Lesson 6: Motivation + Behaviour Change Flashcards
What are thee 4 stages of the client-trainer relationship?
- rapport
- investigation
- planning
- action
What does rapport refer to? What is it built on?
a relationship marked by mutual understanding and trust.
This builds around first impressions, building an early foundation on trust and respect and getting to know each other.
Why is it important PTs present themselves in an approachable and professional manner from day one?
because rapport is built on first impressions as well as relationships
What happens in the investigation stage of the client-trainer relationship?
PT and clients review health and fitness data, any available test results, medical clearance info, goals and exercise history.
What skills help the investigation stage of a client-trainer relationship?
good listening skills as it helps understand the client and elicit as much helpful info as possible
What happens in the planning stage of the client-trainer relationship? What skills are utilized here?
The PT designs an exercise program in partnership with the client using good listening and teaching skills.
What happens in the action stage of the client-trainer relationship?
The client begins their program and you must be able to teach new motor skills here.
Why is rapport the foundation of the ACE IFT Model?
because rapport builds a good relationship with your client which will help you to change their habits and establish a positive relationship with exercise
How can a PT have an immediate impact on a client’s health?
by first creating a positive exercise experience that can lead to exercise adherence
why is it sometimes not suitable to jump straight into a complete battery of initial fitness assessments with a new client? What should be done instead?
because, for the out of shape clients, this can reinforce their negative self-image and beliefs that they are out of shape/overweight.
Instead, you should initially help them modify their behaviour and establish a habit of regular exercise and creating a positive exercise experience.
What are 2 primary functions of PTs who want to help clients achieve meaningful results?
- applying strategies for fitness-related behavioral changes and exercise adherence
- implementing comprehensive exercise programs that help clients reach their unique fitness and wellness goals
What are influence factors of a first impression?
- physical appearance
- facial expressions
- attire
- self-confidence
- verbal/non-verbal communication
What are environmental characteristics of positive client-training experiences? (2)
- facility is neat and clean
- offices/staff have a well-organized appearance
What characters related to a PT’s appearance show positive client-training experiences? (5)
- PT wears professional attire
- PT is fit, neat and clean
- PT is friendly and interested in the client
- PT shows a warm, positive attitude
- PT makes a positive first impression
What interactions with a PT form a positive client-trainer experience? (8)
- client’s have confidence in the trainer’s qualifications, training, experience and skills
- clients have enough time to express concerns
- PT listens carefully and tries to understand the client’s concerns
- clients believe the PT is genuinely interested
- clients perceive an unconditional positive regard from PT
- clients believe the PT respects them and their opinions
- clients trust that the PT will maintain their confidentiality and has their best interests at heart
- instructions are clearly explained and questions answered
What do people look at in non-verbal communication?
- speaker’s appearance
- facial expressions
- body language
- tone of voice
Describe each non-verbal communication components:
Voice quality - should be confident and firm to establish professionalism.
Eye contact - direct + friendly to show the client is center of attention and they are important.
Hand gestures - relaxed + fluid gestures when speaking. No fidgeting, clenched fists, abrupt gestures or finger pointing
Body position - an open, well-balanced, straight body position communicates confidence.
When sitting with a client, how should a PT sit?
leaning slightly forward and keeping arms uncrossed
PTs that want to develop their active listening skills should consider an action plan that consists of?
- identifying areas that need improvement by asking people they trust and using online assessments
- measuring these improvements in specific ways by creating SMART goals
- taking active steps to achieve these improvements by coaching, self-monitoring, requesting feedback, observing oneself daily and reflecting on convos during the day
PTs should use the investigation stage to learn what about their client?
- current health and fitness
- exercise likes and dislikes
Why should PTs ask about a client’s previous experience with physical activity?
to uncover factors that furthered or disrupted exercise adherence
How can PTs respond to clients answer in a way that demonstrates good listening skills?
Encouraging language like ‘I see’ and ‘I know what you mean’ to encourage the client to continue talking and make them aware that you are listening carefully.
Paraphrasing what the client has just said by restating the question/answer to show you understand what has been said.
Questioning with open-ended questions encourage the client to share relevant info whilst demonstrating good listening.
Reflecting on the main points/feelings discussed to move the convo in a more productive direction.
Summarizing key points that have a bearing on exercise program design and allowing the client to confirm/deny.
How would you paraphrase a client’s comment on them maintaining a 20lb lighter weight for several years and wanting to return to it to feel physically fit again.
‘So, in the past you were able to maintain a weight that was 20 lbs lighter than you are now. A goal that is important to you is to return to that weight because you felt physically fit at that time in your life. Am I correct?’
