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
What is the goal of PTs in terms of intrinsic motivation?
The goal should be to maximize enjoyment and engagement but not expect that clients will always demonstrate intrinsic motivation
What is involved with extrinsic motivation?
the engagement in exercise for any benefit other than for the joy of participation
What are some extrinsic motivators and feelings attached?
wanting to lose weight, look good, meet people etc.
feelings attached are usually that of tension, guilt and pressure related to participation
How can you help build both intrinsic and extrinsic motivation?
- through creating mastery
- providing consistent and clear feedback
- including the client in program design
- creating a workout environment that is fun and aesthetically pleasing
What is situational motivation?
motivation as people are exercising
How can you foster the development of motivation at the contextual level? (how the client generally views exercise)
Empower the client with the perception of control of their own participation and giving the client control.
What is self-efficacy?
the belief in one’s own capabilities to successfully engage in a physical activity program.
What does self-efficacy influence? (3)
thought patterns
emotional responses
behaviour
What is a simple way of improving self-efficacy?
Creating short-term success by designing a workout that the client will master and that will demonstrate growth and achievement
What can you teach clients to help them view the feelings of workout in a more positive light?
You can teach them to appropriately identify muscle fatigue, soreness and tiredness as well as the implications of these states.
What is the most important source of self-efficacy?
past experiences
Why should you avoid a whole session of assessments with a new client?
because it can create a negative self-belief / lower self-efficacy if they are already feeling out of shape
Why should you plan ahead and be prepared in your program?
to avoid the occurrence of a relapse to an inactive state
How can you help clients prepare to deal with relapse?
- educate them on how to make changes in their life and how to make good habits for dealing with stressful, busy, difficult times
- show your support as a PT and make sure they know you can answer any Qs and listen
How can a PT create a support system within an exercise environment?
maximize opportunities for group involvement and social interaction, make clients feel as though they belong in the program and are part of a team of people with common interests/goals.
How can social support be employed to help clients? (6 strategies)
- find an enjoyable and reliable exercise partner
- ask friends/family to be encouraging and positive about the program
- ask for reminders from friends/family about appointments/goals
- set up fun contests, rewards based on meeting process goals
- add a social element to the program
- find an enjoyable activity that is based on being physically active
What can you suggest to clients for taking control of a negative influence? (6)
- schedule their contact with unsupportive people after they exercise
- try to balance time with unsupportive people by increasing time with supportive people
- set clear limits for how much time they will spend with unsupportive people
- mentally prepare to respond to negativity
- mentally review why exercise is important prior to spending time with unsupportive peers
- explain why exercise is important to unsupportive peers and ask for encouragement instead of negativity
What is being assertive defined as?
being honest and straightforward of your thoughts, feelings and beliefs
Why should you encourage clients to become effective self-regulators of their behaviours, schedules, time and priorities?
because the more control a client has over these things, the more likely they are to adhere to the program and able to deal with barriers and challenges as they arise.
who is most likely to relapse in their exercise program?
those with poor time management skills, a lack of social support or busy schedules
If clients show signs of feeling overwhelmed, frustrated or worn out - what must a PT do?
take the time to teach these individuals additional coping skills including time management and prioritizing.
What categories can potential determinants for physical activity be broken down into?
- personal attributes
- environmental factors
- physical-activity factors
What are classed as personal attributes that influence exercise adherence?
- demographic values
- health status
- activity history
- psychological traits
- knowledge, attitudes and beliefs
What are demographic values under personal attributes?
Education, income, age and gender.
What demographic values are lower levels of activity attributed to?
increasing age, fewer years of education and low income
Is age a related factor to adherence in supervised exercise settings?
it has shown not to be
What gender typically demonstrates higher adherence rates?
men
What is a health status personal attribute related to adherence?
Those with health illness’ such as heart disease and diabetes typically exercise less.
Why might goal setting with clinicians be an effective way to ensure change for those newly diagnosed with chronic illness’?
Because despite research, those newly diagnosed still have little desire to improve health behaviour following diagnosis - some people don’t believe it will help.
Why is activity history the most important and influential personal attribute variable?
Past program participation it the most reliable predictor of current participation and relates to self-efficacy, support, client preferences, challenges they may face that affect adherence.
What are psychological traits related to personal attributes?
Psychological traits refer to general tendencies that people have in their personality or psychological makeup. It accounts for individual differences and the trait of self-motivation which is reflective of one’s ability to set goals, monitor progress and self-reinforce.
What is a psychological trait related to increased adherence?
self-motivation
Why is knowledge, attitudes and beliefs a personal attribute to program adherence?
