Introduction

We know a lot about exercise prescription. We know how to overload and improve the
cardiovascular system and how to specifically improve muscular endurance, strength or
power. As discussed in Study Unit 1, the exercise prescription must be tailored towards
specific individuals and the optimal program for someone is probably unknown.
However, we do understand typical ranges of response to a training stimulus between
different individuals and do have a good understanding of how to modify programs
based on our clients' training response.
Human behaviour on the other hand is more difficult to predict. Why individuals do
certain things at certain times, and don't do other things, is influenced by many factors.
A client's values and beliefs, previous experience, previous injuries and health issues,
expectations about the outcome of a certain behaviour, how they feel about themselves,
how they feel about the change being contemplated and their level of self-efficacy, will
all affect how they respond. I'm sure you can think of more factors that could affect
whether a client will adopt and respond well to a specific exercise regime.
Self-efficacy is the belief about your ability to engage in or execute the specific
behaviour change. Research suggests that self-efficacy is one of the most powerful
factors to consider when planning a fitness plan with your client. If the client believes
that the exercise plan you develop is beyond their capabilities, the likelihood of them
adopting the plan and/or staying with the plan is very low.
Many BPK students like to focus on the physiological response to exercise, exercise
prescription and fitness testing. Nevertheless, the psychological and social concepts
that are discussed in this study unit are of fundamental importance. In BPK 143, I
frequently said that the best exercise plan is the one that you will do (and I reiterated
this in Study Unit 1). Therefore, if you do not pay close attention to your clients'
motivation and how well equipped they are to implement the required behaviour
change, all of your sophisticated training and physiological knowledge will be of little
help. It is important that you realize that the ability of fitness professionals to affect
behaviour change is a crucial but difficult skill.
Many individuals face a host of barriers when it comes to including physical activity in
their lives. However, a skilled professional can effectively motivate and guide many
individuals in their goal to incorporate physical activity into their lifestyles. While it is true
that the relationship between the fitness trainer and client is hard to predict, the
evidence suggests that you can learn how to help your clients with the process of
behaviour change. Your personality is very important, but it is not enough to believe,
“I'm a good guy/girl they will love my ideas.”
Learning Outcomes
At the end of this study unit, students will be able to:

 Appreciate the importance of motivation and self-efficacy in getting clients to

adopt exercise programs.
  List the reported major barriers preventing Canadians from becoming
physically active.
 Demonstrate a basic understanding of the prevailing theories of behaviour
change
 Outline the five principles of motivational interviewing.
 Develop SMART goals with clients.
 Begin to understand and develop communication skills.
 Interpret how the four styles of counselling could be used in practice.

Note: This study unit is larger than most BPK 342 study units as the required textbook
does not cover many of these concepts in detail. This is because the focus of the text
(which was the BPK 143 text) is the scientific basis for, and practical application of,
exercise prescription. BPK 342 focusses on the design of exercise programs for clients,
and hence has to discuss more psychosocial concepts. 

Canadian Physical Activity Levels

The 2007-2009 Canadian Health Measures Survey (CHMS) estimated fitness levels of
Canadians aged 20 to 69 years (1). We will refer to the results of this study several
times in this course. The interpretation of the results from this survey is simply stated
as: “Based on results of the fitness tests and anthropometric measurements, many
Canadian adults face health risks due to sub-optimal fitness levels” (1). A follow up
paper looked at the results of accelerometer data from the CHMS. Here is a brief
summary of those accelerometer results (2) related to some of the self-reported results
and other measures from the CHMS (1).
CHMS summary. (1)

 Over the past 25 years, the prevalence of obesity has increased among
Canadian adults.
 According to self-report estimates, 52.5% of Canadian adults are physically
active.
 Moderate-to-vigorous physical activity (MVPA) is associated with health
benefits.
 Sedentary behaviour is emerging as a negative contributor to health.

Additional findings from the accelerometer results study. (2)

 An estimated 15.4% of Canadian adults accumulate 150 or more minutes of

moderate-to-vigorous MVPA in 10-minute bouts per week, and 4.8% do so at
least 30 minutes on at least 5 days.
 A third of Canadian adults accumulate an average of 10,000 or more steps
per day.
 On average, men accumulate 27 minutes a day of MVPA, and women, 21
minutes.
 Regardless of age group, men engage in more MVPA than do women.
  Men and women spend about 9.5 of their waking hours being sedentary.

The accelerometer results indicate that 85% of adults are not active enough to meet
Canada's new physical activity recommendations and that close to 95% of Canadian
adults are not following a regular exercise regime, at least one that has 30 minutes of
MVPA five days of the week.
Canada's new physical activity recommendations are available at the website below.
You should know the guidelines for healthy adults (aged 18-64). There is no need to
familiarize yourself with other ages.  https://csepguidelines.ca/adults-18-64/ (Links to an
external site.)
Barriers to Physically Active
There are undoubtedly still some people that believe exercise is not good for you—but
some still believe the earth is flat! There are also many people in this world who are
active because it is necessary part of their lives and they probably do not even consider
the benefits of their lifestyle. However, there is a large percentage of people in the
industrialized world who know that exercise is beneficial but do not act upon that
understanding. Why don't more people act on this belief and become active? After all,
we have had several decades of academics, government agencies and other interest
groups promoting the benefit of fitness.
The 9 most common reasons adults cite for not adopting more physically active
lifestyles according to the Canadian Society for Exercise Physiology (CSEP) are listed
below. It is vitally crucial that you understand what is keeping your client from adopting
a more physically active lifestyle (3).

