Managing health conditions or disabilities in the workplace can be one of the most challenging aspects of leadership. These conversations often feel sensitive and high stakes for employees. They can involve deeply personal information. For managers, they involve balancing empathy, legal requirements, and business goals.
So how do we navigate these discussions in a way that supports employees and strengthens the organisation? The answer might lie in an established psychological framework: Self-Determination Theory (SDT).
What Is Self-Determination Theory?
Developed by Edward Deci and Richard Ryan, SDT explains that people thrive when three fundamental psychological needs are met:
Autonomy – The need for control over one’s decisions
Competence – The need to feel capable and effective
Relatedness – The need to feel connected and supported
When these needs are fulfilled, individuals are more motivated, engaged, and resilient. But when they’re overlooked, especially in sensitive contexts like disability accommodations, employees can feel powerless, disconnected, or undervalued.
Why SDT Matters for Health & Disability Conversations
These conversations are rarely just about logistics, they’re about trust, dignity, and creating a psychologically safe environment where employees feel supported rather than singled out.
Applying SDT principles helps transform difficult discussions into collaborative, empowering experiences.
How to Apply SDT in the Workplace
1. Foster Autonomy: Give Employees a Voice
Employees dealing with health challenges often fear losing control over their work life. Empower them by offering choices and avoiding prescriptive solutions.
✔ Ask, don’t assume: “What adjustments would help you perform at your best?”
✔ Offer flexibility: Remote work, modified schedules, or adaptive equipment can make a huge difference.
✔ Share resources: Be transparent about accommodation policies and support programs.
2. Enhance Competence: Reinforce Confidence
Health conditions can shake an employee’s confidence. Leaders should help restore it by focusing on strengths and providing the right support.
✔ Acknowledge capabilities: Highlight contributions and value, even during transitions.
✔ Offer training if needed: If changes require new skills, provide resources and guidance.
✔ Set realistic goals: Agree on achievable targets that prevent overwhelm and build momentum.
3. Strengthen Relatedness: Lead With Empathy
Isolation is a common fear for employees managing health issues. Cultivate connection and reassurance.
✔ Listen actively: Validate concerns without judgment.
✔ Protect confidentiality: Ensure privacy to maintain trust.
✔ Build inclusive culture: Normalise discussions about well-being so employees feel safe.
Turning Difficult Conversations into Positive Outcomes
Imagine this scenario:
An employee discloses a chronic health condition. Instead of reacting with uncertainty or rigid policies, the manager says:
“We value your expertise and want to support you. What adjustments will help you do your best work? Here’s what we can offer. And if you need anything else, let’s keep the dialogue open.”
This approach addresses autonomy, competence, and relatedness, creating trust and collaboration instead of stress and fear.
Why This Matters
Research shows that organizations with inclusive practices have higher retention, greater employee engagement, and better performance outcomes. SDT provides a framework for creating that culture, where employees feel empowered and organisations thrive.
Your Turn
How does your organization handle health and disability conversations? Do you think autonomy, competence, and relatedness are present in those discussions?
Share your thoughts below, let’s learn from each other.
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