Because people have a wide variety of knowledge, attitudes and beliefs about starting and sticking to a program, by modifying the way an individual thinks and feels about exercise you can influence their intentions regarding being active.
What is locus of control under the knowledge, attributes and beliefs factor in personal attributes?
Locus of control is the degree to which people believe that they, as opposed to external forces (beyond their influence), have control over the outcome of events in their lives.
What are environmental factors related to exercise adherence? (3)
- access to facilities
- time
- social support
Why is access to facilities an environmental factor to exercise adherence?
Because when fitness facilities are conveniently located near someone’s home/work, they are more likely to adhere to the program.
Why is time an environmental factor to exercise adherence?
Because a lack of time is the most common excuse for not exercising and a reflection of not being interested/committed or enjoying the activity.
PTs must change their clients perception of time availability through the use of goal setting, time management and prioritizing.
How can PTs change their clients perception of time availability?
through the use of goal setting, time management and prioritizing
why is social support an environmental factor to exercise adherence?
because it is difficult for a client to maintain a program if their support system is poor and not encouraging
What are physical-activity factors related to exercise adherence? (2)
- intensity
- injury
Why is intensity a physical-activity factor to exercise adherence?
Because the dropout rate in vigorous intensity exercise programs is almost 2x as high in moderate intensity programs.
Why is injury a physical-activity factor to exercise adherence?
Because there is a reliable relationship between physical activity and injury such that the higher the level of activity = the higher the risk for developing an activity related injury
injuries are directly related to dropout
What is the difference between extrinsic and intrinsic feedback?
Extrinsic is the reinforcement, error correction and building motivation.
Intrinsic is information the clients provide themselves based on their own sensory systems.
What is long-term program adherence dependent on?
the client’s ability to provide his or her own feedback
What can be referred to as knowledge of results?
the type of feedback that provides information on progress
Without ________ ___ ______, persistence suffers and people give up.
knowledge of results
An effective PT will become a leader who successfully influences the way his or her clients _____, _____ and _____.
think, feel and behave
What is shown by using systemic goal setting and teaching relapse-prevention techniques?
It shows that the trainer is thinking of the client’s overall well-being and not just the one hour session they are partaking in.
A PT must be able to design a program with regard to each client’s? (5)
- preferences
- schedule
- experience
- apprehensions
- constraints
Why should you clearly clarify your role as a client’s PT at the start of the client-trainer relationship?
as to manage expectations, clarify any questions and maximize the client’s experience and likelihood for adherence
What are some issues to keep in mind during the goal-setting phase?
- avoid setting too many goals, keep the numbers manageable and attainable to avoid the client feeling overwhelmed
- avoid setting negative goals, always reword negatives into positive (‘I’m unsure” becomes ‘I will/know’)
- set short/long/process + product goals
- revisit goals on a regular basis to maximize effectiveness of the goal-setting process, direct attention/effort and make any training changes
What are the PT’s roles in building adherence? (4)
- program design
- role clarity
- goal setting
- contracts/agreements
What does health psychology cover?
it examines the causes of illnesses and studies way to promote and maintain health, prevent and treat illness and improve the healthcare system.
What is the health belief model?
the health belief model predicts that people will engage in a health behaviour based on the perceived threat they feel regarding a health problem and the pros/cons of adopting the behaviour.
What is perceived threat influenced by?
- perceived seriousness of the health problem based on the severity of the potential consequences
- perceived susceptibility of the health problem is based on a person’s subjective appraisal of the likelihood of developing the problem
- cues to action are events that motivate people to make a change
If someone perceives little threat of developing an illness related to their lifestyle, what should a PT do?
make the seriousness of their health more apparent and implement appropriate cues to action
A 39 year old, overweight man comes in to chat about fitness as his 65 year old died of hypertension not long ago. He says he is busy and doesn’t have any health problems at the moment but knows he should probably start as to not develop any and is overwhelmed by his weight gain. What would you do as a PT to get him more motivated?
It is likely they have not had a recent physical exam and this could act as a good cue to action as it may provide good info for motivation.
He has some barriers such as feeling overwhelmed and time restrictions so the PT should create a program that is flexible and easy to start/maintain.
What are 6 sources of self-efficacy?
- past performance experiences
- vicarious experience (knowing someone else’s success with a plan can build your self-efficacy for it)
- verbal persuasion in the form of feedback
- physiological state such as arousal, pain or fatigue will affect their judgements of their ability
- emotional state/mood appraisals
- imaginal experiences of what exercise will be like
What is the most effective way to understand someone’s self-efficacy?