1. Lack of time
2. Inconvenience (possibly for some this is a reiteration of lack of time)
3. Lack of self-motivation
4. They do not enjoy exercise
5. Lack of confidence in their ability to be physically active (lack of self-efficacy)
6. Fear of injury (or fear due to a previous recent injury)
7. Lack of self-management skills (e.g., inability to set effective goals)
8. Lack of support from family and friends.
9. Lack of facilities

This list is not exhaustive and some clients may have another reason for not adopting a
physically active lifestyle. You also need to be aware that many clients will not be able
to easily articulate their particular barriers. You will often have to discuss and explore
the reasons for a client's ambivalence towards a physically active lifestyle. This is a skill
and a component of the motivational interviewing process.
We all know that work and family responsibilities tend to dominate our lives, especially
in families with young children where both partners work, or where there is only one
parent (3). However, many people choose to spend what leisure time they do have in
relatively inactive ways. It may be an important skill to be able to teach clients how to fit
activity into their day by pointing out opportunities to be active without major changes to
their daily structure. In effect, you will often need to build self-efficacy so they believe
the goal of being more active can be achieved without drastically changing their lives.
I will provide a personal example. I often took my children for swimming lessons when
they were young. Occasionally, I would sit and watch but that was quite rare. Instead, I
would use the time to either swim myself or go into the gym and do some other
exercise. Then after their lesson, I would play with them in the pool. During the lesson, I
would see quite a few parents sitting down and just reading a book. That is perfectly
acceptable and potentially some of them achieved enough exercise at other times of the
day. However, if you are reading a book you are not really watching your child swim and
I think we would all agree that some of those individuals did not achieve enough daily
activity. These individuals would likely tell you that they were too busy and couldn't find
time in the day to exercise. Every one of your clients is in a different situation and this is
just one example. My point of giving this example is that I am sure you can think of
many other situations where people could be active but choose not to be. That is not a
criticism of these people, they are probably busy, have other things on their mind and
have become habituated to a sedentary lifestyle. An important point to understand is
that many people cannot identify opportunities to be active. If any of those parents were
my clients and I suggested they exercise during their child's lesson, some of them might
have responded that they hadn't thought about that time as potential exercise time.
Helping clients to identify such opportunities to be active is one important role of a
fitness trainer.
Why People Become Physically Active
Emphasizing to a client that a more physically active lifestyle can help with weight
control, reduced anxiety, better sleep, and lower rates of cardiovascular disease,
cancer, diabetes, and osteoporosis, may be meaningless if the barrier to exercise is
perceived lack of time. If inactive people know that active living is healthy, then what will
motivate them to increase their activity? Clearly there are a whole host of situations that
might motivate someone to begin an exercise program. Perhaps a close friend recently
died. Maybe their doctor recommended, or insisted, they need to be more active due to
health issues. Weight loss motivates many individuals. A birthday milestone can often
be motivating. Personal trainers report seeing a disproportionate number of clients at
age 39, 40, 41, and 49, 50, and 51. This suggests that people at the end of their third or
fourth decades take inventory of their lives and perhaps decide to make changes to
preserve or regain their health.
Another major motivator to begin and continue activity is self-image and this is clearly
linked to weight loss. When you ask why a person has come for a fitness appraisal or
an exercise program, it is common to hear: “To get fit,” or “to lose weight” or “to get in
shape.” Sometimes there is a more specific motive, such as to “build up the size of my
arms and chest” or to “lose four kilograms from my hips and thighs,” but often you will
be told just a general goal.
Wanting to improve one's health or fitness can be a powerful motivator to start activity,
but it is less important as a motivator to continue activity over months and years.
Feeling better, having fun and a sense of achievement or success, enjoying time with
other people (all intrinsic motivators) tend to be more lasting motivators. Humans are
highly social animals but our need to socialize can be achieved through sedentary
pursuits such as watching videos or having meals together. Therefore, a personal
fitness trainer should be aware of the importance of positive social interaction in active
pursuits and help the client decide that they can increase their activity level while still
meeting their needs to socialize. In other words, one important skill is to help clients see
physical activity in a broad way, as fun social time – not just as exercise (such as weight
training or running).

