CSEP 6 A's

Question 1

best practices (4)

Answer 1

-choose appropriate tools/forms
-ensure location is appropriate (private)
-explain purpose of each form and relate it to their health/goals
-use reflective listening techniques

Question 2

List the 6 A’s

Answer 2

ask
assess
advise
agree
assist
arrange

Question 2

objectives of the first A (ask)

Answer 2

get to know the client
1. explain the options and confirm the scope of assessment (full or partial assessment)
2. complete and secure informed consent
3. get clients goals, readiness, and current/hx of activity level
4.complete pre-participation health screening (GAQ, RHR, RBP, Med hx)

Question 2

what is the goal of ‘ask’ (4)

Answer 2

knowledge- importance of PA to their health
primary motivation- goals and drivers (intrinsic or extrinsic)
level of commitment- readiness for change
confidence- self efficacy

Question 3

sample questions to gage motivation

Answer 3

-what brings you in to see me today?
-any reason why you signed up for this appointment?

Question 4

sample questions for current activity level

Answer 4

-how active are you in a typical day?
-does your job require you to sit for long periods of time?
-how do you spend your leisure time?

Question 5

sample questions for PA Hx

Answer 5

-was there a time when you were more active?
-have you ever worked with a personal trainer? What did you like/not like about it?

Question 6

Active listening (3)

Answer 6

• observational interviewing skill to set a positive and productive tone
  -committed to understanding and addressing the clients unique circumstances
  -help the client feel comfortable sharing personal health and lifestyle information

Question 7

sample questions of knowledge and belief

Answer 7

-what is your understanding of PA and how it impacts your overall health?
-do you have any concerns about physical activity?

Question 8

sample questions to gage stage of readiness

Answer 8

-are you interested in increasing or adjusting your physical activity?
-how motivated are you on a scale of 1-10, with 10 being extremely motivated?

Question 9

sample question to undertake an assessment

Answer 9

-how fit would you say you are?
-which components of the PA, fitness and life style assessment are of interest to you?

Question 10

purpose, objective and tool for the second A (assess)

Answer 10

purpose: select assessment options and administer protocols

objective: examination of clients types and levels of PA & sedentary behaviour. Discern clients health benefit ratings from tests.

tools: PASB-Q, healthy sleep assessment, SOC-Q, anthropometrics, aerobic assessment, MSK assessment, Estimating 1-RM worksheet, RPE chart, health benefit rating reference sheet.

Question 11

what is PASB-Q

Answer 11

physical activity and sedentary behaviour questionaire.
provides approximation of clients physical activity and sed. behaviour of a typical week. Used with health benefit ratings

Question 12

what is SOC-Q

Answer 12

stages of change questionaire.
purpose to identify a clients stage of motivational readiness for change
knowing this allows you to decide appropriate strategies for enhancing their commitment to change.

Question 13

purpose, objective and tools for ‘advise’

Answer 13

purpose: discuss assessment findings

objective: present and discuss the assessment findings, supporting the client through weighing of options and setting prioirties for their active lifestyle- interpret results and relate it to client goals

tools: CSEP PATH evaluation summary

Question 14

goals of ‘advise’

Answer 14

discuss assessment results with client (put results into perspective, explain how changes in their behaviour can help them achieve better health/wellbeing & link results to what’s important to them)

use the results to help them move towards making a commitment to change

Question 15

how to support the client to self efficacy (2)

Answer 15

1. adopt a positive, strengths based approach- support autonomy and self efficay for change
2. highlight their key strengths- bolstering clients confidence in their own ability to succeed will help their commitment to getting started

Question 16

When can a client move to step 4 ‘Agree’

Answer 16

This is when change talk is heard, words that evoke desire, reason, ability and commitment

Question 17

purpose, objective and tools used in step 4 ‘agree’

Answer 17

purpose: set goals and make a plan for action

objective: examine options for realizing the clients commitment to change and develop tailored plan of action with SMART goals and tactics.

Tools: inventory or lifestyle needs and activity preferences, goal setting worksheet, CSEP PATH prescription card, 24 hr integrated guidelines, canada food guide

Question 18

creating a plan of action for step 4 ‘agree’

Answer 18

-use info gathered in step 1-3
-consider goals and outcome expectations
-current lifestyle demands that may present barriers to physical activity
-current physical activity and sedentary behaviour patterns
-current level of fitness, strengths & weakness
-make sure there is change talk before making an action plan

Question 19

tools: goal setting worksheet… purpose, stage and instructions

Answer 19

purpose: identify practical, short term and longer terms goals and specific actions for achieving them

stage: preparation

instructions: ask client to complete on their own then discuss their answers with them. Encourage them to refer to the document from time to time to reconfirm their commitment/remind themselves.

