Ch 4 - PTC

Compliments

"I" statements ("I think you are working really hard at this") and put attention onto the fitness professional, not the client.

applying motivational interviewing

-uses targeted questions to help clients visualize their ideal state of being to develop a higher sense of intrinsic motivation -statements and questions are specifically chosen to either help a client maintain a current positive behavior or craft the thought process around changing a negative one -

Which of the following is one of the strongest determinants of physical activity in adults?

Self-efficacy

Affirmations

-Positive statements about character strengths. -show appreciation for clients and their strengths -are different than compliments -("You paid very close attention to technique today") -benefits of affirmation include enhancing self-efficacy, encouraging persistence, decreasing defensiveness, supporting momentum for change, and improving client's feelings of support

self-discrepancy

-An internal conflict that occurs when an individual compares their actual self with their ideal self. -People take in information about their current self, and if a discrepancy is perceived between where they currently are and the ideal version of where they think they should be, they perform behaviors to reduce the discrepancy between the two states. -if a client's idealized best self is a person who exercises four times per week, but in reality they only exercise sporadically, that realization of a discrepancy may be just the information needed to trigger an increased desire to change. -Without a perceived discrepancy, there is no motivation

Some common time management strategies include the following:

-Assigning priorities to daily tasks and completing the more important ones first -Not accepting every request for one's time; keeping hours open for unexpected events and personal needs -Turning key tasks into repetitive habits -Scheduling buffer time between important tasks -Implementing systems of organization -Eliminating nonessential tasks -Limiting time spent on empty activities like scrolling through social media feeds

precontemplation

-Client does not exercise and is not planning to start exercising within 6 months. -may be here because they are not informed about the consequences of inactivity or they do not know about the health benefits of exercise. -Alternatively, they may have tried before, failed to feel confident or maintain consistency, and have become demoralized by their inability to stick with an exercise routine in the past -Cognitive strategies may be the best option for those in the precontemplation stage.

Outcome goals

-Goals focused on the end result. -hey represent the final achievement that hard work will inevitably lead to, such as winning a race or seeing a desired weight on the scale.

Some examples of how fitness professionals can coach a client from a negative to a more positive state include the following:

-Help clients become aware of their negative thought process by making a list of any negative thoughts they might have toward exercise. Keeping a log can help improve awareness of frequency and content of negative self-talk (Hardy et al., 2009). -Help clients come up with a list of positive thoughts they might use toward exercise. For example, I can do it, I can keep going, and I will stick with it. -Help clients notice negative thoughts, stop those negative thoughts, and translate those negative thoughts into something positive from the list of positive thoughts they have generated. -Remind clients that thoughts are just thoughts. They are simply things that pop in and out of the conscious mind and do not represent who a person is or what a person may or may not be capable of. -Remind clients of their goals when they demonstrate negative self-talk.

Active listening

-Listening style that involves having genuine interest in what the speaker is saying; requires the listener to fully concentrate to understand the speaker's message. -fitness professionals should incorporate the following techniques into their conversations with clients: Asking questions Reflecting Summarizing Affirming Asking permission

Process goals

-Tasks that are pursued to reach a final outcome. -refer to the daily and weekly tasks that need to be done to reach that final outcome. -

contemplation

-When a person is thinking about implementing change but has not yet taken any steps to get started; an individual may take action within the next 6 months. -may benefit more from information about the health benefits for exercise (a cognitive process) than they would from adding cues or prompts to engage in exercise (a behavioral process) -begin to see more value in exercise participation, but misconceptions may still be present. In fact, an equal balance between benefits and negatives (i.e., being of two minds about something) may produce ambivalence -education is one of the best strategies to use with people in

Stages of Change Model

-also known as the Transtheoretical Model of Behavior Change -views change as a process that involves progression through a series of stages -These stages are precontemplation, contemplation, preparation, action, and maintenance -People move through the stages of change by using behavioral and cognitive processes of change strategies.

summarizing

-are a series of reflections. -draw all the important points of the conversation together and allow clients to clarify either what they have said or how the fitness professional has interpreted what they have said -three types: collecting summaries, linking summaries, and transitional summaries

achievable short-term goals...