The Operant Conditioning Theory of Motivation

You are all probably aware that positive reinforcement (reward) increases the probability
of a particular behaviour occurring in the future, while negative reinforcement
(punishment) decreases its likelihood. The reason most people know this is the
experiment of Ivan Pavlov on dogs. Pavlov noticed that his dogs salivated when their
food was presented. Pavlov tried an experiment. Just before he fed the dogs, he rang a
bell. The dogs salivated as usual at the sight and smell of the food. After some weeks,
Pavlov rang the bell without presenting the food. The dogs still salivated. They had
become conditioned to the experience of the bell preceding the food.
Although Pavlov's dog experiment is the hallmark of classical conditioning, it doesn't
have anything to do with voluntary responses, such as choosing to be active. Operant
conditioning, on the other hand, deals with increasing or decreasing the likelihood of
certain behaviours, such as exercise, by reinforcing them or punishing them.
Researchers such as Thorndyke and Skinner theorized that behaviours followed by
satisfying consequences tend to be repeated and those that produce unpleasant
consequences are less likely to be repeated.
For the fitness professional, this theory implies that we can help people become more
active by ensuring that their activity experiences are positive. They feel valued and
respected at the activity centre. The atmosphere is positive, upbeat. People are smiling
and talking. Maybe music is playing at a comfortable volume. The staff are professional,
pleasant, and helpful, and perhaps they address clients by name. The activity centre is
pleasant: it smells good, it is clean, nicely illuminated, well ventilated, the temperature is
not too hot or cold, the space is active but not crowded. The activity is fun! The intensity
and duration are stimulating but not too intense. The format allows for individual options
within a group structure. Clients feel accepted and may get talking with some of the
other participants. They leave feeling good and wanting to go back.
There are not a lot of current epidemiological studies that examined exercise retention
rates among previously sedentary individuals in the general population who begin an
exercise program. Dishman reported the statistic that 50% of people who start an
exercise program will dropout within 6 months (4). Knowing that statistic helps the
fitness professional understand the difficulty of getting clients to adhere to an exercise
program, but does not help identify major strategies to improve adherence. It would be
ideal if some randomized controlled studies could identify the best types of exercise
programs and other strategies to enhance adherence. However, I am not sure that this
is possible as we are talking about an individualized response. For example, a study
designed to systematically examine randomized controlled exercise intervention trials
that reported attrition and/or adherence rates to sustained versus intermittent aerobic
exercise programs found no differences (5). I think that result is not surprising as you
can imagine many individuals prefer sustained endurance activities while others would
prefer intermittent interval-type exercise.
The priority at the beginning of a lifestyle change is making the new behaviour a regular
habit. The volume and intensity of activity are not important as long as they are not
excessive. The support of an intimate partner such as a spouse or boyfriend can be
important in adherence. Conversely, an unsupportive or even a neutral attitude by the
partner undermines adherence. Operant conditioning theory is consistent with the fact
that ignoring a specific behaviour, while not as bad as punishing that behaviour, is not
conducive to that behaviour being repeated. Commonly, during the first few weeks of
beginning an exercise program, people tend to get a lot of attention (usually positive)
from friends, family, and fitness leaders. After the novelty wears off, this attention
decreases – it is no longer news. During the time between the initial honeymoon stage
and the regular habit stage, the support of the fitness leader, counsellor, and/or
personal trainer is especially helpful.
Behaviour Change Theories and Models
Trying to ensure your client has a positive experience with their exercise is important
once they begin the exercise program is far from the first step. Many behaviour change
models suggest individuals move through different stages as they initiate and maintain
the new behaviour. The Trans-Theoretical Model of Change is one of the most
popular. Often people will remain stuck at one stage for a while and/or fall back (or go
around, if one views the process as circular rather than linear). The counsellor can help
by recognizing what stage the client is at presently and helping them move ahead to the
next stage. The table below is a summary of the model stages and a brief comment on
the fitness counsellor’s role. We will discuss these roles in more detail later and discuss
some strategies designed to assist the counselling process.

Stage Client's situation Counsellor's role

1. Pre-contemplation Not yet considering change Raise doubt

2. Contemplation Ambivalence Tip the balance

Help client determine best

3. Determination Committed to change
course of action
 4. Action Attempts to change Help client make the change

Has made the change but Help client identify and use
5. Maintenance
is still vulnerable to relapse strategies to prevent relapse

