Chapter 19 Lifestyle Modification and Behavioral Coaching Flashcards
What are the 5 stages of change?
- Precontemplation
- Contemplation
- Preparation
- Action
- Maintenance
What stage of change uses these strategies?
- Suggest where they might get INFORMATION, make it ATTRACTIVE, easy-to-read MATERIAL.
- Find out what they think of exercise and try to DISPEL any MYTHS.
Precontemplation
What stage of change uses these strategies?
- Suggest avenues of INFO for erroneous beliefs.
- Find out what clients see as the PROS/CONS of exercise
- Discuss WAYS to DEAL WITH perceived CONS
- Help client DEVELOP motivational PROGRAMS that will lead to long-term adherence.
Contemplation
Describe a person within the Precontemplation stage of change.
Do not exercise and do not intend to start in the next 6 months
Describe a person within the Contemplation stage of change.
Do not exercise but plan to become more active in next 6 months
Describe a person within the Preparation stage of change.
Do occasionally exercise, but are planning to begin exercising regularly in the next month.
Describe a person within the Action stage of change.
Person has started to exercise, but have not maintained the behavior or 6 months.
What stage of change uses these strategies?
- CLARIFY REALISTIC GOALS
- Maintain belief of IMPORTANCE of exercise
- Discuss building a SOCIAL SUPPORT NETWORK
- Ask about PREVIOUS SUCCESSFUL EXPERIENCES with exercise
- DISCUSS PROGRAMS that work best for different clients
- Consider clients’ SCHEDULES, PREFERENCES, HEALTH concerns
- AVOID exercise that could lead to DISCOMFORT or INJURY
Preparation
What stage of change uses these strategies?
- Continue EDUCATION because it will strengthen their belief in the pros of exercise.
- ANTICIPATE UPCOMING DISRUPTIONS
Action
What stage of change uses these strategies?
- reinforcing PROS
- discuss PROGRESS
- help them CHANGE up their WORKOUT plan.
Old habits can still be tempting.
Maintenance
List 5 Common Barriers to Exercise and their solutions.
Which is the most common
- Time: (most common) Perceived lack of time is not in reality (time journal helpful)
- Unrealistic Goals-use SMART acronym
- Lack of Social Support-discuss 4 types of support and its importance
- Social Physique Anxiety-talk about appropriate attire and -introduce to people of similar physique to normalize their body type
- Convenience-Sometimes perception is different than actual proximity of a facility. Examine all options and work with giving them a program they can do at home if needed.
List 3 Behavioral Strategies to Enhance Exercise Adherence and generally describe each. (you’ll describe each in more detail later)
- Self-Management-managing one’s own behavior, thoughts and emotions
- Self-Monitoring-daily written record of behavior
- Goal Setting-
a. Assessing current level
b. Creating s.m.a.r.t. goal for future levels
c. Detailing the actions
What is the main Cognitive Strategy to Enhance Exercise Adherence? Through what two methods?
Positive Self-Talk via
- Psyching Up
- Imagery
What does the acronym “S.M.A.R.T.” stand for? What is it used for?
Specific-detailed and defined
Measurable-quantifiable (“look better” vs. “lose 5% body fat)
Attainable-correct difficulty
Realistic–willing and able to do it
Timely-both short term and very short term (tomorrow AND in 3 months)
What 7 things can be measured when using SELF MONITORING?
What are 6 benefits?
Includes:
- Time (and date)
- Exercises
- Calories expended
- Perceived heart rate,
- Sleep cycle,
- Food
- Feeling emotionally (track period for females)
Benefits:
- Logging is a REWARD
- Builds CONFIDENCE and self esteem which helps with exercise adherence
- See PROGRESSION OVER TIME
- Helps IDENTIFY CHALLENGES and barriers
- Encourages be HONEST/ACCURATE about activity level
- ACCOUNTABILITY which keeps them motivated
How do you coach an exerciser from a negative state to a positive state using the “Positive Self-Talk” cognitive strategy?
