NASM CH. 4 - BEHAVIORAL COACHING

cognitive strategies including working to understand client's perceived negatives and dispel myths, and providing them with info and knowledge, should be applied in the ____________ stage of change

1. precontemplation -but CPTs don't typically work with people in this stage because even walking into a gym shows contemplation

cognitive strategies to drive behavior change: ways to psych up a client

-music -motivational videos -dancing -specialized warm-up

motivational interviewing - statements and questions are specifically designed to: (2)

-help the client maintain current positive behavior -craft the though process around changing a negative behavior

other aspect of stages of change model - processes of change

-how individual moves through the stages by using behavioral and cognitive processes of change strategies -ex. self-monitoring, enhanced confidence, perceived benefits -early stages: clients apply more cognitive processes (info about health benefits) -later stages: rely more on behavioral processes (adding cues or prompts to engage in exercise

once client is ready to change, the next step in motivational interviewing is to

-identify how motivated a client may be to move on to the next stage -ask them to rate 1-10 on importance of change, confidence in themselves, and readiness -6 or below shows they don't have strong enough commitment to change (need more coaching in that area) -7+ is a good place to start

4 essential elements of behavioral coaching

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

cognitive strategies to drive behavior change: term for imagining a situation that supports & enhances exercise participation

-imagery -mentally rehearse performances with positive feelings -reduce anxiety -appearance imagery, energy imagery, technique imagery

stages of change / transtheoretical model of behavior change model step 2: contemplation

-individual does not currently exercise -planning to start within six months

stages of change / transtheoretical model of behavior change model step 1: precontemplation

-individual does not exercise -not planning to start within the next six months

stages of change / transtheoretical model of behavior change model step 4: action

-individual has been exercising consistently for less than six months

stages of change / transtheoretical model of behavior change model step 5: maintenance

-individual has been exercising consistently for six months or more

stages of change / transtheoretical model of behavior change model step 3: preparation

-individual planning to begin exercising regularly soon -has taken steps toward it (like getting gym membership) -may be sporadically exercising

BCTs used to promote self-regulation for a client (4)

-make a plan -identify coping responses -set SMART goals: specific, measurable, attainable, realistic, timely -promote self-monitoring: client should keep a record of behavior to enhance adherence to the program

5 steps of stages of change / transtheoretical model of behavior change model

1. precontemplation 2. contemplation 3. preparation 4. action 5. maintenance

cognitive strategies to drive behavior change: imagery - when client imagines appearance or health-related outcomes

appearance imagery

the degree to which a person has a favorable or unfavorable evaluation of a behavior is known as

attitude

acting in accordance with how one wants to behave:

autonomy

the active elements for intervention strategies that affect the determinants of behavior are known as _______ ______ __________

behavior change techniques (BCTs)

client's plan "When I am done with work, I will run for 30 minutes." What are they doing?

forming implementation intention: linking goal-directed behaviors with opportunities to act

behavioral strategy to enhance exercise adherence: goal-setting (4 functions)

-**self-regulation provides the basis for goal-directed action 1. direct attention and effort toward relevant activities 2. energizing action and effort 3. influencing persistence and effort 4. leading people to seek out goal-relevant info

aspects of communication: summaries (3 types)

-a series of reflections -collecting, linking, transitional

enhancing self-efficacy - 5 aspects

-action planning (implementation intentions & coping plans) -reinforcing effort and progress toward goals -providing instructions -self-monitoring -social support

aspect of communication where CPT has an attitude of genuine interest and understanding it on a deeper level

-active listening -pay attention, hold any internal dialogue, avoid distractions, eye contact, feedback at appropriate times -take time to reflect / paraphrase what client said

act of showing appreciation for clients and their strength is providing ___________ for the client

