- Transtheoretical Model(TTM) – States that individuals progress through a series of behavior change and that movement through these stages is cyclical, not linear, because many do not succeed in their efforts at establishing and maintaining lifestyle efforts. Comprised of six stages: precontemplation, contemplation, preparation, action, maintenance, and termination.
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- A trait is part of a person’s behavior and shapes their personality while a state is a temporary change in personality such as a strong emotional state. States are unstable and can change rapidly. The different stages(like precontemplation) can stay for a long time.
- Precontemplation pg. 654 – Individuals in this stage do not intend to change their high-risk behaviors in the foreseeable future. Not anticipating starting an exercise regime within 6 months. Non-exercisers.
- Contemplation – Contemplating making a behavior change in next 6 months. Aware of the pros and cons of changing behavior. People often get stuck on this stage as they contemplate costs and benefits of change.
- Preparation – Intend to take action in the near future, usually in the next month. They’ve taken some significant action toward making behavior change in the past year such as joining a gym. Examples are former non-exercisers who may now exercise infrequently but intend to get a more disciplined schedule.
- Action – People in this stage exercise regularly but for less than 6 months. Change in this stage is not stable and you’re at highest risk for relapse here.
- Maintenance pg. 655 – Example someone that has regularly been exercising for 6 months. Generally it takes regular exercise of 5 years before the risk of reverting to old behavior is terminated. It’s still possible to revert but unlikely that an exerciser will revert all the way back to precontemplation. They may revert back to contemplation or preparation but never back to full non-exerciser.
- Termination – Where individuals have zero temptation to engage in old behavior and exhibit 100% self-efficacy. No matter their mood state(depressed, anxious, bored, lonely, angry) they will not return to old habits.
- Application of TTM to Physical Activity pg. 655 – When there is a mismatch between the stage of change and the intervention strategy then attrition is high.
- Confidence pg. 657 – There is a positive relationship between self confidence and exercise adherence. Confidence stems from: performance accomplishments – strongest source of confidence, for example finishing a 5k. Modeling – watching others. Verbal persuasion – being persuaded by someone else(personal trainer helping them do something they thought they couldn’t.) Imagery – imagining themselves performing a task it increases their confidence to actually doing that task.
- Self-Talk pg. 658 – Self talk can be positive and motivational or negative. Most often it is a person’s inner dialogue that turns a temporary setback into a catastrophe. When you’re training a client you need to also train their self talk. Often you’ll find clients saying “I can’t do that.” Or they’ll say “that was horrible” after finishing an exercise. Catch each of these and change it. Over time that’ll help them change their self-talk.
- Interpersonal influences pg. 659 – In short the people around your client will influence their behavior.
- Affective influences – Influences from emotions play a strong role in whether a client sticks with exercise.
- Sensational influences pg. 661 – Try not to overload new clients as the physical pain of a new workout can put them off of exercise.
- Positive reinforcement pg. 662 – Goal is to increase the likelihood of positive behavior by rewarding that behavior. 5:1 ratio of positive to negative feedback is recommended. Rewards can be nonverbal, verbal, material, or activity based.
- Journaling pg. 662 – A type of self-monitoring. Practical way to collect behavior patterns and cues for negative behavior. Can help identify the best times to exercise and other accommodations that may be necessary. Can help identify where they go wrong with nutrition and how to counter it. Looking at your client’s journals will help them stick to positive behaviors.
- Motivational Interviewing pg. 663 – A brief intervention designed to increase likelihood that a client will consider, initiate, and maintain specific strategies for reducing harmful behavior. Involves four areas: expressing empathy. Helping the client realize the gap between values and problematic behavior. Respecting the client’s resistance as normal. Supporting the client’s self-efficacy.
- Verbal Communication pg. 664 – Be direct, be clear and consistent, own your message, deliver messages immediately, be supportive, be consistent with nonverbal messages, look for feedback that the message was actually received.
- Active listening – Paraphrase what the client has said. Ask specific questions to allow a client to express their feelings. You should: listen attentively. Focus completely on the client. Filter out internal chatter. Ask probing questions. Hold silences. Use the client’s language.
- Autonomy-Supportive Style – focuses on creating an environment that emphasizes self-improvement. Provide choices within limits, offer rationales for activity structures, recognize client’s feelings and perspectives, create opportunities for clients to demonstrate initiative, avoid overt control and criticism, provide informational feedback, limit client’s ego involvement.
- Behavior modification approaches pg. 669 – Prompting – cue that initiates behavior. Can be physical, verbal, or symbolic. Contracting – written statements that outline specifically what behavior they will undertake. Charting attendance and participation – self explanatory, helps with adherence. Providing feedback on progress – feedback such as bodyfat measures, exercise tests, resting heart rate are all excellent feedback tools.
- Association and Dissociation pg. 671 – involve thoughts which eventually affect behavior. What clients think and focus attention on while exercising is important. Association is focusing on internal body feedback while dissociation is to focus on external environment. Studies have found people who dissociate have better adherence, so it’s better to get the mind off the pain through music or other external stimuli then focus internally constantly.
- Self monitoring pg. 673 – Ability to recognize and regulate one’s own behavior.
- Cognitive Restructuring pg. 674 – Technique to identify and dispute irrational or maladaptive thoughts. Cognitive distortion – the mind’s way of convincing itself that something is true when it’s actually untrue to reinforce negative thinking or negative emotions.
- Coping pg. 675 – managing specific internal or external demands that tax or exceed one’s resources. Problem focused coping – focuses on altering the problem that is causing the stress. Emotion focused coping – regulates the emotional responses to the problem that’s causing stress through tools such as meditation and relaxation.
- Intrinsic approach – inside-out approach that focuses on emphasizing the enjoyment and fun of exercise and making it something to look forward to.
- Effective Goal Setting pg. 676 – Goals must be defined. They should be objective goals, something that can be specifically attained and not subjective(goals based on experience, expectations, less tangible). Goals can be outcome, performance, or process oriented. Outcome goals are important but the main focus should be on performance and process goals.
- Goal setting principles pg. 678 – Usually 1-2 questions about goal setting on the test. Goals need to be specific and measureable. Realistic but challenging. Both short and long term. Focus on performance and process. Develop goal commitment. Develop goal achievement strategies. Get goal feedback and evaluation. Set timeline to achieve goals.
- Progress Evaluation Practices pg. 682 – Not likely to be tested. The short version is to schedule regular progress reviews and to keep good records.