Ch.4 Effective Communication, Goal Setting, and Teaching Techniques Flashcards
How can a PT have an immediate positive impact on a client’s health?
By creating enjoyable exercise experiences and then gradually progressing the exercise plan by applying program-design strategies that produce results
What is rapport?
A relationship marked by mutual understanding and trust
In the stages of a client-PT relationship, what does the investigation stage focus on?
- Discussing the client’s health, fitness, and lifestyle info
- Discussing test results, physician recommendations
- Discussing client’s goals and exercise history
- Likes and dislikes
In the stages of a client-PT relationship, what does the planning stage focus on?
PT designs the exercise program in partnership w/ the client
In the stages of a client-PT relationship, what does the action stage focus on?
Ability to effectively teach new motor skills
What is cultural competence?
The ability to communicate and work effectively with people from different cultures
How can a PT develop cultural competence?
Taking time to learn about clients’ beliefs, attitudes, values, and lifestyle
What does nonverbal communication consist of?
- Voice quality
- Eye contact
- Facial expressions
- Hand gestures
- Body position
Body language signals- crossed arms
Anger, defiance, or disinterest
Body language signals- feet pointed toward the door, repeatedly looking at watch
Bored or anxious to leave
Body language signals- biting lip
Tension or trepidation
Body language signals- cracking knuckles
Comforting habit
Body language signals- use of a barrier (such as a purse, backpack, brief case
Personal space is being invaded
What can you do when you encounter a difficult client?
- Ask clarifying questions to better understand clients’ perspectives about exercise and what they see as barriers, challenges, and discomforts, as well as what they see as the value/benefit of being more active
- Let client know you have worked with clients like them
What is active listening?
Listening carefully, empathetically, and with an open mind, trying to put him- or herself in the client’s shoes
What is motivational interviewing?
A method of speaking with people in a way that motivates them to make a decision to change their behavior
What is a directing style of communication?
PT takes charge of the conversation and advises a client on what to do, telling him or her how to best proceed, by offering advice and specific direction
What is a guiding style of communication?
PT encourages, supports, and assists the client in the process of change
What is the importance ruler refer to?
Asking the client to rate the level of importance of something on a scale of 1-10
How should a PT respond to a client’s answer of an importance ruler question?
- PT’s should ask a client why they chose a higher number on the ruler, rather than a lower number.
- Provokes change talk rather than sustain talk (reasons for sustaining the current unwanted behavior)
What are the 4 interconnected components of motivational interviewing?
- Collaboration
- Acceptance
- Compassion
- Evocation
What does the OARS of motivational interviewing refer to?
- Open-ended questions
- Affirmations
- Reflective listening
- Summarizing
What is the process of motivational interviewing?
Engaging->focusing->evoking->planning
What happens in the engaging phase of motivational interviewing?
- Personal trainers talk to their clients to understand their perspectives in a nonjudgmental way
- Develop rapport and build a helpful connection & working relationship
What happens in the focusing phase of motivational interviewing?
- Collaborative process wherein the client’s goals are clarified and the direction the client wants to move forward is determined
What happens in the evoking phase of motivational interviewing?
- PT elicits the client’s own motivations for change
- Prompting the client to voice his or her arguments for change
- Heart of motivational interviewing
- Redirect sustain talk to change talk
What happens in the planning phase of motivational interviewing?
- Collaborate on how to execute change
- PT helps clients talk through their goals, identify resources to achieve those goals, and set up ways to evaluate how well the plan worked after it is enacted
Component of motivational interviewing- collaboration
- The PT functions as a partner in collaboration with the client, based on the recognition that people are the undisputed experts on themselves
- Allows the client’s ideas to be integrated into how the behavior change should occur
Component of motivational interviewing- acceptance
- The PT values the inherent worth and potential of every client through empathy, honoring individual autonomy, and affirming the person’s strengths and efforts
- Involves respecting the client’s decisions about whether and how the behavior change should occur
Component of motivational interviewing- compassion
- The PT demonstrates compassion when he or she deliberately pursues the welfare and best interests of the client, giving priority to the client’s needs
Component of motivational interviewing- evocation
- The PT elicits the client’s own motivation for a particular change, instead of telling the client why he or she should change
OARS of motivation interviewing- asking Open-ended questions
- Queries asked in a way that allow a client to reflect and elaborate
OARS of motivation interviewing- offering Affirmations
- When the PT makes a statement valuing a positive client attribute or behavior
OARS of motivation interviewing- Reflective listening
- The skill of active listening whereby the PT seeks to understand the client’s feelings by offering reflections as guesses about the client’s statements
- Once a reflective statement is given, the client has a chance to either confirm or correct what the PT reflected
OARS of motivation interviewing- Summarizing
- When a PT reflects two or more statements said by a client
- Longer version of reflective listening
5 Open-ended Practice Questions:
- Why do you want to make this change?