-that provide a focused path, motivation, and confidence when each short-term goal is accomplished -help focus clients' attention on the now and help them narrow down goals to the ones that are the most important and doable -

asking permission

-it is important to recognize that people respond best when they have the autonomy to make their own choices instead of being told what to do. -Asking first puts the decision in the clients' hands and will help them to be more open to new experiences. -For example, asking questions like, Do you want to try a fun new technique? or What cardio equipment would you like to use for your warm-up? -honors respect, choice, collaboration, and the life experiences the client is already bringing to the encounter

importance of effective communication skills

-it's not only what fitness professionals say, but how they say it. Good communicators should strive to do the following: Create a safe environment where challenging and emotional issues can be discussed. Clear away distractions such as cell phones and focus on the client. Ask questions to understand the meaning of what the person is saying. Observe nonverbal cues such as body language. Provide empathy and validation

Ambivalence

-occurs when the positives and negatives surrounding a potential change are equal with each other, creating a situation where the individual is unsure of which side of a decision is best. -defining feature of the contemplation phase -

SMART goals

-stands for specific, measurable, attainable, realistic, and timely -work through four functions that include the following: --Directing attention and effort toward relevant activities and away from counterproductive activities --Energizing action and effort --Influencing persistence of effort --Leading people to seek out goal-relevant information

coping plans

A behavior change technique that involves anticipating barriers to goal action and proactively preparing strategies that prioritize intentional behavior over counterproductive habitual responses.

implementation intentions

A behavior change technique that links a goal-directed response to situational cues by specifying when, where, and how to act. -are specific plans that drive behavior by identifying cues toward action. -a client connects the exercise routine with a specific event, such as during a lunch break or after work

Self-determination theory

A broad theoretical framework for the study of human motivation. -

third space

A communal space, separate from home or work, where the client experiences their own sense of identity and relationship to others. -Should elicit a playful mood, helping clients to feel like they are in a home away from home. -Consider before joining a gym: Are there a variety of training options to choose from? Is the training environment supportive? Does it look like they will fit in with the club's culture? What is the cost of a membership and personal training? How convenient is the location? Are the facilities clean and neat?

planning

A concrete representation of when and where exercise will occur. -a self-regulatory strategy -Regular exercisers report higher levels of self-monitoring as well

intention

A construct that captures motivational factors that influence behavior. It indicates how hard people are willing to try and how much effort they are planning to exert.

What do the health benefits of exercise depend on?

A long-term commitment

Which behavior change technique allows individuals to identify external triggers that lead them to behave in certain ways? Coping planning Enlisting social support Self-monitoring Action planning

Self-monitoring is a strategy that allows clients to get the information they need to evaluate their goals.

rapport

A relationship in which two people understand each other's ideas, have respect for one another, and communicate well.

collecting summaries

Short sentences that continue the client's thoughts and add momentum to the conversation.

autonomy

Acting in accordance with how one wants to behave.

At what point should a client's first exercise program be designed?

After the initial consultation

What are cognitive strategies intended to do?

Alter the way someone thinks about an activity

What is the defining feature of the contemplation phase?

Ambivalence

perceived behavioral control

An evaluation of whether one has the means, resources, and opportunities to perform a behavior.

A client is asked, "Why do you want to lose weight?" This is an example of what kind of question? Closed-ended Open-ended Contemplation Directive

An open-ended question allows a client to give more information.

When a person is ambivalent about changing, what stage of change are they likely in? Precontemplation Maintenance Contemplation Action

For people in the contemplation stage, the pros and cons of change may be in balance, causing ambivalence. -Contemplation

Subjective norms

Belief that an important person or group of people will approve and support a behavior.

When a Certified Personal Trainer wants to enhance a client's self-efficacy by breaking down exercises or goals into easier-to-achieve tasks, what behavior change technique are they using? Experience mastery Verbal persuasion Set specific tasks Provide instructions

Breaking down tasks into manageable subcomponents is a feature of setting specific tasks.

behavior change techniques (BCTs)

Client interventions that are used to change some determinant of behavior. -page 87 is the chart with a lot of information

motivational interviewing

Client-centered, directive method for enhancing intrinsic motivation to change by exploring and resolving ambivalence. -provides directions for how to get clients out of the contemplation phase, over their ambivalence, and ready to act -empathetic, collaborative, nonconfrontational, goal-oriented style of communication that helps clients discover their own personal reasons for making a change in their life.

other factors associated with physical activity

Cognitive and emotional factors, attitudes, intention, outcome expectations, stress, perceived behavioral control, and selfefficacy

Open-ended questions

Nondirective questions that can't be answered with a simple yes or no; they require critical thinking to formulate a response. -important for building collaborative relationships with a client because they invite discussion and can be used to explore the client's own perceptions and concerns. -Example that elicit optimism for change may include the following: How might you go about making this change? What challenges do you see and how can you plan to overcome them? What work are you prepared to do to reach your goal? What have you tried in the past to reach your fitness goal?

