CSEP 6 A's Flashcards
best practices (4)
-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
List the 6 A’s
ask
assess
advise
agree
assist
arrange
objectives of the first A (ask)
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)
what is the goal of ‘ask’ (4)
knowledge- importance of PA to their health
primary motivation- goals and drivers (intrinsic or extrinsic)
level of commitment- readiness for change
confidence- self efficacy
sample questions to gage motivation
-what brings you in to see me today?
-any reason why you signed up for this appointment?
sample questions for current activity level
-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?
sample questions for PA Hx
-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?
Active listening (3)
- 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
sample questions of knowledge and belief
-what is your understanding of PA and how it impacts your overall health?
-do you have any concerns about physical activity?
sample questions to gage stage of readiness
-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?
sample question to undertake an assessment
-how fit would you say you are?
-which components of the PA, fitness and life style assessment are of interest to you?
purpose, objective and tool for the second A (assess)
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.
what is PASB-Q
physical activity and sedentary behaviour questionaire.
provides approximation of clients physical activity and sed. behaviour of a typical week. Used with health benefit ratings
what is SOC-Q
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.
purpose, objective and tools for ‘advise’
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
goals of ‘advise’
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
how to support the client to self efficacy (2)
- adopt a positive, strengths based approach- support autonomy and self efficay for change
- highlight their key strengths- bolstering clients confidence in their own ability to succeed will help their commitment to getting started
When can a client move to step 4 ‘Agree’
This is when change talk is heard, words that evoke desire, reason, ability and commitment
purpose, objective and tools used in step 4 ‘agree’
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
creating a plan of action for step 4 ‘agree’
-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
tools: goal setting worksheet… purpose, stage and instructions
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.
define SMART goals
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.
define outcome goal
intended results that will occur from carrying out a behaviour, long term measure of strategic effectivness
define actionable goal 9also known as behavioural)
goals framed around actions/activities of the client that are under complete control of the individual
What must the client do for the goal to work
They must adhere to the goal 80-85% of the time
describe the Hawthorne effect
people behave differently when they are being watched
how can the Hawthorne effect be used in behaviour change
logging or tracking a behaviour (exercising, eating habits, financial spending, ect…)you want to change brings attention to the behaviour.
What should you do if you do not hear change talk?
skip step 4 ‘agree’ and move onto step 5 ‘assist’
step 5 ‘assist’ list the purpose, objective and tools
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
list examples of change talk
I want…
I think I can…
I need…
I am going to start…
what tactic/strategies could you use to elicit change talk
reflection tactics and open ended questions
Stage: pre contemplation, list the cues and response strategies
Cues: I won’t/I can’t
response: acknowledge, confirm autonomy, re-frame.
stage: contemplations, list the cues and response strategies
cue: I may
response: acknowledge and encourage further consideration
stage: preparation, list the cues and response strategies
cues: I will…
response: praise, support planning
Stage: action, list the cues and response strategies
cue: I am
response: Praise and reinforce
Stage: maintenance, list the cues and response strategies
cue: I still am
response: Track progress
tools: Barriers to physical activity. List the purpose, stage and instructions
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
list (8) common barriers
time
not interested
self conscious
no energy
prior failure
fear of injury
no support system
cost
tool: decision balance worksheet. List the purpose, stage and instruction
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
Tool: First step planner. List the purpose, stage and instructions
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)
Tools: Alternatives for action. List the purpose, stage and instruction
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.
Step 6 ‘arrange’ list the purpose, objective and tools
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…)
List the goals (3) of step 6 ‘arrange’
-thank the client for coming in
-discuss the clients requirements for subsequent sessions
-send client away with words of encouragement and any helpful resources
When to refer out (7)
-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
How to terminate an interview
-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