Through conversation and taking the time to understand what they believe about their ability to succeed
What 4 components is the Transtheoretical Model of Behavioral Change divided into?
- stages of changes
- processes of change
- self-efficacy
- decisional balance
What are the 5 stages of change as seen in the first component of the TTMB? Describe each one.
- Precontemplation - people are sedentary and not thinking about an activity program.
- Contemplation - people are still sedentary but starting to realise the implications of being inactive yet not ready to commit.
- Preparation - they start to engage in some inconsistent activity and mentally/physically prepare to adopt a program.
- Action - Engage in regular physical activity but have been doing so for less than 6 months.
- Maintenance - regular activity for over 6 months now.
What does the processes of change stage in the Transtheoretical Model of Behavioural Change entail?
This involves using interventions to progress the client to the next stage as to help them succeed.
What are the interventions for the process of change from Precontemplation to Contemplation? (3)
- provide information on the risks of being inactive vs pros of being active.
- provide info from multiple sources as it is more effective.
- make inactivity a relevant issue.
What are the interventions for the process of change from Contemplation to Preparation? (3)
- provide opportunities to ask questions and express apprehensions.
- provide info about exercise in general and different activity options, programs, facilities, classes.
- provide cues for actions such as passes to nearby facilities and invitations to info sessions/tours
What are the interventions for the process of change from Preparation to Action? (6)
- provide continued support and feedback
- identify things/events that are potential barriers to adherence
- identify high-risk individuals/situations
- educate about the likelihood of relapse and triggers
- teach physical/psychological skills to deal with potential barriers
- provide continuous opportunities to be active and maintain levels of activity in changing seasons
What are the interventions for the process of change from Action to Maintenance? (5)
- maintain social support from friends/family and fitness facility
- provide continued education about barrier identification
- keep exercise environment enjoyable and switch it up to avoid boredom
- create reward systems for continued adherence
- identify early signs of staleness to prevent burnout
What is the relationship between stage of change and self-efficacy in the Transtheoretical Model of Behavioural Change?
The relationship is that by influencing self-efficacy, a person may progress through the stages more efficiently.
What does decisional balance as part of the Transtheoretical Model of Behavioural Change refer to?
This refers to the numbers of pros and cons perceived about adopting and/or maintaining an activity program.
What are some potential headings to utilize on a decisional balance worksheet?
- perceived gains associated with adopting desired behaviours
- perceived losses associated with adopting desired behaviours
- strategies to maximize potential for achieving gains
- strategies to minimize potential of perceived losses
Why is it important to focus on both short term and long term benefits during the decisional balance component of the TTM?
because by emphasizing only long term benefits you could overwhelm the client and they may fail it will take too long to get there.
What is operant conditioning?
the process by which behaviours are influenced by their consequences. It examines the relationship between antecedents/precursors, behaviours and consequences.
What does operant conditioning examine?
the behaviour chains that lead to the engagement of certain behaviours and avoidance of others.
What is the most basic positive or healthy behaviour a client can show?
simply showing up to the gym
How are behaviours strengthened in a PT context?
when they are positively reinforced and the client is awarded.
What is stimulus control?
A variable tool in behavioural modification
that is used to manipulate antecedents in the environment to maximize the likelihood of desirable behaviours.
/
making adjustments to the environment to increase the likelihood of healthy behaviours.
What is the most important component of operant conditioning?
What happens after a behaviour is executed aka the consequence
Consequences fall under what 3 categories?
- presentation
- non-occurrence
- removal of a positive or aversive stimulus
What are positive and negative reinforcements?
A positive reinforcement is the presentation of a positive stimulus that increases the likelihood that the behavior will reoccur in future.
Negative reinforcement consists of the removal/avoidance of aversive stimuli following undesirable behaviour increases the likelihood that it will reoccur.
What is an example of negative reinforcement?
If a client is late to a session and instead of mentioning it, the PT extends the session for the amount of mins the client was late.
What does extinction refer to?
Extinction occurs when a positive stimulus that once followed a behaviour is removed and the likelihood that the behaviour will reoccur is decreased.
What does punishment refer to?
Punishment decreases the likelihood of a behaviour to reoccur and consists of an aversive stimulus following an undesirable behaviour.
What is an example of a punishment?
Cancelling a session due to a client being late.
Why must punishment be used sparingly?
because it decreases the unwanted behaviour but also increases fear and decreases enjoyment
When should punishment be used?