There is a potential sixth stage—relapse, where the client reverts back to their former
lifestyle. In this situation the counsellor must help the client renew the processes of
contemplation, determination, and action instead of becoming stuck back in the old
behaviour.
Motivational Interviewing
One of the biggest challenges for the fitness professional is motivating people to begin
and to continue a fitness program. Part of the difficulty is that many fitness leaders are
themselves habitually physically active, so we have trouble relating to the mindset of the
sedentary individual. Sometimes we talk about the unmotivated client, implying that
motivation is a trait of the individual. Yet, it is puzzling to see the same client pursue
other goals with enthusiasm and diligence. What's going on? The model of motivational
interviewing provides some insights (6). According to this model motivation is not a trait
of the client but the result of the interaction between the client and the
counsellor, environment, spouse, etc. People are by their nature ambivalent. They see
costs and benefits of specific behaviours. So, a client is drawn to exercise for some
reasons (health, appearance, sensation, socialization, achievement, etc.) but at the
same time sees some disadvantages to exercise (time, inconvenience, cost, tiredness,
etc.). Motivating the client is a matter of tipping the balance, of adding to the weight of
the good things about exercising and perhaps gently removing some of the negatives.
There are five principles of motivational interviewing. First, express
empathy. Acceptance facilitates change. Accept the client as another valuable human
being, with hopes and fears, joys and sorrows that are not your own but are just as
valid. Your role is not to sympathize; doing so can reinforce the negatives and
undermine the client's self-efficacy. Skilful, reflective listening is fundamental.
Ambivalence is normal. Showing respect for the client is one of the simplest and most
genuine ways to express empathy. For example, start appointments and classes on
time; starting late implies that the client's time is less important than your own.
Second, develop discrepancy. Psychologists use the term cognitive dissonance to
mean internal conflict between a person's behaviour and that person's beliefs or values.
Inconsistency within the individual requires a change to decrease the discrepancy.
Awareness of consequences is important. Consequences that conflict with important
goals favour change (“I'm not doing any exercise, but I know that exercise makes me
feel and look better, and I'd like that”). The client should be the one to present the
arguments for change. The counsellor can facilitate by helping the client explore the
good things and not-so-good things about being inactive (or smoking, or abusing drugs,
or other negative behaviours). Avoid labelling (for example, “you're a couch potato”).
When discrepancy is increased, there are several possible outcomes, not all of them
good, so sensitivity and skill are indicated. The client may resolve the discrepancy by
denying the behaviour (“I get all of the exercise I need”). Or, the client may lower his or
her self-esteem (“I know I'm killing myself by not exercising, but I'm no good anyway”) or
his or her self-efficacy (“I know I should be exercising, but I just can't do it”).
Alternatively, the discrepancy is resolved by changing the behaviour, which is what we
want to happen. The counsellor's tasks are to increase dissonance and then direct the
dissonance so that the result is changed behaviour rather than modified belief.
Third, avoid argumentation or confrontation. Arguments are counterproductive.
Defending breeds defensiveness and decreases the probability that the client will
change in the direction that the fitness leader wants. Resistance from your client is a
signal to change strategies. Many fitness professionals believe logic will carry the day
and that a person can be persuaded to a point of view if the concepts are explained
clearly and repeated if not initially agreed upon. Unfortunately, if that doesn't work some
raise their voice as if the client wasn't hearing the arguments.
Let me give an example. A client comes for counselling regarding the choice to have
children. The client describes a complex set of motivations. On the one hand, it is
desirable to have children because it is a life experience that cannot be had any other
way, children bring out the fun and youth in grown-ups, there is perhaps additional
security and companionship in old age, and so on. The individual also has a list of
reasons not to have children: financial burden, lifelong commitment of time and emotion,
possibility that the children might not turn out right, and so on. Suppose that the
counsellor was to reply, “Well, after listening to all of this, I'm certain that you should not
have children.” After inquiring a bit about how you reached your decision, the client will
probably begin to argue with you – to defend the other side of the coin. This action
might appear harmless, except that people tend to learn what they believe as they hear
themselves talk. That is, as a person verbally defends a position, he or she becomes
more committed to it. Direct argumentation is absolutely the worst way to change the
opinion of another person.
The fourth element of motivational interviewing is to roll with
resistance. Resistance dictates a change in strategy. Perceptions can be shifted and
positions re-framed. New perspectives should be invited but not imposed. The client is
the most valuable resource in finding solutions to problems. Techniques of reflective
listening are fundamental: use voice and body to good effect, paraphrase, invite
clarification, use open-ended rather than closed-ended questions (“Why do you think
that happened?” is more useful than, “Are you finding the program boring?”).
Finally, support self-efficacy. Empower clients by helping them to tap into their
strengths and resources. Belief in the possibility of change is an important motivator.
The client is responsible for choosing and carrying out personal change. Let the client
decide how much of a problem there is and what needs to be done about it. The
counsellor presents reality in a clear fashion but leaves the client to decide what to do
about it. The counsellor is a resource, providing information and perspectives,
alternatives and possibilities. It is not the counsellor's role to confront clients and make
them face up to reality. Treat the client as a responsible adult, capable of making
responsible decisions and coming to the right solution. The client is responsible for the
current situation and gets the credit for any change. If an individual is responsible for
having accomplished a change, then it is more likely the change will be maintained. If
the counsellor imposes the change, the client has less invested in the program.
If you're having trouble with an unmotivated client, and you haven't used the
motivational interviewing model before, you might want to give it a try. This change in
the way of looking at the problem may help clients to succeed where they have failed
before. Also, it takes pressure off of the fitness leader by shifting the locus of control
from the counsellor to the client. The expert at the front becomes the guide by the side.
Finally, it should help move things in the direction of your long-term goal for your
relationship with the client when you foster self-determination rather than continued
dependence.
More Is Not Always Better
Sometimes fitness leaders need to slow down their participants. People who make too
large a change in their lifestyle have more difficulty maintaining that change and are
more likely to fall off the wagon altogether. For example, a client who expresses the
wish to improve her aerobic fitness, stop smoking, eat better and lose weight may be
best advised to start with an exercise program. As stated previously this cannot be
imposed, but the counsellor can discuss the benefits of focusing on one initial goal and
help the client make a decision they are happy with. Once she has established a regular
habit of exercise, she may notice that she has already lost some weight. Perhaps her
total weight is the same, but her pants fit more loosely, suggesting that she has lost
some fat and replaced it with denser, more compact muscle. She may have become
more selective about the type of food she eats, and may be eating less despite the
increase in her energy expenditure. She may even spontaneously stop or reduce
smoking without formalizing a strategy to stop. By focussing on exercise, I do not want
to suggest smoking cessation and other goals are not worthwhile. The problem with too
many goals is that the client can become overwhelmed and once she fails with one goal
she may associate the others with that failed goal and then fail completely. In addition, it
is often noted that regular activity is often a starting point for other health behaviour
changes. Perhaps the reason is that the rapid positive feedback that most people get
from exercise increases self-image and self-efficacy, which gives people the confidence
to make other changes.
Another example of the more is not better principle is the story of Bob, a participant in a
community-based healthy heart program. Bob entered the preventive fitness program
with several pre-conceptions of exercise. One was that without some pain there would
be no gain. He worked compulsively most of the time, staying in the upper ranges of his
exercise prescription. His fitness trainer often encouraged him because of his special
fortitude. Like so many other dropouts, however, Bob eventually got tired of running in
high gear and he quit. Basically, he “burned-out.”
What went wrong? For Bob, backing off from his usual driven self would have meant no
gain – there was no outcome expectancy under conditions of low-level exercise. In
addition, the client was being reinforced for his intense behaviour by the accolades of
exercise professionals. Do you think he could risk ruining his image? Although Bob held
a potentially constructive outcome expectation for exercise, the specific elements were
destructive. It does not require pain to make gain. It was too late to attempt to right this
wrong by the time he was prepared to quit. He should never have been allowed to
initiate this behaviour in the first place.

