week 1 notes

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Internation Sports Sciences Association *

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261

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Psychology

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Dec 6, 2023

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Lecture Notes Week 1 Lecture Transcript – Week One 1. "Welcome to the Complete Behavioral Change Guide for Personal Trainers. This guide is designed to help personal trainers move from merely disseminating information to clients to becoming true agents of change. In this complete guide to behavioral change, personal trainers will learn from the latest research in the fields of behavioral change, positive psychology, and behavioral economics the skills that are needed to effect a qualitative shift in client behavior. Drawing first on the evidence-based practice of motivational interviewing, this course provides a fundamental understanding of how to identify and use client strengths to overcome ambivalence and direct change. Trainers will also learn the powerful skill of how to conduct the motivational interview to enhance and direct client motivation toward change. Presented next is the latest research in the field of positive psychology, providing a fundamental understanding for how to significantly improve clients' mood-both in and out of the training program. Personal trainers will learn the strategies and skills to teach a client to think optimistically, identify and employ strengths, find and direct passion toward meaningful goals, generate positive emotional states, experience more engagement in life, strengthen relationships, find meaning in everyday experience, and use small gains to enjoy more long-term achievement. This course then looks to the field of behavioral economics and introduces powerful commitment devices-self- imposed arrangements that help people stick to commitments they have made and would like to keep-that personal trainers can use to help make their clients' behavior last. Personal trainers will learn how to help their clients bridge the gap between the present self who employs self-control to make conscious healthy choices and the future self who loses conscious control, has trouble delaying gratification, and ultimately falls prey to poor choices. Finally, this course offers the innovative and effective method of behavior change known as experience sampling. In this powerful approach, personal trainers will learn how to use real-time data to measure the shift in client attitudes about exercise and healthy behavior and how to incorporate clients in developing and adopting the skills that create and maintain change. Now let's begin! 2. It's true that today personal trainers face an uphill battle. Clients arrive at their doors with a host of problems, histories, and motivational conflicts, yet all clients want one thing: to change their lives and live healthier. Knowing just how to help clients create lasting change can be overwhelming. For one thing, not all clients are the same or respond in similar ways. And although academic programs do provide valuable information about creating and implementing

safe, effective exercise programs for clients, a gap between this knowledge and the practical realities of working day to day with clients often exists. 3. While personal trainers can easily become wrapped up in quickly creating physical change within the client, behavioral change-the type of change that lasts-depends on first developing a relationship that sustains change. What does that mean? That the personal trainer responds to the client in a way that makes him or her feel accepted completely and unconditionally and free to present him or herself without disguise. Not only does the personal trainer listen fully and completely, but also the trainer conveys this to the client through a powerful skill called reflective listening, which we will learn in this course. The trainer also uses nonverbal responses that reflect acceptance and warmth, creating the type of environmental conditions that support change. 4. If you were to ask most personal trainers today: "What is the most important part of facilitating behavioral change in clients? " You would likely hear a host of answers. Yet what research in behavioral change now clearly recognizes is that regardless of the model of behavioral change used, the relationship with the personal trainer (or coach or therapist) is the strongest predicator of long- lasting behavioral change. It is this human connection that serves as the glue that sustains the difficult aspects of behavior change. And although transformative factors are needed for change to occur, without first developing a trusting and authentic relationship with a personal trainer, clients simply will not change. Why is the relationship so important? Because as you will see in this course, the process of change is one of self-investigation and discovery of both strengths and of weaknesses along with behavioral discrepancies. The process can be exposing and uncomfortable. To stay the course, clients need a strong connection with a personal trainer-one who accepts them fully (without judgment or condemnation) and also recognizes and can identify with the difficulty of change. 5. Developing a trusting relationship with the client isn't just the basis of behavioral change; it is also a fundamental tool to understanding the client fully. As I'm sure you are aware, not all clients are the same, and certainly not all clients are in the same stage of change. Some clients are only considering change and are not ready to take action, whereas others have taken steps to prepare for change. Understanding these unique differences serves to guide how a personal trainer will approach each client and what specific strategies he or she will use. Not only does this allow the personal trainer to better understand the client but also to tailor an approach that truly meets the client at the stage at which he or she is situated.

