The process of changing human behavior is challenging and complex given that it is an ongoing, nonlinear process influenced by a number of different factors that change over time. There’s no single formula to help fitness professionals predict why, how, or if a client will adopt a healthy behavior, making coaching a client toward behavior change a unique challenge for us. However, truly understanding a client’s readiness to change is an important factor in their success adopting of new behaviors. Personal trainers able to evaluate and respond optimally to that readiness will be the most masterful coaches.
A Framework for Understanding a Client’s Readiness to Change
A widely referenced, researched, and utilized framework for describing the process of behavior change is Prochaska and DiClemente’s (1984) Transtheoretical Model of Behavior Change (TTM) or the stages-of-change model. This model can easily be applied as a “ruler” for gauging a client’s readiness to engage in a change process.
The tenets of the TTM include five stages of change, processes of change (what an individual relies on to transition from stage to stage), self-efficacy (the degree to which an individual believes he or she can make a change), and decisional balance (evaluation of pros and cons of change). The following outlines the five stages of change and their associated characteristics.
- Stage 1: Precontemplation: Individuals are nonbelievers and are not considering a change. They do not generally perceive current behavioral habits to be a concern. They do not see physical activity as important. (Probably not a current client, although current clients may be resistant to a specific plan of action that you have deemed vital or quite important)
- Stage 2: Contemplation: Individuals in this stage are inactive but are considering making a change soon (within the next 6 months). They are beginning to see physical activity as important.
- Stage 3: Preparation: Individuals in this stage are making attempts to change and generally have a plan to make a full change in the next month.
- Stage 4: Action: This stage is characterized by individuals actively engaged in physical activity but have been active for less than 6 months.
- Stage 5: Maintenance: Clients in this stage have been active for longer than 6 months.
Strategies to Apply Based on Stage of Change
The TTM uses what are called processes of change to describe how a client might be motivated to transition from one stage to the next. These processes or strategies are defined as either cognitive process (results in new ways of thinking) or behavioral processes (new behaviors that support change).
The cognitive processes are especially useful for clients in the earliest stages of behavior change (i.e. precontemplation, contemplation, preparation). In contrast, the behavioral processes are more often applied with clients during the later stages of change. Refer below for the processes, their characteristics, and an example of their application.
Consciousness Raising: Raising awareness; finding and learning new facts.
- Example: Your client is provided information about the benefits of physical activity (i.e. increased energy, better sleep, boosted productivity, etc.).
Dramatic Relief: Experiencing a negative emotion due to the unhealthy behavior
- Example: Your client has a “close to home” experience with a relative diagnosed with Type II diabetes due to a hypokinetic lifestyle.
Environmental Reevaluation: Recognizing how the current unhealthy behavior is impacting the individual’s social environment.
- Example: Your client considers how a lack of consistent healthy nutrition at home affects her children.
Self-reevaluation: Realizing the importance of making a change.
- Example: Your client sees her sedentary lifestyle as a barrier to other activities she wishes to enjoy.
Self-liberation: Deciding to make a positive change and developing new beliefs in his/her ability to make a change.
- Example: Your client is moved to change and begin to increase activity and establish better eating habits to support a new lifestyle approach.
Helping Relationships: Identifying and relying on social support resources.
- Example: Your client accepts help from friends so that she can attend exercise sessions without worrying about care for her kids
Reinforcement Management: Increasing rewards for healthy behavior change; decreasing rewards for engaging in unhealthy behaviors
- Example: Your client rewards herself for making it to her exercise sessions. She decides to reward herself with a massage twice a month.
Stimulus Control: Using reminders to engage in healthy behaviors and removing cues to engage in unhealthy practices.
- Example: A client sets out her workout clothes the night before and packs a healthy lunch for work to avoid the breakroom food options.
Counterconditioning: Substituting healthy behaviors for unhealthy behaviors.
- Example: Your client plans a new response to triggers that encourage her to return to old habits. Instead of watching TV on the couch, she does light calisthenics during her favorite program.
Social Liberation: Engaging with people who help to model newly adopted and healthy behaviors
- Example: Your client engages socially with other members of her gym and office coworkers who are avid exercisers and gym goers. She is enjoying feeling happier and more energized.
Personal Trainers as Coaches
Personal trainers are uniquely positioned to actively coach their clients toward lifestyle change – not just toward a specific fitness goal. Many clients seek the services of a personal trainer to “lose weight”, “tone up”, “or get healthier” – each of which are outcomes of adopting and maintaining behavior changes that support the attainment of those goals. As a personal trainer, you have the opportunity to identify a client’s readiness to change and apply specific strategies accordingly to help your clients move from stage to stage.
It’s important to understand that although you may have a client in the action or maintenance stages of change, you should not assume permanency. Relapses and lapses can and do occur, which is why it’s crucial to help clients identify potential barriers to success, plan for high-risk situations, and incorporate strategies to address both. If you continue to take a coach approach in encouraging the continued sustainment of an existing positive change, clients will have a greater likelihood of long-term success.
Where to Begin Coaching Behavior Change
Begin as you always would, engage in a thoughtful conversation (pro tip: use motivational interviewing where necessary if the client is ambivalent) with your client about his or her beliefs about healthy change and work to identify ways to combat problems that threaten to interfere with sustained motivation and commitment to that change. Eventually, those changes will become important facets of your client’s everyday lifestyle.
In what ways do you gauge a client’s readiness to change and commitment to activity?
Brehm, B. (2014). Psychology of Health and Fitness. Philadelphia, PA: F.A. Davis
Prochaska, J.O. & DiClemente, C.C. (1984). The Transtheoretical Approach: Crossing Traditional Boundaries of Therapy. Homewood, Ill.: Dow Jones/Irwin.