FMCA Quizes
2.9 When a client is pursuing a SMART Goal, if the client fails to reach the goal, it is likely because Correct! a) the goal is somehow in conflict with their values. b) they are not motivated to change. c) they don't think it is important for them to change. d) they don't understand the risk of not changing. e) all of the above.
A It is important to not get tempted to skip the process of SMART Goal setting and "get on with it" without fully analyzing the values behind the goals. Common obstacles to achieving goals include goals that are: set by another person, based on extrinsic motivators, set too early in the Stages of Change process, not believable, have no clear rewards, and are not incorporated into a realistic and specific plan.
2.9 The primary coaching focus of the Maintenance stage in the Stages of Change model is helping the client to Correct! a) prevent relapse. b) identify appropriate change strategies. c) identify alternative ways to meet their needs. d) develop a behavior change plan. e) resolve ambivalence.
A Techniques that can be helpful in the Maintenance stage are: supporting self-efficacy, identifying negative self-talk, conducting a Functional Analysis to identify triggers, developing a coping plan, and planning for follow-up support.
2.9 Sylvia is an older woman who is attending coaching at the behest of her doctor and daughter. She feels pretty good, enjoys eating and trying new restaurants, loves bread, pasta, and sweets, and does not want to return to cooking meals. She admits that she could "lose a few pounds," that her joints ache, that her blood sugar is under control with Metformin, and that her grandchildren (who she loves playing with) wear her out, but says, "That happens when you get old. I'm too old to change now." In what stage of change is this client? Correct! a) Pre-contemplation b) Contemplation c) Preparation d) Action e) Maintenance
A In pre-contemplation, everybody thinks the client has a problem (e.g., the doctor, her daughter), but the client doesn't think they have a problem. They are not quite open to change yet.
2.9 For health behaviors to stem from intrinsic motivation, we must tap into these three innate needs: (choose the three innate needs from below) Correct! a) autonomy b) admiration c) competence Demonstrate and exert control over our environment. Challenging, yet attainable. d) relatedness Need to be in meaningful relationships; find our place in the social order e) deference
A To be the origin of our own actions; self-determined.
2.9 While most clients understand the importance of healthy lifestyle behaviors in disease prevention, very few are able to regularly implement those practices, which Dr. Fairies refers to as Correct! a) the intention-behavior gap. b) poor goal recognition. c) health indifference. d) resigned hopelessness. e) laziness.
A For those with the intention of improving lifestyle behaviors to manage chronic disease, only 3% of the population are able to maintain the four key health habits of not smoking, maintaining a healthy weight, regular physical activity, and eating plenty of fruits and vegetables. Intention only predicts 30-40% of behavior.
2.9 When setting SMART Goals, a client is more likely to be successful if they focus on a) changing or stopping an unhealthy behavior. b) achieving a new behavior. c) getting to the larger goal as quickly as possible. d) making the lifestyle changes recommended by their practitioner. e) all of the above.
B It is easier and more inspiring to achieve a new behavior than it is to change and give up an old behavior. It is important to tie goals to internal, intrinsic values, rather than the recommendations and values of others (extrinsic). Focus should primarily be on achieving the small, short-term goals that will carry a client toward their long-term larger goals.
2.9 When a client is aware that their behavior is resulting in negative consequences, but is ambivalent about changing and feels stuck, they are most likely in the ______________ stage of the Stages of Change model. a) Pre-contemplation b) Contemplation c) Preparation d) Action e) Maintenance
B The primary coaching goal for moving clients from Contemplation to Preparation is to help them resolve their ambivalence and choose to make the behavior change. Techniques might include: evaluating pros and cons; identifying and promoting new, positive outcome expectations; identifying personal strengths; and having clients state their next step.
2.9 Clients often don't enjoy many health behaviors (e.g., eating vegetables), making it essential for a health coach to a) be very clear about recommended health guidelines. b) be open-minded when brainstorming options with the client. c) push clients to try something new even if they don't like it. d) articulate the benefits of activities that you like. e) sigh heavily and give up on changing client behavior.
B It is important to help clients discover behaviors with intrinsic motivation. Don't try to force them to do something they don't like, build on something they already do like.
2.9 According to the Stages of Change model, clients will generally a) move in a linear route from Pre-contemplation to Maintenance. b) recycle through the stages a least once. c) move quickly through to the Action stage, then move back and forth between Action and Maintenance. d) get a bit stuck in the Preparation stage. e) all of the above.
B Most individuals find themselves "recycling" through the stages of change several times ("relapsing") before change becomes truly established. Only 5% of self-changers follow a linear route from Pre-contemplation to Maintenance without at least one setback.
2.9 Ben is a middle-aged man, who works long hours, helps out with his four young children, and struggles with chronic stress. His health concerns include Irritable Bowel Syndrome, irritability, and a family history of early heart attacks. He recognizes that he should take better care of himself, and identifies some possible options, including wearing a monitoring device, meditation, going to the gym, and riding his bicycle (which is currently broken). He says, "There's lot's to change, but I don't even know where to start." Based on Ben's stage of change, what would be the primary coaching goal for the first session? a) Help Ben to clarify why it is important to make lifestyle changes. b) Collaborate with Ben to prioritize one or two very simple steps to take. c) Collaboratively write nutrition, fitness, and stress management SMART goals. d) Schedule when Ben will go the gym and take a bike ride. e) Challenge Ben's beliefs that he cannot make time for lifestyle changes.