6. Understanding the stage a client is in and using strategies designed for this stage is a way of respecting to the client's autonomy and uniqueness. Clients cannot be force-fed change, and attempting to push them into change only disrupts the relationship between the trainer and the client. Yet when the trainer matches the intervention to the stage the client is in, this draws the client in, as he or she thus feels understood. Furthermore, stage-matched strategies effectively incorporate the client into the process of change and draw upon the client's own strengths and wisdom to support change. 7. The stages of change model recognizes that although there are five stages a person can be in while undergoing the process of change, change itself hinges on three factors: that people are aware of the decisional balance – that is, what the upside and the downside are; that people feel they can change (this is called self-efficacy); and that people have strategies to change. Change often begins with a person's coming to terms with the pros and cons of change and "tipping the decisional balance" such that it becomes easier to change than to remain the same. Often, a strong warning from a doctor, spouse, or loved one can shift this balance such that a person realizes how behavior is affecting his or her health and that of those around him or her. But, a person must also believe that change for is possible – that is that the psychological, cognitive, and physical ingredients necessary to make change happen exist. Finally, achieving change requires a set of strategies to overcome all the internal and environmental barriers to change-essentially, these strategies give a person "leverage over himself or herself." 8. What are the stages of change? The Transtheoretical Model of behavioral change, which was later refined into a set of five distinctive stages that described the thoughts, feelings, and behaviors of people in the process of change. Stage 1: Precontemplation (Not Ready) People at this stage are often either unaware of the risks of their behavior, or they will minimize others' concerns about the risks. For this reason, clients will often say things such as, "I don't see anything wrong with what I do, but I guess my wife wanted me to come here," or "I think I'm fine, but my doctor said I should see you." Statements such as these indicate that a person in the precontemplation stage not has not thought much about making the change and does not have any concrete plans to start a new healthy behavior in the near future (within six months). Furthermore, those in the precontemplation stage have a decisional balance that does not support change (they see more cons than pros) and may not feel a high sense of self-efficacy about making change.

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Stage 2: Contemplation (Getting Ready) People in the contemplation stage are more aware of the benefits and cons associated with the change and, at this stage, weigh them equally. Because of this, the decisional balance (they see the pros as equal to the cons) can often cause a stalemate wherein change behavior is put off for some time. At this stage, there is also a high degree of ambivalence, and self-efficacy is not quite developed. People at this stage will often say things such as, "I know I will feel better if I lose weight, but I just don't know if I can," or "I know I will be happier if I start working out, but I'm not sure I can fit it in." Stage 3: Preparation (Ready) Now ready to take action, those in the preparation stage see the pros as greater than the cons, meaning that the decisional balance has shifted in favor of change. In this stage, people will often begin to plan out and initiate small steps toward change, however, will still experience some doubt about their success, as self- efficacy is still low. For this reason, this stage is characterized by thinking about and planning change in preparation for action. Here, people will often say things such as, "I am going to start working out three times a week, starting next week, but I'm still not sure how I will fit everything in," or "I am planning to eat low-carb from here on out, but I don't know what I will order when I eat out with friends." Stage 4: Action People in the action stage have taken measurable steps toward changing behavior, within the last six months. In this stage, people give more weight to the pros of changing and less to the cons, which further shifts the decisional balance toward change. Also, as positive and measurable change has been made, self- efficacy is higher, and people speak with greater confidence about the change yet, at the same time, still express some doubt. They may say things like, "I'm really happy that I've been able to maintain my diet for the past few weeks; I just hope I can keep it up," or "I can see my body changing, and I like it, but I just hope I keep losing weight." Stage 5: Maintenance As people in the maintenance stage have held onto their positive changes for more than six months, they speak with greater confidence about themselves, experience higher levels of self-efficacy, and consistently rate the pros of change as greater than the cons. Now that their behavior is more stable, they are much more likely to continue toward healthy behavior; however, people in the maintenance stage can still relapse toward unhealthy behavior when in stressful situations. They may say things like, "I am really feeling confident with my weight now, and I'm wondering if I can start eating some of the things I used to really