What steps does the planning stage generally move through? (4)
- setting goals
- generating and discussing alternatives
- formulating a plan
- evaluating the exercise program
What is a SMART goal?
one that is Specific Measurable Attainable Relevant Time-bound
What is the difference between a process goal and a product goal?
A process goal is something a client does, such as completing a certain number of workouts per week.
A product goal is something achieved like a resistance lifted on a strength-training machine.
What are 12 fitness indicators for SMART Goal setting? Describe them.
- emotional health indicators: measurable improvements in mood, energy level, sleep quality, stress
- RHR: clients new to exercise will often experience a decrease in RHR after a few months of exercise
- HR during given submaximal workload: clients performing aerobic exercise are likely to experience decreases in HR during exercise at a standard workload on equipment similar to ones used in fitness testing
- Muscular strength/endurance: gains in these occur quickly during first few months and are easily measurable
- Walking test: measuring fitness improvements with a timed walking test usually yields positive results if they have been walking as part of their program for several weeks
- flexibility: very slow to improve and only use if the program includes regular stretching/ROM
- balance: shows most improvements for adults in balance-training programs
- skill level: developments in motor skills for a specific activity
- medical indicators: RBP, blood lipid levels, blood sugar levels
- body weight: can be a poor indicator of body-comp changes and may remain unchanged despite body changes
- body size: watching for any changes in the way clothing fits
- body composition: indicative of weight loss or increases in muscle size
What are 8 steps to setting health and fitness goals that motivate clients for long-term adherence?
- listening carefully to understand what clients hope to accomplish with an exercise program
- help define specific, measurable goals
- suggest additional goals they may have not thought of i.e more energy, feeling less stressed
- break large goals (6+ months) into small goals (8-10 weeks) and weekly goals
- include process goals
- record goals and set up a record-keeping system to record workouts/track progress toward goals
- be sure clients understand what types of exercise will help them reach their goals
- reevaluate and revise goals and exercise recommendations periodically to prevent discouragement if large goals aren’t met
What are 5 goal-generating questions?
- what are your short term and long term goals?
- what things are most important to you? How will a healthy lifestyle complement or support this?
- what did you like most and least about your previous exercise programs?
- what is something you are good at now? Did you know you were good at it before you did it or the first time you did it?
- when was the last time you exercised regularly and how long did it last? Why did you stop?
What is the ultimate goal for every client?
adherence to the exercise program
What advice can you give a client to help them feel prepared to begin an exercise program?
Many clients appreciate advice on what to wear, where to go, facility etiquette and customs that might help them feel more at home.
An exercise program should be evaluated both in terms of?
exercise challenge and adherence
What is motivational interviewing?
This refers to a method of speaking with people in a way that motivates them to make a decision to change their behaviour.
What is the PTs goal in motivational interviewing?
to create awareness in clients that a sedentary lifestyle will likely cause health problems.
PTs that use motivational interviewing will be most successful if they do what? (6)
- ask probing/open-ended questions about their daily activity levels, health concerns and physical-activity history and move to questions that will conclude with the benefits of good health and physical activity.
- listen effectively to the client’s answers that uncovers valuable information.
- provide educational information such as the dangers of a sedentary lifestyle and benefits of regular activity.
- keep the conversation friendly as to avoid negative feelings that can create a sense of defence.
- build self-confidence through helping the client identify areas of success no matter how small.
- encourage clients to generate ideas for improvement.
What should be done in addition to a specific written exercise plan during the action stage?
The PT should give or design with the client a system for recording exercise sessions including any relevant data they wish to track.
E.g reps, resistance, exercise, HR, intensity
In what two ways does self-monitoring an exercise program help the client?
- they increase client self-awareness by giving a more objective view of their behaviours
- it enhances client-trainer communication as clients come to expect careful surveillance of their records which they present to their PT every session
How do self-monitoring systems enhance the client-trainer relationship?
because the client has to present this to their PT with every session, the PT will review their adherence and question what is working/not working which leads to productive discussions between the trainer and client.
What are the 3 ways of learning?
visual, auditory, kinesthetic
What are the client actions that suggest they are a visual / auditory / kinesthetic learner?
visual - watches intently, prefers reading
auditory - listens carefully, prefers hearing
kinesthetic - touches/holds, prefers to be spotted
What are the client statements that suggest they are a visual / auditory / kinesthetic learner?
visual - ‘oh, I see’ ‘let me see that again’
auditory - ‘yeah, I hear you’ ‘say that one more time’
kinesthetic - ‘I feel that’ ‘this does not feel right’
What are strategies for teaching a visual / auditory / kinesthetic learner?
visual - demonstrations
auditory - question and answer
kinesthetic - hands on supervision
What is motor learning?
the process of acquiring and improving motor skills
What is the 3 step proverb you should know for teaching clients?
tell show do
Motor skills are taught most effectively when what points are kept in mind?