B Since Ben is in the contemplation stage of change, he is feeling overwhelmed and waiting for the "mythical magical moment to change." He is not ready to write or implement goals yet, as this would feel out of reach for him. The goal is to compassionately help him feel less stuck, and to gain a little hope that change is possible.
2.9 When clients consider behavior change, they compare themselves to a standard (e.g., medical guidelines, social concept of beauty), which impacts their motivation level. In which three comparisons below is a client most likely to put out high effort to make changes? (choose 3 answers) a) well below standard and depressed b) slightly below standard and frustrated c) at standard and eager d) slightly above standard and happy e) well above standard and blissful
B, C, D B - Often when clients feel frustrated, they are energized to create change. C - We want to always keep our goals within reach in order to stay motivated, yet they also need to keep us challenged. D - When clients are hopeless and depressed they give up and stop trying. Conversely, when clients are overly happy and blissful, they tend to coast and their effort drops. (complacent)
2.9 When assisting clients to move from Contemplation to Preparation in the Stages of Change model, it is essential to a) help clients identify rewards for positive behavioral change. b) develop a plan to prevent relapses. c) acknowledge and normalize ambivalence. d) formulate coping strategies for triggering situations. e) all of the above.
C Clients in the Contemplation stage are ambivalent about changing, and are not yet ready to make a commitment to take action. The focus is on examining options, emphasizing client control ("You are the best judge of what will be best for you."), improving the client's expectation that they can achieve positive outcomes, and normalizing fluctuations in commitment to change. If the coach gets too intense at this point, it is extremely easy for the client to step away due to their ambivalence.
2.9 When considering SMART Goals, at what stage in the Stages of Change model is it best to talk about setting goals and planning? a) Pre-contemplation b) Contemplation c) Preparation d) Action e) Maintenance
C When a client has reached this stage, they are feeling less ambivalent about the need to change, and are ready to focus on the process of creating new behaviors.
2.9 When a client publicly announces their plans to change their behavior, according to the Stages of Change model, this indicates a transition from a) Pre-contemplation to Contemplation. b) Contemplation to Planning. c) Planning to Action. d) Action to Maintenance. e) Maintenance to Termination.
C Announcing their new behavior is an important part of transitioning into the Action stage. Other activities include identifying pros and cons of various treatment or change options, lowering barriers to change, and enlisting social support.
2.9 Sylvia is an older woman who is attending coaching at the behest of her doctor and daughter. She feels pretty good, enjoys eating and trying new restaurants, loves bread, pasta, and sweets, and does not want to return to cooking meals. She admits that she could "lose a few pounds," that her joints ache, that her blood sugar is under control with Metformin, and that her grandchildren (who she loves playing with) wear her out, but says, "That happens when you get old. I'm too old to change now." What is the primary coaching goal for the first session with this client? a) Create a nutrition plan. b) Establish goals. c) Raise the client's consciousness about how change could benefit her. d) Encourage the client to maintain her current health behavior. e) Get the client to agree to taking some action steps to improve her health.
C It could be helpful to focus the client on her desire to play with her grandchildren, and that improving her energy and decreasing her joint pain could move her toward being able to more comfortably increase her activities with her grandchildren.
2.9 Of the five types of motivation described by Dr. Faries, the most likely to lead to positive health behavior change is a) Amotivation (e.g., resistant to exercise). b) Extrinsic Motivation (e.g., exercise to lose weight). c) Intrinsic Motivation (e.g., exercise for pleasure). d) Other Determined Extrinsic Motivation (e.g., exercise because your practitioner said you should). e) Self-Determined Extrinsic Motivation (e.g., exercise to not feel guilty).
C Motivation based on inherent enjoyment of a behavior is most likely to be maintained and to provide positive health benefits.
Question 5 1 / 1 pts 2.9 When a client is working on SMART Goals, in the Action stage of the Stages of Change model, the focus should be on a) brainstorming goal possibilities. b) writing clear and specific goals. c) re-evaluating and revising goals. d) moving on to new goals. e) all of the above.
C Once a client has begun taking action on their goals, it is important to continue to sculpt the goals to best meet the needs of the client, which may include considering the ways these behavior changes affect the client's environment, emotions, and self-concept.
2.9 Choose the best answer that describes how the experience of transformation is different than making a change. a) Goal oriented b) Measurable c) Occurs in the present moment d) Specific e) All of the above
C One feels "transformed" when they experience a major shift in perception and understanding that motivates a change in behavior. Change is goal oriented, measurable, past and future based, and is a reaction to an identified problem. All transformation involves change. All change does not involve transformation.