like," or "I thought maybe because I've been doing so well in my exercise, I could take a few days off." 9. As mentioned above, behavioral change begins with first understanding the stage of change the client is in. To do this, the personal trainer should first listen fully to the client, as often, previous attempts at change, readiness to change, and current preparation and efforts to change will be evident in what the clients says. The use of open-ended questions can be very helpful in engaging your client in a conversation about change, which will help reveal the stage of change she or she is in. You can also use more specific questions to assess the stage of change, such as: Tell me what your thoughts are about making this change? Is there anything specific that motivated you to make a change? How would you describe the benefits of making a change? How would you describe the costs of making the change? At this point, do the benefits outweigh the costs? On a scale of 1–10, how confident are you in your ability to make the change? On a scale of 1–10 how strong are the factors that may derail your change? At this point, have you made plans to change? Have you taken any measurable steps toward changing? If you haven't taken any steps toward change, do you plan to in the next six months? The way in which your clients answer these questions will help you better understand their thoughts about changing their behavior and, more importantly, help you identify the specific stage of change. In terms of knowing just which stage they may be in, here are some important descriptors:

Precontemplation (Not Ready) The hallmark of a precontemplator is someone who underestimates the pros of changing, overestimates the cons, and is often in denial about this misperception. Contemplation (Getting Ready) Someone in the contemplation stage is more aware of the benefits of changing and the risks of not changing; however at this point, they often receive equal weight, which leads to a high level of ambivalence about change. 10.(Assessing the Stages-cont.) Preparation (Ready) The preparation stage is characterized by a person who is ready to start taking action within the next 30 days. Often, people in this stage speak about plans to change and tell their friends and family that they want to change their behavior. Action People at this stage have already changed their behavior; however, because the change has occurred within the last six months, they may still experience urges to return to unhealthy behavior. Maintenance Although the maintenance stage is defined by changes that have been made more than six months ago, and behavior begins to develop more consistency,

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people in this stage may continue to experience urges, especially in stressful situations. 11.How then do we work with clients in each stage? Let's take a look: Stage 1: Precontemplation (Not Ready) As people in the precontemplation stage are either unaware of the risks and benefits associated with changing, or may deny them, to help them move toward change, the decisional balance needs to be moved (where the benefits outweigh the cons) to support change. To do this, you can educate your clients about the healthy behavior they are considering and encouraging them to educate themselves. It is also helpful to ask your clients about their perception of the negative affects their behavior might be having on their lives or on the lives of others. Questions such as "Describe how your unhealthy behavior affects you on a daily, weekly, and monthly basis? What long-term outcomes do you think your behavior will lead to? In what ways might your behavior be affecting those around you?" In terms of raising self-efficacy about the change, it is also helpful to ask them to rate their confidence in their ability to change and to ask what steps they can take that would raise their confidence. In addition, a discussion about the obstacles to change can help reduce any self-doubt your client may feel about external events that may deter change. Asking questions such as "What might get in the way of change? What seems to make change difficult?" can help your clients reduce the power these things have over them and them see that change may not be as costly (or have as many cons) as initially thought. Finally, people at this stage can be helped with encouragement about their ability to change. Stage 2: Contemplation (Getting Ready) As there is a high degree of ambivalence in the contemplation stage, and the decisional balance is at a deadlock, efforts toward raising self-efficacy and heightening awareness of the benefits of change can be very helpful. To do this, you can draw your client's attention to additional benefits of changing that she might have overlooked. Include questions such as, "In what ways might your relationships improve if you changed? In what ways might your work life (or productivity) improve if you changed? In what ways would you see yourself