Required Reading

Please read/review:

 Textbook: Leyland, A. J. (2017). Exercise Programming Science and

Practice. Simon Fraser University Publications.
o Chapter 5

Goal Setting

Have you read the Lewis Carroll novel, Through the Looking Glass (otherwise known as
Alice in Wonderland)? This book tells the fictional tale of Alice, who discovers that she
can walk through a mirror, and does so to end up in a strange and magical world. At
one point in her fantasy journey, confused and disoriented, she encounters the
Cheshire Cat sitting on a tree limb. She calls up to the Cat, “Sir, can you please tell me
which way to go?” The Cat replies, “That depends upon where you're trying to get to.”
She answers, “That's just the problem, I don't know!” He offers, “In that case, it doesn't
matter which way you go.” She complains, “But I have to get somewhere.” The Cat
concludes with a grin, “You most certainly will!” The point is that without goals, we will
certainly get somewhere, but maybe it isn't the somewhere that we want to go.
In addition to the obvious fact that you need to know where you want to get to, you also
have to know where you are. If you do not know your starting point you cannot devise a
plan to get somewhere! This is a crucial role of exercise assessments which we will
discuss in later study units of the course. We will also discuss what constitutes realistic
goals throughout the course as I find many BPK 143 students struggle with that
question when they first develop their own personalized fitness plan. Despite the
importance of fitness assessment and common fitness adaptation rates, which are
discussed later in the course, it is important that we start with a discussion of the
framework and process of helping your client set good goals.
Helping Clients Set Goals
An alternative to Alice's aimless wandering is to set goals. Many students are already
accomplished at goal setting, which is why they have succeeded in school and are
enrolled in university. Others are intelligent and progress well enough to enter university
without setting goals. However, goal setting is a common habit of successful people.
Setting goals with clients is a delicate process. As fitness leaders, counsellors, personal
trainers, and so on, we must resist the urge to tell others what to do. Even when people
explicitly ask you for advice, they rarely respond well to being told what to do. The
content of the advice might be perfectly appropriate, but it may meet with resistance if
we do not attend to the counselling and goal setting process. That is, the way of
communicating with people, including clients, is usually more significant than the
content of the communication. Yes, it is true that most traditional teaching emphasizes
content; the teacher teaches us by organizing, summarizing, and delivering information
in a lecture or a book. However, the role of the counsellor is different from that of the
teacher.
Modern counselling practice is based on the client-centred approach. The client is the
one who decides what the problem is, and what, if anything, he/she wants to do about it.
The counsellor is there to help clients explore their thoughts and feelings and, possibly,
later to help them develop an action plan. Your role is mainly to listen, guide, facilitate,
and reflect. Even if you have personally had an exactly parallel situation to the one that
the client presents, it is probably not productive to tell the client, “I know! The same
thing happened to me,” and “I know exactly what you should do.” It is not that the
counsellor's personal experience is useless; it is just that the client must be engaged at
every step of setting goals. It is usually more effective if you inquire, “Why do you think
that is?” “What do you think might help?” “Has this ever happened before?” “What did
you do about it then?” “How did that work?”, etc. At some point, after you have helped
the client explore the matter, you might offer, “Well, what has worked for some people
is…” but note that this is offering a suggestion rather than a directive.
The SMART Model of Goal Setting
Goal setting can be trickier than many people think. If your client says he/she wants to
improve aerobic conditioning, how will he/she know when this goal has been achieved?
Even after a few sessions of aerobic work clients will have improved but is this enough
to motivate them to continue? If the client only has a vague idea of how aerobically fit
they want to be, or what improvement they want, the chances for relapse are higher. It
is better to be specific by setting measurable targets. Being able to run 1.5 miles in 11
minutes is an example of a specific measurable goal. I realise it is difficult to set this
type of goal for a client as you may not have the knowledge or experience of what
improvements can reasonably be expected. In addition, many clients do not really want
to set numbers to their performance levels. In fact, setting numbers might scare them
away by reducing their self-efficacy.
Another option is to set adherence goals. For example, if your client is focussed on
starting a program you could help them set goals such as, "swim for 30 minutes, three
times per week for the next 4 months and to swim twice per week in any week I fail to
make three swimming sessions.” Despite this goal not having a performance outcome,
they can measure (quantify) whether they have achieved this adherence goal. Note that
this goal has some built-in defence against relapse. You would not want the goal to be
too rigid where the client will feel they failed after the smallest of slips.
I am not suggesting that it is unacceptable for your client to have general long-term
goals like improving aerobic conditioning, losing some weight, feeling less stress, etc.
However, they should be encouraged to set short-term specific and measureable goals
which should help with feedback and motivation. These goals should be regularly
updated if the client attains them or realises it was a goal that was set too high. A goal
that is attained can no longer motivate a client so goals must be reviewed frequently.
Similarly, a goal that is set so high that the client feels it is unattainable will likely fail to
motivate. Remember that building self-efficacy is crucial to someone starting an
exercise program. A goal set too high will destroy the chance of developing self-
efficacy. From this discussion you should see why fitness assessments should be
performed frequently.
Goals can be developed using the acronym SMART that is explained below. This
concept was introduced in BPK 143.
Specific • Is the goal specific?
Do you know what, how, where, when, with whom, and how long you will do this? For
example, the goal may be to hold an isometric wall-sit for 60 seconds with my knees at
90 degrees and my arms resting loosely by my sides or do 50 seated leg presses on the
Universal Gym machine set at 80 kg. If you have stated goals in measurable form
progress can be accurately appraised.
Measurable • Is it measurable?
Will you know when it is done? See discussion above.
Acceptable • Will your client feel good about doing this?
Is the goal meaningful to the client? Is this your client's personal goal or did you or
someone else influence their choice? A common situation is a spouse or significant
other influencing what your client is telling you.
Realistic • Is your client able to do this?
Current phenotype, genetic characteristics, personal preferences, time, money, etc. all
play a role. As stated above it can be difficult to set realistic goals at times, however, if
goals are given careful consideration they should work for most clients. For example,
losing more than 0.5 kg per week is considered unsafe and potentially ineffective; a
more rapid change in weight may be impossible or hard to maintain (3).
Timely • Is there a deadline attached?
This is clearly linked to being a realistic goal. It is possible to have a realistic goal in the
sense your client can achieve that but the achievement date is set too soon. It is also
possible to set an achievable goal too far away in time, which will likely diminish
motivation. Get your client to develop short and long-term goals and create new goals
once old ones are achieved. Maslow's Theory states that once a need (or goal) is
satisfied, it no longer motivates. This may appear to be an obvious statement, but we
often do not re-evaluate our goals once we have achieved them.
Goals should indicate when specific actions will be taken and have a target date for
when they will be attained. It is important to break long-term goals down into short-term
goals so that clients can keep track of their progress better. For example, you have a
client who has the long-term goal of completing a 10-km fun run in under 60 minutes in
six months. She informs you that her current best time for that course is 65 minutes. In
discussions with you, the client should decide to set some short-term goals. It is very
difficult to give a hypothetical suggestion because actual time and distance targets
would depend on the initial test results and progression over the 6 months.
You would obviously begin with an initial assessment. There are several options but for
this example we will start with a 5-km time trial (this would help establish what her
current running speed is for this distance). Based on the initial test you might target
further tests based on improving speed, gradually increasing the distance. This would
be a scenario where the 5-km time trial was still run close to the 6.5 minutes per
kilometer. Such a result indicates she needs to work on speed, as she can run 10-km at
this 6.5 minutes per kilometer pace, so should be faster over 5-km. On the other hand, if
she could run 5-km at a pace close to the 6 minutes per kilometer target, this indicates
she needs to work more on endurance. For this example, I am going to assume she is
like a lot of recreational runners that tend to have a set comfortable pace and have
never really trained at faster speeds. The table below is one example of a series of
short-term goals you could set. Keep in mind there is no one correct way to go about
the design of such testing.