- Help clients become AWARE of their NEGATIVE thought process by making a LIST of any negative thoughts they may have around exercise.
- Coming up with a LIST OF POSITIVE thoughts that surround exercise helps to use for REFERENCE WHEN FEELING NEGATIVE.
- Creating a positive that counteracts every negative will help create awareness and help TRANSLATE NEGATIVE thoughts INTO POSITIVE.
What is the process created to produce internalized experiences to support or enhance exercise participation?
Exercise Imagery
What are 4 psychological benefits of exercise?
- Promotes positive mood
- Reduces stress
- Improves sleep
- Reduces anxiety and depression
Once the client has identified the need for social support, help them identify what kind of social support is good for them. What are the four types?
- Instrumental
- Emotional
- Informational
- Companionship
What are 4 types of people whose influence may either help or hinder clients’ abilities to reach their fitness and wellness goals?
- Family
- Parental
- Exercise Leader
- Exercise Group (both size and composition)
\_\_\_\_\_\_\_\_ support is the TANGIBLE and PRACTICAL FACTORS NECESSARY to help a person adhere to exercise or achieve exercise goals. Examples: - Transportation to facility - Babysitter - Spotter for weight-lifting
INSTRUMENTAL support
________ support is encouragement, caring, empathy, concern
- will enhance self-esteem and reduce anxiety
examples: Praising client for efforts, encourage to work harder, sympathize with sore muscles
EMOTIONAL support
__________ support is directions, advice, suggestions about how to exercise, feedback regarding their progress
- (one of the main reasons why people come to personal trainers in the first place)
INFORMATIONAL support
__________ support is the availability of family, friends and coworkers with whom clients can exercise with
-Produces positive feelings and may DISTRACT people from the negative aspects of exercise-related feelings such as fatigue, pain, and boredom and can provide a sense of CAMARADERIE and ACCOUNTABILITY
COMPANIONSHIP support
List 7 effective communication skills.
- Nonverbal Communication
- Active Listening
- Asking Open Ended Questions
- Reflecting back what was said
- Summarizing what was said
- Affirmations like “you are… “ about something they value like thoughts plans or skills. Instead of complements with “I like” statements
about their possessions. - Asking Permission to give information
Affirmations versus Compliments
- Compliments are more “I like” statements and create an EXTERNAL advantage point
- Affirmations are more “you are” statements and creates an INTERNAL client attribute
- Affirmations show appreciation for clients and their strengths
- Important to genuinely affirm something the client PERSONALLY VALUES (about client’s thoughts, plans or skills) rather than clothes, sneakers, HR monitor, etc
- P.T. must LISTEN CAREFULLY to know what to affirm
What is a conversational technique that expresses the purported meaning of what was just heard.
Importance:
- Expresses caring and communicates understanding
- Making sure what you heard was accurate to what the client was trying to say
Reflecting
What is SELF-MANAGEMENT?
What are 2 benefits?
Name 5 helpful self-management skills for improving exercise adherence. (how to)
- Managing one’s own:
1. behaviors
2. thoughts
3. emotions
and changing what’s not working.
Benefit:
1. Improves ability to MONITOR and CHANGE WHAT ISN’T WORKING
- COPING WITH and adapting LIFESTYLE CHANGES and DIFFICULTIES THAT might OTHERWISE SHORT-CIRCUIT PLANS to exercise regularly
associated with beginning or returning to exercise
How-To:
- Goal Setting
- Self-Monitoring
- Positive Self-Talk
- Psyching UP
- Imagery
How can the client have passion, inspiration and focus from their goals?
What questions can help achieve this?
If the goal is an extension of their values
What long term accomplishments do I want? 6 mo, 1 year, next 5 years, and my dream accomplishment
What is the difference between Self-Monitoring and self-management?
Monitoring -Daily record of the behavior trying to change
Management-Self control
What is Social Physique Anxiety?
What are 2 things to do about it?
- Concern with body image
- OVEREMPHASIZE the DIFFERENCE between their BODY TYPE and the body types of others when in a fitness facility.
