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Establish change readiness in your clients

This is an excerpt from Professional's Guide to Small-Group Personal Training, A by Keli Roberts.

An essential element of your success will ride on your ability to recognize your client’s readiness to change. In the transtheoretical model of behavioral change (TTM), behavioral change is broken down into five distinct stages. The stages can be related to any behavior, but in the exercise context the stages are as follows:

  1. Precontemplation stage. In this stage, people are sedentary and not even considering an activity program. These people do not see activity as relevant in their lives, or may even discount the importance or practicality of being physically active.
  2. Contemplation stage. In this stage, people are still sedentary. However, they are starting to consider activity to be important and have begun to identify the implication of being inactive. Nevertheless, they are still not ready to commit to making a change.
  3. Preparation stage. This stage is marked by some physical activity as individuals mentally and physically prepare to adopt an activity program. Activity during the preparation stage may be a sporadic walk or even a periodic visit to the gym, but it is inconsistent. People in the preparation stage are ready to adopt and live an active lifestyle.
  4. Action stage. During this stage, people engage in regular physical activity, but have been doing so for less than six months.
  5. Maintenance stage. This stage is marked by regular physical activity for longer than six months.

Having a working knowledge of the TTM is helpful, but more importantly, it is key to recognize which stage of change your client is currently experiencing. This understanding can guide the types of questions you ask them and how you approach their needs. For example, your client may already be active, but still smokes cigarettes. They may not even be considering quitting; therefore, they are in the precontemplation stage. At this stage of change, providing education about the dangers of smoking and examples of people who’ve quit can be helpful. Using examples of success as proof that quitting is possible and brings about positive effects may provide the necessary motivation to start thinking about change.

Recognizing which phase your client is in so that you can appropriately coach, motivate, and facilitate behavioral change begins with motivational interviewing (MI), which incorporates empathy and reflective listening to promote honest and open communication. This is especially critical for properly assessing individuals in the crucial precontemplation and contemplation stages, when they are particularly resistant to change.

Here are some questions that utilize MI techniques for clients in the precontemplation and contemplation phases.*

Precontemplation Stage

Goal: Client will begin thinking about change.

What would have to happen for you to know that this is a problem?
What warning signs would let you know that this is a problem?
Have you tried to change in the past?

Contemplation Stage

Goal: Client will examine benefits of and barriers to change.

Why do you want to change at this time?
What were the reasons for not changing sooner?
What would keep you from changing at this time?
What might help you overcome those barriers?
What things (people, programs, and behaviors) have helped in the past?
What would help you at this time?
What do you think you need to learn about changing?

*Questions are reprinted by permission from Dr. Timothy Moore.

One of the biggest mistakes a trainer can make is to assume everyone in their group is at the same state of behavioral change or that change is easy. For many folks, starting and sticking with an exercise program is a complex process. By applying the TTM, trainers can more readily recognize and understand the factors that control behavior and know how to coach new behaviors.

When a client is in the preparation phase, they are ready to take small but important steps toward changing their behavior, including seeking your services. Establishing a schedule, sharing your plan with them, and encouraging them to share their plans on social media or with friends and family can help build excitement and confidence. This builds a relationship of trust that will help move them through the preparation and action phases into maintenance. However, if you skip directly to the action phase without ascertaining the client’s specific readiness and needs, you can set them up for failure.

When working with groups, it is important to spend time using MI with each individual during the initial assessment to discover the best approach to designing a targeted action plan. Remember, you can’t jump directly from preparation to maintenance without taking clients through the action phase. To move from action to maintenance, it’s necessary to create solid support systems while overcoming obstacles or barriers to participation as they arise. Small groups naturally allow for social support; by creating a team environment you can create greater accountability, leading to greater levels of sustained participation. Look for opportunities to celebrate success and treat setbacks or challenges as opportunities for self-improvement. One of the biggest mistakes you can make when moving clients from the action to the maintenance phase is to set up unrealistic goals and expectations. If a client is expecting tangible results in an unrealistic time frame, they are sure to feel like a failure.

Working with clients who are in the maintenance phase in a group with other members still in earlier phases is a challenge that requires great skill and sensitivity. For a client who’s established an active and healthy lifestyle, social support through family and friends, smart use of social media, and stress management skills can be extremely helpful. Some of the biggest obstacles to overcome in the maintenance phase involve boredom, distraction, suffering an injury, or overtraining. This is where great program design, multilevel teaching, understanding different learning styles, and working at multiple skill levels can all add up to a greater level of participation for everyone in your group.