Month
5-km time trial. 33-minute target
1

Month 1-km at target pace (6 minutes per km), two-

2 minutes break, repeat 6 times.

Month
5-km time trial. 31-minute target
3

Month 1-km at target pace (6 minutes), one-minute break,

4 repeat 8 times.

Month
8-km time trial. 25-minute target.
5

Month
Race day target 59.5 minutes
6

We will discuss potential programs and additional tests in later study units. This
example was just to show possible short-term goals that should help to keep the client
motivated. I deliberately changed the type of testing just to show you some examples.
The client might be happy with a 5 km test in month one, a 6 km test in month 2, etc., or
some other linear progression of aerobic fitness tests. In reality, I would test much more
frequently than once per month. Again, I will reiterate that this is simply a brief example
to get you thinking about such concepts.
In absence of clearly defined goals, we become strangely loyal to performing daily acts
of trivia.Author Unknown
I want to come back to the issue of trainability, the ability to improve fitness, as this is
crucial to effective goal setting. Assuming the client is motivated and adheres to an
exercise program, trainability will depend heavily on current fitness level, even more so
than genetic potential. If you look at Figure 2.1 you can see that when a person begins
training, there is usually a rapid increase at first and then the improvement will start to
plateau (7). However, if you look back at Study Unit 1, Figure 1.3: Theoretical
Relationship Between the Rate of Adaption, Performance Improvement and Training
Complexity, you will see that where you start on that upward curve will affect the rate of
improvement. For example, oxygen uptake for a beginner may increase by 20 percent
in three months (8). On the other hand, an athlete who has been doing aerobic training
for years may only see an increase of one or two percent over a whole year of training.
Eventually, fitness does not increase any further if training levels are maintained or you
are that rare person who is at, or extremely close, to your genetic potential. The level at
which an individual plateaus will depend upon genetics, age and other constitutional
factors. An untrained person with a maximal aerobic power of 32 ml.kg -1.min will
probably never be able to achieve the 70+ ml.kg -1.min-1 level associated with elite
distance runners even with the best of training, coaching, equipment, nutrition, and so
on.
Prior training history is one major factor that makes goal setting difficult. If you have a
client who scores low on a fitness parameter but previously was very fit in that
parameter, you will likely see their progress to be quicker than a client with a similar
fitness score but with no previous history. As you can imagine, the exact effect of prior
training history is not something we can design a randomized clinical trial to study. With
many of the concepts in this course, and especially in this study unit, you need to
develop experience over years of practicing in the field of fitness programming.
Figure 2.1. Physical and Physiological Adaptations to Aerobic Exercise
Source: Milvy, P. (Ed.). (1977). The marathon: Physiological, medical, epidemiological,
and psychological studies (Vol. 301, p. 25). New York: New York Academy of Sciences.
(7)
 