- remind beginners it takes time and practice to improve motor skills
- introduce new skills slowly and clearly (tell show do)
- allow clients opportunity for focused practice
When describing certain movements, should the PT focus on explaining the goal of the movementor details of limb position? Give example
goal of the movement
e.g when explaining the elliptical, emphasize the movement of pedals in a smooth and steady motion as opposed to talking about bending and straightening the knees
When teaching strength training exercises or positions, why do they require some explanation of limb position?
to prevent injury and increase effectiveness
why should you allow a client to perform an exercise before giving feedback?
because it can be distracting when talking or listening to a PT whilst doing it
What 3 things should feedback do?
- provide reinforcement for what was done well
- correct errors
- motivate clients to continue practicing and improving
When should PTs discuss training methods and explain the purpose of any physical contact/ask clients for permission of physical contact?
During the early stages in the client-trainer relationship
What are positive/negative reasons for exericse?
Positive - reduce stress, health and fitness improvements
Negative - lose weight, improve appearance
What are behavioural contracts?
Contracts that typically spell out the behaviour the client is expected to perform.
Why do behavioural contracts sometimes instill a sense of frustration?
When the behavioural expectation is set too high, it can instill frustration if they are not achieved.
Who is said to have extrinsic and intrinsic motivation?
Those that want to achieve an external reward like a free session have extrinsic motivation whereas those that enjoy competition or feel good exercising have intrinsic motivation.
What are some elements to a behavioural contract?
- I will do this, when, how often and how much
- how confident is the client that they can do this
- what is the reward for doing it successfully
Do process or progress goals work better for rewards? Why?
Process because they are more predictable and controllable.
What is cultural competence defined as and how should a PT develop it?
Cultural competence is the ability to communicate and work effectively with people from different cultures.
PT’s should develop this by taking time to learn about all client’s beliefs, attitudes and lifestyles.
What is the difference between empathy and personal involvement?
Empathy occurs when the trainer demonstrates understanding and acceptance toward the client whereas personal involvement occurs when the trainer becomes friends with the client or enters into a romantic relationship.
What are 3 stages of motor learning?
- cognitive
- associative
- autonomous
What is the cognitive stage of learning? What are signs of this stage?
The stage in which clients try to understand a new skill.
Those in this stage will often show them thinking a lot about it, performing uncoordinated and ‘jerky’ movements.
How can you tell a client has progressed to the associative stage of learning?
The client begins to master the basics and are ready for more specific feedback that will help them refine the motor skill.
How can you tell a client has progressed to the autonomous stage of learning?
The client is performing motor skills effectively and naturally and the PT is doing less teaching and more monitoring.
Why is the Fitts and Posner model (cognitive, associate, autonomous) model less helpful when working with some athletes? What should the PT do instead?
because this model can be to much explanation and cognitive work may interfere with the client learning the complex motor skills needed.
Instead, the PT should talk to the athletes coaches about other resources and devise a plan.
What are 5 daily interactions that PTs should do to build productive relationships with clients?
- periodically reinforce credentials to build an educated/competent view
- prepare for each PT session by cultivating mindful focus
- ask clients for feedback on their own performance to establish improvements on communication and teaching skills
- use electronic communication channels with discretion, always ask about contact preferences
- make training fun
Briefly describe the skills and needed and what is done in each stage of the client-trainer relationship:
Rapport stage establishes trust and understanding with good and effective listening and communication skills.
Investigation stage uses good listening to gather info from clients.
Planning uses good listening and teaching skills to design a program in partnership with the client.
Action stage uses effective and individualized teaching techniques to help clients learn motor skills and increase self-confidence.
What is the most effective way to teach a new exercise to a client?
tell the client what the exercise is, demonstrate the exercise and have the client perform the exercise while providing feedback
according to the US Department of Health + Human Services, how many mins of both vigorous intensity and moderate intensity aerobic activity should people perform each week?
150 mins moderate
75 mins vigorous
A well known statistic shows that more than __% of people who start a new program will drop out in within the first 6 months.
50%
What are commonly discussed approaches for evaluating motivation?
A person’s intrinsic/extrinsic motivation and self-efficacy.
What does it mean to be intrinsically motivated in exercise context?
It means that a person is engaged in exercise activity for the inherent pleasure and experience that comes from the engagement itself.
What are some intrinsic participation motives/goals associated with exercise? (3)
social engagement, challenge, skill development
What sort personality traits/efforts are associated with intrinsic motivation?
- positive attitudes and emotions like happiness, relaxation
- max effort
- persistence when faced with barriers