- How might you go about making this change?
- What are the 3 best reason for you to do it?
- How important is it to you to make this change?
- What do you think you will do?
3 Things you can say when a client shares a difficult piece of information:
- I am so sorry
- That must have been very hard
- I can only imagine how difficult that must have been for you and your family
What are the 4 steps of the planning stage?
- Setting goals
- Generating and discussing alternatives
- Formulating a plan
- Evaluating the exercise program
What are some key considerations during the goal-setting process?
- Avoid setting too many goals
- Avoid setting negative goals
- Set short- and long-term goals, as well as process and performance goals
- Include client in the process
- Revisit the goals on a regular basis
According to the goal-setting theory, goals affect people’s performance, or inspire behavioral change, through what 4 primary mechanisms?
- Directed attention
- Mobilized effort
- Persistence
- Strategy
What does SMART goals stand for?
- Specific
- Measurable
- Attainable
- Relevant
- Time-bound
SMART goals- Specific
Goals must be clear and unambiguous, stating precisely what should be accomplished
SMART goals- Measurable
Goals must be trackable so that clients can see whether they are making progress
SMART goals- Attainable
- Goals should be realistically achievable by the individual client
- The achievement of goal reinforces commitment to the program and encourages the client to continue exercising
SMART goals- Relevant
Goals must be pertinent to the particular interests, needs, and abilities of the individual client
SMART goals- Time bound
- Goals must contain estimated timelines for completion
- Clients should regularly monitor progress toward goals
What is a process goal?
Something a client does, such as completing a certain number of workouts per week
What is a performance goal?
Something achieved, like weight loss or a resistance lifted on a strength-training machine
What 2 ways does self-monitoring support behavior change?
- It increases the client self-awareness, acts as a mirror giving clients a more objective view of their behaviors
- May enhance client-PT communication and productive discussion, prompting PT to question what is working and not working
What are the 3 stages of motor learning?
- Cognitive
- Associative
- Autonomous
What happens in the cognitive stage of learning?
- Client is trying to understand the new skill
- Movements in this stage are often uncoordinated and jerky
- PT should be using the “tell, show, do” teaching technique
What happens in the associative stage of learning?
- Client begins to master the basics and is ready for more specific feedback that will help them refine the motor skill
What happens in the autonomous stage of learning?
- Client is performing motor skills effectively and naturally
- PT is doing less teaching and more observing
- PT might decide to teach progressions or new exercises or routines
Client actions for visual learning:
- Watches intently
- Prefers reading
Client actions for auditory learning:
- Listens carefully
- Prefers hearing
Client actions for kinesthetic learning:
- Touches or holds
- Prefers to be spotted
What are the 3 key points to remember when teaching new motor skills?
- Remind beginners that it takes time and practice to improve motor skills
- Introduce new skills slowly and clearly
- Allow clients the opportunity for focused practiced
Explain “tell, show, do” teaching style
- Short description of what the client is going to do and why (goal of movement). Include safety measures.
- Demonstrate for client
What is knowledge of results?
The type of feedback that provides info on progress
What does extrinsic feedback consist of?
Reinforcement, error correction, and encouragement that PTs give their clients
What does intrinsic feedback consist of?
Information that the clients provide themselves based on their own sensory systems (e.g. what they feel, see, or hear)
What 3 things should PT feedback do for the client?
- Provide reinforcement for what was done well
- Correct errors
- Motivate clients to continue practicing and improving
How should feedback be phrased?
Positively, pointing out what a client should do (not what they shouldn’t be doing)