Only for lack of effort never for poor performance
What lifestyle-modification strategies have most commonly been successful in sustaining weight-management efforts?
- engaging in regular amounts of physical activity at least 1 hour per day
- eating a low-cal, low-fat diet
- eating breakfast daily
- self-monitoring body weight regularly
- maintaining a consistent eating pattern every day 7 days a week
What does shaping refer to?
Shaping refers to the process of using reinforcements to gradually achieve a target behaviour
How does shaping work?
Shaping begins with the performance of a basic skill that the client is already capable of doing, the skill demands are gradually increased and reinforcement is given as more is accomplished.
What does shaping lead to and what technique is it?
Shaping leads to the execution of a desired behaviour and is a powerful behaviour control and teaching technique.
What is the effectiveness of shaping and programs based on?
The trainer’s ability to successfully identify the appropriate starting level. If it is too easy, the client will likely get bored but if it is too hard they will likely feel overwhelmed.
What is observational learning? What should trainers encourage?
This is learning through your environment. Everyone is influenced by their surroundings and people at home, work, social environments.
Trainers should be aware of the environment and encourage the client to make friends with others in the facility.
How can you help a client replace irrational thoughts with healthier, more productive and factual thinking?
By helping them answer some questions such as:
- what is the evidence for/against this thought?
- what would I tell a friend in this situation?
- what is the worst that could happen?
- is it really true that I must, should, have to?
- are there any other possible responses besides blaming myself?
- is there any conceivable way to look at this positively?
- is thinking this way helping me?
- how have I tolerated these situations in the past?
What are some simple stimulus control strategies?
- choosing a gym that is in direct route between home & work
- having a gym bag in the car with all required items for a workout
- laying clothing/gym gear out for early mornings
- writing down your weekly split/routine
- surround yourself with others who have similar health/fitness goals
What does willpower refer to?
it is a biological function that refers to the ability to ignore temporary pleasure or discomfort to pursue a longer-term goal.
What are some strategies to conserve willpower?
- planning in advance for moments of weak self-control
- plan ways to deal with specific obstacles/barriers
What are cognitive behavioural techniques?
Effective tools that influence behavioural change by targeting how people think and feel about being physically active.
What are the steps to using cognitive behavioural techniques for change?
- identifying problematic beliefs that are barriers to change
- change obstructive thoughts
- goal setting, feedback, decision making, self-monitoring
What does the growing interdisciplinary movement called Health at Every Size challenge?
The significance of promoting weight loss and dieting behaviour, it argues for a shift in focus to weight-neutral outcomes.
What guidelines should a PT focus on when considering Health at Every Size?
- continue to set healthy behavioral goals that are SMART
- long-term goals should focus on health not weight
- interventions should have a holistic focus and consider the emotional, physical, social, occupational, intellectual, spiritual and ecological aspects of health
- programs should focus on promoting self-esteem, self-efficacy, body satisfaction, body-size diversity
- interventions should focus on modifiable behaviours to improve health not weight
How can PTs teach clients effective decision-making skills?
by giving clients control over their own program participation
What pieces of info does a PT need to obtain when working with a new client in regards to their behaviour?
- past experience: apprehensions, comfort zones, abilities
- social-support network: at home, work, gym, social situations
- their attitudes, opinions, beliefs of physical activity
True or false, adherence is defined as the psychological drive that gives behaviour direction and purpose.
False, adherence refers to voluntary and active involvement in an exercise program.
Motivation is defined as the psychological drive that gives behavior direction and purpose.
Approximately what percent of the US population meets both aerobic activity and muscle strengthening guidelines?
20%
Which type of goal BEST represents the statement “I want to bicep curl 10lb dumbbells for 10 repetitions by April”?
Product goal
A personal trainer who is seeking clarification from a client by trying to restate the main points and feelings in a client’s communication is using which method of effective listening?
reflecting
“I will perform a full-body resistance-training workout twice every week” is an example of which type of goal?
process goal
Motivational interviewing is most commonly done during which stage of the client-trainer relationship?
planning
Clients who are beginning the basics of a particular movement and are ready for specific feedback are in which stage of motor learning?
associative
A prospective client tells you that he has been going for 2-mile walks a couple of times each week for the past two months, and that he joined the gym because he is finally ready to adopt a more structured workout regimen. What is this individual’s stage of change?
preparation
What occurs when a positive stimulus that once followed a behavior is removed and the likelihood that the behavior will reoccur is decreased?
extinction
When should behavior contracts and written agreements be revised or updated?
when goals are met or programs are modified