Closed-ended questions

Directive questions that can be answered with one word, typically a yes or no.

What is nonverbal communication?

Information derived from bodily cues, not speaking

positive selftalk

Internal dialogue in which the individual interprets feelings and perceptions, regulates and changes evaluations and convictions, and gives himself or herself instructions and reinforcement. -Positive self-talk is a form of encouraging and motivating internal dialogue that increases self-efficacy. -The second is to help them move past their negative self-talk.

fitness professionals should work hard to exhibit the following qualities to create an inclusive environment that keeps clients coming back:

Look professional: neat, clean, and appropriately dressed. Take time to build a trusting relationship with new clients. Ensure that the client feels heard and understood. Ensure the client's safety when exercising. Build community by making a client's exercise routine a collaborative effort

A good first impression

Making eye contact (if culturally accepted) Introducing oneself by name and asking the client's name Smiling Shaking hands with the client (if culturally accepted) Remembering the client's name and using it Using positive body language

Without a perceived discrepancy between a client's current state and making a change, what is lacking? Self-efficacy Positive outcome expectation Autonomy Motivation

Motivation - refers to confidence

self-monitoring

Observing, measuring, and evaluating one's own behavior, often in the form of a diary or log.

self-efficacy

One's belief that they can complete a task, goal, or performance; also known as self-confidence. -one of the strongest determinants of physical activity in adults

What stage of change is a person in if they are planning on exercising within the next 6 months? Contemplation Precontemplation Maintenance Action

People in the contemplation stage are planning on exercising within the next 6 months.

What stage of change is a person in if they are not planning on exercising within the next 6 months? Precontemplation Maintenance Action Contemplation

Precontemplation refers to not planning to exercise within the next 6 months.

affective judgment

Referring to expected pleasure or enjoyment.

determinants of behavior.

Refers to the psychological, social, or environmental factors that influence behavior. -including motivation, self-efficacy, stage of change and intention, self-regulation, exercise history, body weight, stress, social support, access, time constraints, and characteristics of the exercise behavior -Self-determination theory variables, including autonomous motivation and perceived competence, have also been found to be related to

decisional balance

Reflects the clients' weighing of the pros and cons of changing.

reverse listing technique

Replacing negative statements with positive statements.

To help individualize goals for clients, ask open-ended questions to more clearly understand their intrinsic motivation and barriers to new lifestyle habits.

Some examples include the following: What are your biggest concerns about your health and exercise habits? What work are you prepared to do to reach your goal? How motivated are you to reach your goal? What have you tried in the past to reach your goal? Did it succeed? Why or why not? What has prevented you from reaching your goal in the past? Have you already started making changes to your exercise or dietary habits?

What is another term for vague goals?

Subjective goals

linking summaries

Summaries that tie together information the client has presented, perhaps even from previous sessions.

transitional summaries

Summaries used to wrap up a session or announce a shift in focus

Change talk

Talk that reflects movement of the person toward behavior change. -can be identified when a client voices dissatisfaction with the status quo, advantages of change, intention to change, and optimism for change -admits, "I'm afraid I may not be able to play with my kids if I don't get into better shape," is using change talk, whether they realize it or not.