- Introduce them to people of similar body type to normalize their body type
- Discuss appropriate attire
Why are unrealistic goals a common barrier to exercise? (name 3)
- Lowers motivation
- Decreases self-esteem
- Does not provide the exerciser a sense of success
What are 4 ways to Psych Up?
1a. List negative self talk
1b. List positive self talk ideas
1c. Notice negative self talk and stop. Identify positive thoughts from the list, or key words you can TRANSLATE them to.
2. Also use any techniques your clients currently use to get psyched up for other projects in his/her life, come up with a list that will help get them psyched up for exercise.
3. Use keywords, imagery, specific food, music, etc.
4. Fine tune what works in different situations
What is a process created to produce internalized experiences to support or enhance exercise participation.
Exercise Imagery
What is a word that means an attitude and genuine interest in seeking a client’s perspective and getting to know him/her, honoring client’s perspective, and building a relationship with client.
What does it require?
- Active Listening
Requires:
- Paying attention
- Eye contact
- Minimize distractions
- Provide feedback only after client has finished speaking
What is a word that means a series of reflections? Why is it important to do?
- Summarizing
- Show a greater depth of listening throughout an entire conversation
Describe a person within the Maintenance stage of change.
Person has maintained change (consistent exercise) for 6 months or more.
What 6 things should you do in the first 20 seconds of a first impression?
- Eye contact
- Introduce and exchange names
- Smile
- Shake hands
- Use their name
- Body language
Give 5 question that help clients during the stages of change?
Which stage is helpful with each question?
- What EXPERIENCE with physical activity in the past?
- WHAT WORKED best to HELP them STICK to an exercise program?
- What WORKED LEAST, what caused them to QUIT?
- What KEPT FROM exercise in the past 6 mo?
- HOW did they KEEP UP WITH EXERCISE while there was DISTRACTIONS, LESS TIME, TRAVEL
Pre-contemplation 1, 2, 3, 5 Contemplation 1, 2, 3, 5 Preparation 1, 2, 3 Action 1, 2, 3, 5 Maintenance 1-5
What is one of the primary reasons people stick to exercise programs?
Stress reduction
What are two categories of fitness goals? Which one is more important and why? How can that type be motivating?
Process Goals
Product Goals
Process goals are more important because the client has MORE CONTROL over them.
Tracking process goals can be very motivating in SMALL STEPS that happen OVER SHORT PERIODS.
What are 5 positive questions that can elicit happy memories and recollection of success that can be incorporated into the present?
- Did you ever FEEL GOOD after working out?
- Did you ever notice having MORE ENERGY during the day?
- Did you SLEEP BETTER at night?
- Did you feel MORE RELAXED?
- We’re you able to THINK MORE CLEARLY?
What are 6 detailed questions about the client’s last experiences with exercise?
- Was exercise more successful CERTAIN TIMES of day?
- Because of attending a CLASS?
- Have you tried listening to MUSIC?
- Is it easier to stick to a program when exercising with other people?
- What made last experiences POSITIVE?
- What led to your quitting?
What is important to check in with clients frequently about?
If they are feeling any of the things they had mentioned led them to quitting?
In what general ways should you be communicating as a trainer? (3)
- Express EMPATHY. Be sensitive to clients feelings and connect emotionally.
- Use a POSITIVE approach. that includes ENCOURAGEMENT, SUPPORT and POSITIVE REINFORCEMENT
- Communicate CONSISTENTLY with your PERSONALITY and training style
In communication with clients, the goal should not be to communicate information but what instead?
Goal should be to build a relationship through a genuine interest in getting to know them.
Communicate with understanding more than information
What is one of the strongest predictors of exercise adherence?
Social support
What is it called when someone responds to pressure to do something by actually doing it less.
BEHAVIORAL REACTANCE
A good group instructor will do what 6 things?
- Ask and remember names
- Acknowledge new participants
- Introduce new and veteran members
- Ensure they are properly set up for class
- Talk about member’s goals and expectations
- Check in after class
In a study, group exercise with members who are enthusiastic, encouraging and socially interactive had what 2 sort of responses in people?