-affirmations -ex. "you paid very close attention to technique today!" -enhance client's self-efficacy -NOT just compliments

enhancing self-efficacy: action planning through coping plans

-anticipating barriers and creating alternative plans -planning does not turn good intentions into behavior for people with low self-efficacy (in contemplation stage) so must review barriers that have already risen

self-determination theory variables

-autonomous motivation: motives for exercise relate to valuing the outcome, when exercise is consistent with client's identity, when they enjoy exercise -perceived competence

communication - talk that shows movement toward a change

-change talk -client voices dissatisfaction with current state, advantages of change, optimism -may not notice they are using change talk! "I'm afraid I may not be able to play with my kids if I don't get into better shape"

enhancing self-efficacy: aspects of self-monitoring

-client can identify external triggers that lead them to behave in certain ways (ex. less likely to exercise if they did not sleep enough) -use exercise log and/or food journal, notes on calendar, fitness tracker app -they can also note how they felt before and after workout and which exercises they enjoyed

self-discrepancy - feedback loop thought process to drive behavior

-client takes in info about current self -if discrepancy is found between that and their ideal self / where they think they should be, perform behaviors to reduce the discrepancy between the two states -the realization can trigger an increased desire to change -without a perceived discrepancy, there is no motivation to change

cognitive strategies to drive behavior change: term for when people believe the exact content of their own thoughts

-cognitive fusion -problematic when it is regarding negative self-talk -CPT say "if you let this thought be true, would it help you reach your goals?

characteristics of good communicators (5)

-create safe environment: client can discuss challenging/ emotional issues -no distractions -ask questions to understand meaning -observe nonverbal cues -provide empathy and validation

term defined as the generic, modifiable factors that impact behavior

-determinants -BCTs affect these

BCTs used to manage social influences for a client (2)

-encourage social support: ask specifics on how they will get it -foster discipline: skills for resisting social pressure

cognitive strategies to drive behavior change: imagery - when client uses mental images to increase energy and relieve stress

-energy imagery -"I will feel good when I exercise"

the impact that family members, peers, or coworkers have over someone's decision to exercise describes which term

-group influence -NOT societal influence - which refers to the effect that society in general has on behavior

outcome vs. process goals

-outcome: refer to goal consequences & represent the final achievement (winning a race, seeing desired number on scale) -process: the daily/weekly tasks to reach that final outcome; progress milestones (schedule 1 hour of practice each day after school)

cognitive strategies to drive behavior change: (3)

-positive self-talk -imagery -psyching up

other aspect of stages of change model - decisional balance

-process of weighing the + and - outcomes of engaging in / increasing exercise behavior -move toward maintenance as benefits increase and negatives decrease

other than the 5 steps, the stages of change model also includes: (3)

-processes of change: how they move through the stages by using behavioral and cognitive processes of change strategies -self-efficacy -decisional balance: weighing positive and negative outcomes of engaging in or increasing exercise behavior

benefits of motivational interviewing

-provides directions for how to move forward from contemplation stage and their ambivalence -get them ready to act -an empathetic, collaborative, non-confrontational, goal-oriented style of comm -helps client discover their own reasons for making change

cognitive strategies to drive behavior change: ______ _______ and the ____ _________ are ways to move past negative self-talk

-reverse listing: identify negative inner narrative and replace with positive statements -stop technique: literally say "stop" out loud when you identify negative thought patterns -can keep a list of negative self-talk to raise awareness of frequency and content -list positive thoughts as well! -remind client of their goals

BCTs used to lead client to improved self-efficacy (4)

-set specific tasks: progressive goals and easier-to-achieve tasks along the way -provide instructions -practice for mastery: frequent and with feedback -communicate positively

components to a "third space" as the environment to exercise

-special, communal, separate from home or work -client experiences their own sense of identity and relationship with others -"home away from home"

enhancing self-efficacy: action planning through implementation intentions

-specific plans that drive behavior by identifying cues toward an action (where, when, how) -connect exercise routine with a specific event (ex. during lunch break, right after work)

SMART goal components

-specific: objective -measurable: quantifiable data -attainable: challenging yet achievable -realistic: relevant to client's life -timely: specific timeframes and frequent check-ins