Question 20

define SMART goals

Answer 20

Specific well defined clear actions
Measurable, objective and quantifiable so you know when the goal is achieved
Actionable, based on things the client will do/control
Relevant, goal must be important and meaningful to the client
Timed, set a deadline that is reasonable.

Question 21

define outcome goal

Answer 21

intended results that will occur from carrying out a behaviour, long term measure of strategic effectivness

Question 22

define actionable goal 9also known as behavioural)

Answer 22

goals framed around actions/activities of the client that are under complete control of the individual

Question 23

What must the client do for the goal to work

Answer 23

They must adhere to the goal 80-85% of the time

Question 24

describe the Hawthorne effect

Answer 24

people behave differently when they are being watched

Question 25

how can the Hawthorne effect be used in behaviour change

Answer 25

logging or tracking a behaviour (exercising, eating habits, financial spending, ect…)you want to change brings attention to the behaviour.

Question 26

What should you do if you do not hear change talk?

Answer 26

skip step 4 ‘agree’ and move onto step 5 ‘assist’

Question 27

step 5 ‘assist’ list the purpose, objective and tools

Answer 27

purpose: provide support

objective: explore motivation, ambivalence and barriers

tools: barriers to physical activity, decision balance worksheet, first step planning worksheet, alternatives for action worksheet

Question 28

list examples of change talk

Answer 28

I want…
I think I can…
I need…
I am going to start…

Question 29

what tactic/strategies could you use to elicit change talk

Answer 29

reflection tactics and open ended questions

Question 30

Stage: pre contemplation, list the cues and response strategies

Answer 30

Cues: I won’t/I can’t
response: acknowledge, confirm autonomy, re-frame.

Question 31

stage: contemplations, list the cues and response strategies

Answer 31

cue: I may
response: acknowledge and encourage further consideration

Question 32

stage: preparation, list the cues and response strategies

Answer 32

cues: I will…
response: praise, support planning

Question 33

Stage: action, list the cues and response strategies

Answer 33

cue: I am
response: Praise and reinforce

Question 34

Stage: maintenance, list the cues and response strategies

Answer 34

cue: I still am
response: Track progress

Question 35

tools: Barriers to physical activity. List the purpose, stage and instructions

Answer 35

purpose: identify which obstacles prevent them from changing
stage: pre contemplation/contemplation
Instructions: readiness scale by asking them the level of importance this change is for them, and discuss options for addressing them as part of the clients action plan

Question 36

list (8) common barriers

Answer 36

time
not interested
self conscious
no energy
prior failure
fear of injury
no support system
cost

Question 37

tool: decision balance worksheet. List the purpose, stage and instruction

Answer 37

purpose: helps clients weigh the possible benefits and drawbacks of increasing PA
Stage: contemplation/preparation
Instruction: client comes up with their own list of reasons to make the change as well as the drawbacks to doing so. Review the answers with them and come up with strategies that might help lessen the consequences

Question 38

Tool: First step planner. List the purpose, stage and instructions

Answer 38

purpose: find the clients best option for getting started
Stage: contemplation
Instruction: client chooses and activity to try then rates it once tried. Add up their points (6+ they have made a good choice)

Question 39

Tools: Alternatives for action. List the purpose, stage and instruction

Answer 39

purpose: consider the potential benefits and downsides of increasing PA and identify coping strategies
Stage: pre contemplation/contemplation
Instructions: generate a list of alternatives that will achieve their desired objective, then have client list the pros and cons for each alternative, have the client choose the best alternative.

Question 40

Step 6 ‘arrange’ list the purpose, objective and tools

Answer 40

purpose: meeting wrap up
objective: establish timing and format of follow up and continuing relationship to help the client stay on track
Tool: weekly planner & log, relapse planning exercise, other resources (website, video, pamphlet…)

Question 41

List the goals (3) of step 6 ‘arrange’

Answer 41

-thank the client for coming in
-discuss the clients requirements for subsequent sessions
-send client away with words of encouragement and any helpful resources

Question 42

When to refer out (7)

Answer 42

-you have permission of the client
-suspect disordered eating
-client is compulsive/obsessive about PA
-client has overuse injury
-client wants info on dietary supplements/drugs
-unsure of exercise implications for any reason

Question 43

How to terminate an interview

Answer 43

-begin to summarize
-begin to pause longer
-change topics to less intense topics
-wrap it up if necessary
-try to finish the session smooth/discreetly