Communication Skills

Communication is an essential part of human relations. It is the way we share

information, establish rapport, empathize. Humans are highly social animals who live,
work, and play in groups: families, peer groups, communities and societies. We
communicate with sophisticated verbal and symbolic (e.g., mathematical, computer)
languages. We also give and receive subtle, rich, nonverbal messages.
Open-Ended Questions
Effective counsellors often use open-ended questions. Here are some examples:

 Why do you think that is?

 What do you think might help?
 Has this ever happened before?
 What did you do about it then?

Closed-Ended Questions
Closed-ended questions are those that can be answered briefly, usually in a single
word such as yes or no. For example, the counsellor could have asked, “Did you try
stretching your calves before running?” Such questions tend to stifle rather than
encourage dialogue with a client (or with people you meet at a party, for that matter).
The client can feel as if you are dragging the answer out of him – and you are! Let the
client tell his story in his own way. It will often be non-linear, and you may subsequently
want to backtrack and ask the client to help you fill in gaps or add detail. Open-ended
questions typically elicit much lengthier answers, which is the reason to ask them. Be
prepared to listen to the answer. Resist the urge to interrupt with questions or
observations that will disrupt the flow. You will however often find that the client has
wandered off topic or is repeating herself. In such cases, it is useful to refocus the
session. For example, “O.K., I'm getting a good picture of how you spend your time on
the weekends. Tell me about your weekdays.”
Body Language
Position yourself close enough to the client to be able to converse in a normal voice – a
metre or two away. Don't crowd into the client's personal space. Personal space
averages about a metre, or arm's length, but it varies between individuals and with
circumstances. Most people feel uncomfortable, anxious, or threatened if someone
intrudes into this space. There are situations in which people accept such an intrusion.
In intimate relations, people reduce their private space so they can hug and kiss. People
shrink their private space when they crowd into an elevator, a ticket line-up, or a bus.
Usually they maintain a sense of distance or separation by remaining silent and looking
at the floor, the ceiling, or straight ahead. Eye contact and conversation are unusual in a
crowded elevator. We permit intrusions into our personal space when a person is
working on our body – applying a bandage, giving a massage, or fitting a suit. A good
indicator is the individual's behaviour. If he withdraws as you move closer, you are
probably intruding. When people are conversing, they tend to sit within a metre or two of
each other. This is the traditional distance a counsellor assumes from the client; in the
counselling room, two chairs can be positioned at this distance.
Position yourself so your eyes are at about the same level as the client's. If she is sitting
and you stand, you will create a power imbalance. It places her in a position of
vulnerability, inferiority. Some people (not counsellors, we hope) exploit this natural
feeling; an office manager may have the chair behind her desk on an elevated platform
so that people called in for an interview sit at a lower level. Turn your body so that it
generally faces the client and is inclined forward slightly. This posture shows
acceptance of, and interest in, the client. Make eye contact, but don't stare fixedly. Keep
your face pleasant and open. Smiling is nice when it is genuine and not excessive.
Crossing your arms or legs can imply that you are putting a barrier between the two of
you. Resting your feet on the floor with your arms resting on your legs or the arms of
your chair is a classic, active-listening posture.
The fitness professional needs to intrude into a client's private space when performing
some fitness appraisals (e.g., taking heart rate, blood pressure or waist girth) or when
correcting the client's position during resistance training or stretching. Professionalism
dictates that this should be done with the client's knowledge and consent. I'm not
suggesting that the informed consent form should say “…… and at times I may have to
touch your body.” However, you should ask for permission. Knowledge and consent can
be imparted casually; for example, “I'll put on the blood pressure cuff now. Please roll up
your sleeve and place your arm on the table. Are you okay with that?” or “If you don’t
mind, could you please lift your shirt a bit so that I can measure your waist
circumference.” It is very important that you let the client know they are about to be
touched. The professional can also help the client feel comfortable by approaching from
the front (rather than from the back or side). However, when taking waist or girth
measurements it is best to do so from the side of the client rather than directly in front,
due to the obvious potential for the client being uncomfortable with your head at waist
level.
Active Listening
In a good counselling session, the counsellor typically does only 20 percent of the
talking. When she is not talking, the counsellor does more than just sit quietly. Good
listening is active listening, and it includes a number of communication skills.