BCTs used to lead to client's positive outcome expectations and attitudes (3)

-supply information: science of health benefits -prompt anticipated regret: clients should imagine how their life would change if they changed behavior, compared to the consequences of not -apply motivational interviewing: guiding questions, resolve ambivalence about change

communication - talk that encompasses statements made by clients that support current behaviors, such as physical inactivity

-sustain talk -client may voice advantages of current situation, disadvantages of changing, intention not to change, pessimism -complaints about time

cognitive strategies to drive behavior change: imagery - focusing on exercise technique

-technique imagery

strategies such as listening to the needs/desires of the client and connecting their goals to evidence-based solutions, and outlining small, achievable goals, are used by CPTs for people in the __________ stage of change

2. contemplation -CPT has lots of influence on what person decides to do in this stage -person begins to see value but misconceptions are still present (ambivalence) -people in this stage are low in self efficacy so start with small goals

strategies used when CPT meets the individual and plans when, where, and how they will exercise, and begins to build intrinsic motivation through motivational interviewing to develop consistency

3. preparation -person may have joined a gym and be exercising sporadically but plan to start a formal plan within the month

strategies including continuing to discuss barriers and prepare for potential roadblocks, and NOT allowing short term slip-ups to turn into a departure from the program, are used by CPTs in the _______ stage in the model

4. action -make a specific plan if client misses a session, could be preplanned "emergency" workouts they can do from home

using behavioral strategies such as inviting others to join workout and consistently making up missed sessions are used in the _________ stage

5. maintenance -client's self-efficacy levels are generally high here

stage of change where client has been exercising but for less than six months

action

level of commitment to a behavior or plan of action:

adherence

type of summary - CPT says short sentence that continue a client's thoughts to keep a conversation moving and stay on track

collecting summary

stage of chance when person is ambivalent about changing

contemplation

the generic, modifiable variables that cause a behavior are known as __________ of behavior

determinants

what BCT is a specific plan that drives behavior by identifying cues toward action

implementation intention

the construct that captures motivational factors that influence behavior & indicates how hard people are willing to try and how much effort they plan to exert IS CALLED

intention

type of summary - tie together info presented over an entire conversation or multiple conversations over time

linking summaries

examples of determinants of behavior

motivation, self-efficacy, social support, self-regulation, exercise history, body weight, stress, access, time restraints, characteristics of the exercise behavior

a method of client-centric coaching during a conversation that helps enhance the desire to change by resolving a client's feelings of ambivalence

motivational interviewing

type of communication involving the exchange of info through bodily cues that can have a profound impact on social interactions

nonverbal communication

intentions are a predictor of behavior, but what has been shown to help translate intentions into behavior

planning

having an informal role in an exercise group is demonstrated by:

planning social gatherings for the group, inspiring the group, providing mentorship to new members

moderate intensity exercise is the most optimal for providing which benefits

providing psychological benefits

if client's goal is to "lose weight," the technique of asking them what that goal will allow them to achieve is using ________ to _______ goals

reflections; clarify

aspect of communication involving making the best guess as to what the speaker means and stating it back to them as confirmation

reflective listening

participation in ________ training, which is more challenging to start than aerobic exercises, requires knowledge of how to design programs and the skills to execute complex movements

resistance training

name for an internal conflict between what someone thinks their ideal self should be and what their actual self is

self-discrepancy

if a CPT helps a client improve their technique by using guided practice to enhance confidence, what determinant of behavior are they targeting?

self-efficacy

one's belief that they can complete a task, goal, or performance:

self-efficacy: one of the strongest determinations of participation in exercise for adults

BCTs that improve exercise adherence are equally as important as the ______ __ ________ used & the relationship the CPT has built with the client

style of delivery (communication)

within the context of participation in resistance training, the variable of _______ _____ is the belief that an important person / group of people will approve of and support a behavior

subjective norms

type of summary - wrap up one topic before moving to the next

transitional summary

stages of change model aka

transtheoretical model of behavior change