The Psychology Behind Elsa

The Psychology Behind Elsa

A rheumatic diagnosis can change the conditions for living the life you desire, and therefore it can be necessary to review your routines. But how do you actually proceed to find new habits that can be maintained in the long run? We met with Niklas Laninge, a psychologist and an expert on behavior change.

Changing your behavior can be a challenge, even if the change is not substantial. We are all creatures of habit who live our lives from habits and routines that we have created, consciously or subconsciously. 

The Elsa app exists to support individuals with rheumatic diseases to overcome changes—in everyday life and with the challenges that accompany the disease. This aids you in finding your own way forward. In the developmental work, Elsa was aided by Niklas Laninge and his colleagues at PBM*, and now we have met him again for a discussion about behavior change.

Behavioral psychology’s wide-ranging relevance

Niklas is a psychologist, entrepreneur, and writer. He has written books about behavioral design and digital behavior, and additionally, he assists both businesses and public officials with behavioral challenges of diverse natures. Behavioral psychology exists anywhere people work towards a change of any form. As an example he explains his reasoning when the Swedish Environmental Protection Agency wanted to propose a suggestion to reduce the consumption of plastic single-use coffee cups: 

“If you want fewer single-use cups to be consumed you need to create friction for the consumer to buy takeaway coffee in a single-use cup. Maybe adding a fee for the cup or by splitting the purchase into steps, so that you first buy a cup and then buy the coffee. The key is to create barriers to prevent single-use cup purchasing behavior,” he explains. 

At present, Niklas and his colleagues are working with many of Sweden’s counties and regions in order to continue the reopening of society, despite the ongoing pandemic:

“How can organizations open in a safe manner so that we can make the most of what they have to offer without added risk? Above all else, we are looking into how we can get people to visit indoor swimming pools and other establishments outside of typical visiting hours.”

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Self-care and motivation

In what manner then is the psychology behind habits and patterns of behavior important for Elsa? Individuals with rheumatological disease spend on average about one hour per year with their rheumatologist. But the rest of the year’s nearly 9,000 hours is about taking care of yourself. 

Many individuals experience that the healthcare system is not enough to get the necessary support and that they need to take matters into their own hands to keep their condition in check and minimize its impact on their health. Elsa aims to be a tool in this self-care—to provide knowledge and, with scientific backing, motivate and inspire to find ways for an improved quality of life. 

Maybe you want to start exercising twice a week, but you have difficulties finding time in a life filled to the brim with the logistics of work and family life? Maybe you are finding it difficult to get started due to pain? Or you may lose the will to power walk if it is raining?

Importance of celebrating the small steps

In the Elsa app, you can set up physical activity goals after finding support in your approach to motivation and planning. With the help of Elsa, you can also learn to predict which obstacles that may prevent you from exercising and have a backup plan if your body is not cooperating in the way you want it to. 

“The key to consistent change is, in this case, to take small, small steps forward for a long time, at your own pace, and equally important, to celebrate the progress on the way. Celebrating is important because it can be difficult to envision the long-term rewards,” says Niklas. “Continuous feedback and understanding the benefits of doing something is an important aspect in the majority of health projects.”  

For Elsa, it is of the greatest importance to stay grounded in science and research. That is why we always have the support of experts in different fields—physiotherapists, clinicians, and nutritionists, but also individuals who live with rheumatic diseases and who are thus the true experts of life with such a condition. Niklas elaborates:

“A meaningful factor regarding behavior change is the use of expertise and trustworthy sources. If the source of a message is trustworthy it contributes to increasing the user’s motivation, which is the foundation to success in changing behavior.” 

Challenges ahead

We ask Niklas what he thinks of the future. He says that even if there are enthusiasts in care who recommend digital support as a healthcare companion, it will take a few more years until healthcare in general takes advantage of actors like Elsa in order to develop and improve. 

“But the apps will continue to play a big role, not just to motivate people to be physically active, but also to offer a more personalized and empathetic experience. What does the guidance look like that actually motivates a certain individual to take the small next step in their behavior change? It is a big challenge, but I believe that it is possible.” 

“In the United Kingdom, there is a list of quality-assured apps and techniques that healthcare professionals should use when treating conditions such as rheumatoid arthritis or depression. I wish such an initiative would also be implemented in Sweden,” Niklas finishes. 

* PBM offers services in behavioral psychology at