Sustain talk

Talk that represents and predicts movement away from change. -encompasses statements made by clients that support current behaviors, such as physical inactivity -can be identified when a client voices advantages of the current status quo, disadvantages of changing, intention not to change, and pessimism about change. -client who says something like, "My busy lifestyle makes it too hard to schedule time to work out," is using sustain talk

stopping technique

The act of saying "stop" out loud to undesired statements.

maintenance

The client has been exercising for more than 6 months and is working to prevent relapse. -These individuals do not use cognitive change processes as frequently as they would have in the action phase, and they are less tempted to relapse. At this stage, their self-efficacy levels are generally high -may use certain behavioral strategies, such as inviting other people to exercise with them or making plans to make up missed sessions, to avoid relapsing back to earlier stages.

action

The client has made specific modifications in their exercise routine within the past 6 months. -As benefits increase and negatives decrease, people move toward the maintenance end of the stages of change continuum -it is important to not allow short-term slip-ups to turn into a departure from the exercise program. Fitness professionals should continue to discuss barriers to exercise and help clients anticipate any potential roadblocks that could arise. -specific plans should be put in place in advance if a client misses a scheduled session with suggestions for maintaining progress, such as supplying preplanned "emergency" workouts that they can do from home.

preparation

The client intends to act in the near future, usually within the next month. -This is a stage where fitness professionals will most likely meet the most individuals. -They know they want to start exercising, and they are making the right moves to join a club and potentially even attend a personal training consultation. Individuals in this stage may already partake in multiple forms of physical activity, just without any form of structure or consistency. -can help clients plan when, where, and how to fit exercise into their schedule. -is all about establishing a plan that clients feel confident they can follow. Building intrinsic motivation for exercise is also important for developing consistency in this group. -motivational interviewing can be a highly beneficial BCT to use with all new potential clients, helping to uncover their underlying desires and turn a plan into action.

What does the term decisional balance refer to?

The client's weighing of the pros and cons of changing a behavior

attitudes

The degree to which a person has a favorable or unfavorable evaluation of the behavior of interest.

outcome expectations

The expected positive and negative consequences of a behavior.

imagery

The process created to produce internalized experiences. -process of imagining a situation and experiences that support or enhance exercise participation -Clients can imagine themselves approaching exercise or physical activity with greater confidence. They can mentally rehearse their performances with positive feelings and outcomes, and they can imagine positive outcomes to contribute to continued motivation. Imagery may improve self-confidence, either directly or through reducing anxiety

Reflective listening

The process of seeking to understand the meaning of the speaker's words and restating the idea back to the speaker to confirm that they were understood correctly.

psyching up

The process to get oneself into a state of psychological readiness for performance. -

What is a client-centric coaching style that helps enhance their desire to change by resolving ambivalence? Motivational interviewing Affirming Collecting summaries Reflective listening

The purpose of motivational interviewing is to help clients resolve ambivalence.

stress

The state of mental or emotional tension from demanding circumstances.

Which of the following is a question that may provoke resistance? What might work for you? What makes you think you are not at risk? What might you want to change? If you decided to make a change, what might you do?

What makes you think you are not at risk?

Questions That Promote Change

What might you want to change? What do you think might happen if you didn't make any changes? Do you think this could work for you? If you decided to make this change, what would be different in your life?

Energy imagery

When a person creates mental images that increase energy and/or relieve stress.

Appearance imagery

When a person imagines appearance or healthrelated outcomes.

Technique imagery

When individuals mentally rehearse their technique. -involves focusing on exercise technique

autonomous motivation

When motives for exercise relate to valuing the outcome, when exercise is consistent with the client's identity, or when the client enjoys exercise.

Cognitive Fusion

When people believe the exact content of their own thoughts. -hould use motivational interviewing techniques to help the client work through mental roadblocks. For example, asking clients, "If you let this thought be true, would it help you reach your goals?" is one way to help them realize the negative value of a thought for themselves.

Questions That Provoke Resistance

Why don't you want to change? What makes you think that you're not at risk? Why don't you just do this? Why can't you make this change to your schedule?

Which of the following is a question that may provoke resistance? What might you want to change? Why don't you want to change? What might work for you? If you decided to make a change, what might you do?

Why don't you want to change? This question may lead the person to defend the status quo.

There is evidence to support the relationships between resistance training participation

and affective judgment, self-efficacy and perceived behavioral control, self-regulatory behaviors, and intention -In other words, people tend to engage in resistance training when they think it feels good, believe they can do the exercises correctly and overcome barriers, can self-monitor and makes plans, and have high levels of motivation.

reflecting

are conversational techniques that express the supposed meaning of what was just heard and form the basis of the previously discussed reflective listening technique. -both subtle and powerful and represent an opportunity to make sure what each person says is accurately understood; it gives clients an opportunity to ensure they said what they thought or felt -powerful because they help clearly demonstrate that active listening is occurring. -is advantageous because it can emphasize why a client feels ambivalent about change, what their strengths are, and why change is important to the client -are one of the best ways to demonstrate empathy with a client

The training environment....

can either hinder or foster intrinsic motivation. Staff members who are friendly, caring, and supportive of clients' goals can have a positive impact on whether a client continues to return. Therefore, the environment that Certified Personal Trainers work in reflects who they are and will ultimately determine the type of clients they attract. For this reason, the most successful health clubs work hard to create a third space environment for their members.