2.9 When a client is taking action consistently and has successfully changed their target habit or behavior for two months, according to the Transtheoretical Model of Change theory, they are in the __________________ stage of change. a) Pre-contemplation b) Contemplation c) Preparation d) Action e) Maintenance f) Termination
D A client transitions to the Maintenance stage when they have been able to sustain the behavior change for six months. This is an important time to discuss the possibility of relapsing. If moving from Preparation to Action comes easily, clients can often underestimate what it will take to stay in Action and make it to the Maintenance stage.
2.9 In the Stages of Change model, the coaching goal for clients in the Pre-contemplation stage is to help clients a) begin to think about negative consequences of their behavior. b) consider change as a possibility. c) identify appropriate change strategies. d) A and B only. e) A, B, and C
D Discussion of change strategies is not appropriate until the client reaches the Preparation stage. In Pre-contemplation, the client has not yet accepted that there is a need for change. The goal is to move them to the Contemplation stage, where they recognize the need to change.
2.9 Sylvia is an older woman who is attending coaching at the behest of her doctor and daughter. She feels pretty good, enjoys eating and trying new restaurants, loves bread, pasta, and sweets, and does not want to return to cooking meals. She admits that she could "lose a few pounds," that her joints ache, that her blood sugar is under control with Metformin, and that her grandchildren (who she loves playing with) wear her out, but says, "That happens when you get old. I'm too old to change now." If the client gives you an opening to give her information about food choices, what should be the primary focus of the information you share? a) Understanding the different IFM food plans. b) How to lose weight with nutrition changes. c) Identifying food allergies. d) The association between nutrition and joint pain and energy. e) All of the above.
D It is important to help the client understand the general concept that healthier food choices would increase her energy and decrease her joint pain, thereby moving her toward her desire to play more with her grandchildren. Since this client is in the pre-contemplation stage of change, the coach must be cautious to not overwhelm her with information.
2.9 What are the defining characteristics of being in preparation? a) Ambivalence b) Announce an actual start date c) Planning to take action within the very next month d) answers A and C e) answers A, B and C
D People in preparation are ambivalent. And while they plan to take action within the next month, they don't announce an actual start date. Announcing a start date, along with the intended change, is what moves the client from preparation to action.
2.9 One of the benefits offered by the Trans-theoretical Model of Stages of Change is that a) it can be used as a road map for those embarking on changing a habit or behavior, which can reinforce staying the course. b) the process can be conceptualized as a series of steps or stages. c) it depicts the process that people go through when they successfully make changes in their lives. d) it allows counselors with widely differing theoretical orientations to share a common perspective. e) all of the above.
E
2.9 When a client exercises, he/she will have a subjective exercise experience, where the brain interprets whether the activity is pleasurable or painful. Moderators that make a positive interpretation of exercise more likely include all of the following except a) self-efficacy. b) fitness level. c) experience. d) confidence in one's ability. e) high exercise intensity.
E High intensity exercise is often promoted, but may not be good for clients new to exercise or who are not fit if it causes a negative interpretation of exercise and lowers motivation.
2.9 Ben is a middle-aged man, who works long hours, helps out with his four young children, and struggles with chronic stress. His health concerns include Irritable Bowel Syndrome, irritability, and a family history of early heart attacks. He recognizes that he should take better care of himself, and identifies some possible options, including wearing a monitoring device, meditation, going to the gym, and riding his bicycle (which is currently broken). He says, "There's lot's to change, but I don't even know where to start." Ben discussed interest in doing some meditation to help manage his stress, but he is not sure where to start. As a coach, what would be your best approach? a) Advise Ben to start meditating for 5 minutes a day. b) Tell Ben that since he doesn't know where to start, he must not be ready for change. c) Recommend that Ben commit to joining a daily meditation group. d) Work with Ben to create SMART goals for a meditation practice. e) Explore what might be a first step, such as breathing for a minute or two throughout the day.
E Since Ben is in the contemplation stage of change, you want to help him figure out the next step towards the preparation stage, but not pressure him to commit to actions that might feel out of his reach. Breathing for a minute or two every time he picks up the phone or is at a stoplight begins the process of Ben connecting with his breath, and allows him to feel a sense of accomplishment.
2.9 Goal setting with clients the SMARTER way includes Evaluating and Revising goals. This is an important step in the process because a) being flexible will help clients adjust their goals rather than give up on them. b) if goals are too easy, they won't be worthwhile. c) if goals are too tough, clients will start thinking the idea of goal setting is worthless. d) narrowing a goal sometimes helps maintain focus on the small victories. e) all of the above.
E Steps that can support the process of evaluating and revising goals include: sharing your goals with friends and family; asking someone to hold you accountable to your goals; writing your goals where you will see them often; and checking your progress regularly.
2.9 The acronym SMART Goal stands for
Specific Measureable Attainable Realistic Time-bound Specific Know what you will do and how. Able to answer the questions: who, what, where, when, which, why. Measureable Concrete facts that identify when the goal has been attained. Attainable Able to visualize the path. Within reach, with clear actions that will produce results. Realistic Able to visualize the results. Resources to attain the goal are available. Time-bound Realistic time frame to achieve goals. Make it public.