What should be done about this?
- Most had greater enjoyment and stronger intentions to join
- Some first time exercisers worried about embarrassing themselves and being evaluated by others.
- For those new to exercise people, help them focus on mastering the skills before introducing them to an enthusiastic group
Self Management is the ability to monitor what 3 things?
- Behaviors
- Thoughts
- Emotions
Should short term or long term goals be established first?
Long
What is one key to setting successful short term goals to achieve the long term ones?
Narrow down goals to the ones that are the most important so they don’t get overwhelmed.
Short term goals should include what 2 types of skills?
Give an example
Physical and Mental skills
Like set goals to become more motivated. I’m at a 2 but I should be at a 9.
What six questions can you ask to help develop your goal specifics?
- What needs to be accomplished DAILY?
- Where is my CURRENT STATUS in my goal?
- When is the TARGET DATE to complete it?
- Why do I want to do this? (what’s my OBJECTIVE)?
- How can this be accomplished? (what RESOURCES)?
- How will I experience POSSIBLE DIFFICULTIES I might have to overcome?
Benefits to setting goals? Name 7
- Direct attention to important elements of the skill
- Learning what’s within their control
- Empowerment
- Satisfaction
- Self-confidence
- Incr. focus
- Incr motivation
6 Common problems with goal setting
- Failure to convince them its important
- Setting only OUTCOME-oriented goals
- Failing to set SMART goals
- Having TOO MANY goals
- Not knowing which to PRIORITIZE
- Lack of support.
What is it called when anxiety is part of your character?
And when anxiety is a result of the circumstances?
Trait anxiety
State anxiety
What are 5 tips for exercise imagery?
- Use similar past positive experiences.
- If no past experience use role models in media
- Include as many thoughts, emotions, and senses as you can
- Write it down
- Or record it and listen to it
What is are 2 examples of a strategy for someone in the Precontemplation Stage of Change?
Education:
- Suggest where they might get INFORMATION, make it ATTRACTIVE, easy-to-read MATERIAL.
- Find out what they think of exercise and try to DISPEL any MYTHS.
What is the best strategy for someone in the Contemplation Stage of Change? List 4 examples.
Education:
- Suggest avenues of INFO for erroneous beliefs.
- Find out what clients see as the PROS/CONS of exercise
- Discuss WAYS to DEAL WITH perceived CONS
- Help client DEVELOP motivational PROGRAMS that will lead to long-term adherence.
What are 7 strategies for someone in the Preparation Stage of Change?
- CLARIFY REALISTIC GOALS
- Maintain belief of IMPORTANCE of exercise
- Discuss building a SOCIAL SUPPORT NETWORK
- Ask about PREVIOUS SUCCESSFUL EXPERIENCES with exercise
- DISCUSS PROGRAMS that work best for different clients
- Consider clients’ SCHEDULES, PREFERENCES, HEALTH concerns
- AVOID exercise that could lead to DISCOMFORT or INJURY
What are 2 strategies for someone in the Action Stage of Change?
- Continue EDUCATION because it will strengthen their belief in the pros of exercise.
- Discuss ACTION STEPS FOR BARRIERS to exercise and to ANTICIPATE UPCOMING DISRUPTIONS
What is the best strategy for someone in the Maintenance Stage of Change?
Old habits can still be tempting.
Suggest that clients have a MAINTENANCE CHECK-IN PLAN that includes
- reinforcing PROS
- discuss PROGRESS
- help them CHANGE up their WORKOUT plan.
What is it called when they
- Are concerned with body image
- Overemphasize the difference between their body type and the body types of others when in a fitness facility.
Social Physique Anxiety Social Physique Anxiety Social Physique Anxiety Social Physique Anxiety Social Physique Anxiety! o.O
ANXIETY about your PHYSIQUE in SOCIAL settings.
What is cognition?
The ongoing thought process and constant internal dialogue that someone has about anything at any given moment.