The Stages of Change model also includes processes of...

change, self-efficacy, and decisional balance.

avoiding arguments

fitness professionals should present a variety of exercise options and solutions for driving change that the client can choose from until ones that are manageable and appealing are identified -Carefully wording questions is important to avoid arguments against change.

Negative self-talk

form of inner dialogue that critiques a person's own abilities.

Self-regulatory BCT

have previously been identified as important for helping individuals adopt exercise regimens and are associated with positive outcomes

To map out a successful intervention for the client, some of the essential elements include...

identifying the determinants of exercise behavior, understanding theory and techniques to drive behavior change, identifying client needs in the initial session, and determining the most effective style of delivery (which includes effective communication skills)

Several techniques have been shown to enhance self-efficacy for physical activity,

including action planning, reinforcing effort or progress toward exercise, providing instructions, self-monitoring, and social support

Self-monitoring logs...

provide the client with several benefits, including the following: -Opportunity to observe progress over time, which can enhance confidence -Accountability if the client knows that the fitness professional is going to ask to see the log -Awareness of precursors to behavior, which can serve to identify barriers or facilitators of exercise

Self-monitoring

provides information needed for setting realistic goals and assessing progress toward those goals. Allows individuals to identify external triggers that lead them to behave in certain ways

Goals

represent the what that sits at the crossroads of how and why, where why represents a client's values and how represents the way the goal will be achieved. -can be broken down into subgoals that should be well-defined and trackable

What is the practice of identifying a negative inner narrative and replacing it with positive statements? Stopping Reverse listing Imagery Cognitive fusion

reverse listing

Methods to reduce negative self-talk include

reverse listing and the stopping technique.

making a goal SMART

should adhere to the following criteria: -Specific --The intended goal outcome must be clearly defined. For example, "I want to lose weight" is a vague goal with no objective way to know when it will be accomplished. A specific goal says, "I want to lose 5 pounds (2.2 kg)," which precisely details that the goal will be achieved when 5 pounds are lost. -Measurable --Goal progress must be objectively measured and tracked over time with hard data, not based on subjective reports. For example, regularly scheduled weigh-ins can track a weight loss goal by recording the date and the client's scale weight each time. This data is then used to objectively track progress toward the specific outcome that is desired. -Attainable --A goal must be challenging yet achievable by the client. If a goal is too easy, the client may not put in sufficient effort. Similarly, if the goal is too challenging, the client may become discouraged and stop following the fitness plan. -Realistic --Realistic goals are relevant to the client's life. Even though something may be technically possible, it may not be possible for a particular client when viewed in the context of their lifestyle. For example, it may be unrealistic for a busy business owner, who works 10 or more hours per day, to lose 100 pounds (45 kg) in 6 months. It is up to the fitness professional to make sure that client expectations are managed accordingly. -Timely --To properly measure and track goals, they need to have specific timeframes with frequent check ins. The timeframe to complete a goal should be as challenging and realistic as the intended outcome. It should be short enough to build urgency, but long enough to allow for one or two slip-ups along the way. goal that is not SMART could be, "I want to lose some weight so that I look better on the beach this summer." This goal has no specific outcome defined, no way to track progress or know how it will be accomplished, and a vague completion window, and depending on the beginning state of the client's fitness, it may or may not be attainable and realistic within their lifestyle. To better serve that client, the goal could be reframed to, "I want to lose 5 pounds (2.2 kg) of body fat in 6 months, by running for 1 hour per day, 4 days per week in my free time after the workday is over."

Two planning behavior change techniques...

that are often used are called implementation intentions and coping plans.

Initial goal-setting sessions...

with new clients should be focused on developing long-term goals first based on their personal values. To set overarching long-term goals, fitness professionals may ask clients some of the following questions: -What do you want to accomplish in the next 6 months? -What do you want to accomplish in the next year? -What does success in fitness look like to you?