differently if you changed?" can help your client begin to broaden the benefits of changing to other areas of her life. Further, it can be helpful to tell your client about others like him or her who have changed and the ways in which the cleints' lives have improved as a result. Turning your client's attention to previous challenges in life that he or she has been able to overcome (or changes he or she has been able to make) will help raise self-efficacy. You can do this by asking questions like "Can you tell me of times in the past when you have been able to make positive changes? Describe other challenges that you have been able to overcome. How did you manage those changes?" Finally, in this stage, it can be helpful to have your client make a list of the skills that will help him or her make a change. Stage 3: Preparation (Ready) Once in the preparation stage, the decisional balance has shifted toward change, and clients are ready to start taking action. However, because self-efficacy about the change is not yet formulated, efforts to raise self-efficacy can be especially helpful in this stage. In particular, addressing the fears associated with failing can help mitigate self-doubt. Questions such as "What is your attitude toward failing? Can you learn from failing? Does failing mean that you cannot try again? If your fail one time at this change, does that mean you have failed altogether and cannot start again?" can help your client begin to reframe any potential failure as a normal part of the learning process – and one to be learned from. Additionally, as self-efficacy is highly linked to feeling supported and believed in, efforts to help build your clients' social support network can be effective in raising their confidence levels. To do this, you can have your clients make a list of their supporters and inform them of the client goals and ways in which the supporters can support clients in making changes. Finally, to overcome fears about not being able to maintain change, it can be helpful to address situations in which your clients are likely to give in to impulses, have trouble maintaining change, or relapse to unhealthy behaviors and then make a plan for how to navigate these situations. Stage 4: Action

As the action stage is characterized by change that is extremely new (within the last six months), people at this stage have increased levels of self-efficacy and now see the benefits of changing as much greater than not changing; however, in this stage, the novelty of the change has worn off. For this reason, focusing on commitment strategies (which we will discuss in a later section) to maintain the change can be useful in overcoming the urge to slip back to unhealthy behavior. To do this, you can teach your client techniques that use incentives and penalties to maintain change. Focusing on strategies like avoiding the unhealthy section of the grocery store, removing unhealthy food from the home, using text reminders of the benefits of an activity while performing it, and increasing awareness of the positive feelings associated with exercise will help maintain your client's motivation toward change. Finally, incorporating the three drivers of motivation (which we will discuss in detail in the section on motivation), autonomy, mastery, and purpose, into your client's program can enhance motivation. To do this, questions such as "In what ways do you feel more confident now that you have changed? What do you feel like you are really getting good at? What steps have you taken on your own (or come up with) to help keep your change going? Can you describe any underlying or deeper reason for this change?" can help increase your client's awareness of his or her sense of mastery, autonomy, and purpose in changing behavior. Stage 5: Maintenance Once in the maintenance stage, there is greater consistency in behavior as people now feel a greater level of confidence in their ability, have overcome some obstacles on the path toward change, and have also experienced some benefits associated with change. However, in this stage, stressful situations can pose a risk for relapse to unhealthy behavior. For this reason, addressing any stressors (or stressful situations) can help your client develop a strategy for how to manage stress in a positive way. Ask questions such as "Whom can you turn to for support when in a stressful situation? What is your attitude toward stress? Can stress be used in a positive way? What are three things you can do to respond to stress in a positive way (as oppose to reacting in a way that might hurt yourself or others)? What skills do you have that help you deal with stress? What skills can you learn to help you better manage stress?" Finally, in maintaining change, it can be especially beneficial to help your client engage ongoing social support for the change. To do this, you can ask the following questions: "Who most supports you in your healthy behavior? Who motivates you to continue being healthy? Whom do you (or can you) share your healthy experiences with? Are there any accomplishments you would like to take on now that you are healthier (such as running a marathon, doing a bike ride, or learning a new sport)?"

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In conclusion, knowing what stage of change the client is in is an essential part of the change process. Not only do clients respond better and feel more respected when you meet them at the stage they are at, but also they achieve much better outcomes.

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