 Bridging is the use of little words such as “uh huh,” “oh!” “yes,” “go on,”
“really?” and “I see.” They signal to the speaker that you are listening, but
they do not disrupt the flow.
  Restating consists of repeating the last word or few words the client said. It is
definitely not parroting or copying that children often do to tease a sibling.
Here is an example of restating. Client: “Often I plan to go for a run after
work, but when I finally do make it home with all of the traffic, I'm too tired and
frazzled. I just feel like taking my shoes off and flopping on the couch. I
wonder what's wrong.” Counsellor: “what's wrong?” Client: “Yes, I’m so
organized and disciplined at work, I can't understand why I'm so flaky with my
fitness program.” Restating prompts the client to continue. When it is done
effectively, the client does not even notice it.
 Paraphrasing is summarizing in your own words what you have just heard.
For example, if the client has described for ten minutes the impending visit of
a family member, the counsellor might paraphrase: “It sounds as though you
are looking forward to your brother's visit, but that you are concerned that it
will interfere with your regular after-work sessions at the gym.” Restating
helps ensure that you understand what the client is thinking and feeling. It
also shows the client that you have been listening.
 Asking for clarification is used when you're not sure that you have
understood the client. For example, the counsellor might say: “Could you
elaborate on that?” or “Tell me more about your wife's activity interests,” or
“I'm not sure I know what you mean by all-around fitness.”

Empathy
Empathy is defined as “the feeling that you understand and share another person's
experiences and emotions.” Sympathy on the other hand, means “the feeling that you
care about and are sorry about someone else's trouble, grief, misfortune, etc.” An
effective counsellor empathizes rather than sympathizes with the client. It's appropriate
to accept clients for who they are, and to try to understand and relate to them and their
situation. Empathy helps clients make positive changes. It's not appropriate for you as a
counsellor to get so involved with the client that it makes you feel good when things are
going well for him and to share the discouragement he feels when things aren't.
Sympathy may be appropriate from a partner or friend, but not from a counsellor. The
counsellor's relationship with the client is a working relationship, not a personal
relationship.
Physical Space
All human interaction occurs in physical space, a place that has a certain size, shape,
colour, temperature, lighting level, furnishings, and so on. As architects and designers
know very well, the physical environment affects the way people feel and interact. Thus,
a certain feeling or type of interaction can be facilitated by manipulation of physical
space. Consider, for example, the way a group discussion might go if the participants
sat behind rows of desks facing the front of the room (Figure 2.2A). Discussion will likely
be inhibited; people will twist in their seats trying to see those behind them, and a lot of
the discussion may flow through the moderator or teacher who sits or stands at the
front. Now, imagine what would happen if the participants sat in chairs or on the floor in
a circle facing each other, with the moderator also sitting in the circle (Figure 2.2B). This
is a more inclusive setting, implying that all are equally welcome to participate and that
the moderator's voice is no more important than anyone else's (9).

Figure 2.2. Furniture
arrangement affects group
dynamics. A. Traditional
classroom with desks facing
the teacher. B. A circle
connotes sharing of power
and promotes interaction
among group members.

Figure 2.3. Some options for positioning furniture in an office also used for counselling
or interviewing.
Source: Nairn, K. (1997). Hearing from quiet students: The politics of silence and voice
in geography classrooms. In Jones JP, Nast HJ, Roberts SM. Thresholds in Feminist
Geography: Difference, Methodology, Representation. Rowman & Littlefield; 1997. p.
428
Pay attention the next time you are eating out. Where do people sit? You may notice
that people who are by themselves tend to occupy seats with their backs to the wall.
What if two people are sharing a meal? Do they sit across from each other, side-by-
side, or at adjacent corners of the table? Where do you sit when you're eating out with
another person? Now, apply these observations to the fitness leadership setting. Your
counselling room may have a desk at which you work. What happens when you are in
the room with a client? Do you remain behind the desk with the client seated across
from you (Figure 2.3A)? Perhaps it would be better if you rearranged the furniture so
that you could rotate your chair away from the desk to face the client's chair (Figure
2.3B). Are there times when you and the client write or read together? In this case,
sitting at adjacent corners of a table or side-by-side would seem more suitable (Figures
2.3C and 2.3D).
Where there is a potential distraction (e.g., another group playing basketball nearby
while you are leading a stretching session), arrange things so that the distraction is not
in view. If there is bright sunlight, make arrangements so that the sun is not in anyone's
eyes. Perhaps you can draw the blinds, move the group into the shade of a tree or
building, or shift the group so that the sun comes from a different angle. If no strategy
succeeds completely, then you should be the one squinting into the sun not your
clients/participants. Sunglasses may be suitable during group activities (e.g., coaching
on the soccer field), at closer range however they are usually inappropriate for the
leader/counsellor/personal trainer because the client(s) can't see your eyes and the
non-verbal information they convey.
Counselling Styles
There are four different counselling styles.

1. The preacher urges the client to adopt a healthy lifestyle. He tells clients

what to do, but not much about how to do it. The preacher style motivates
some people (maybe through guilt), but it imposes value judgments and
prevents dialogue.
2. The director tells the client what to do, and how to do it. This style provides
guidance and structure. It may be most appropriate at the action stage.
However, many clients resent being told what to do and it under-uses the
client as a resource.
3. The educator delivers information in an objective, non-judgmental, and non-
directive way. It is efficient for covering a lot of material in a given time period.
It is reassuring for people such as university students who are familiar with
this style, but it intimidates other clients, and it prevents dialogue.
Furthermore, information alone has a disappointingly small effect in altering
behaviour. As you have heard already in this course, many factors affect how
people behave, including outcome expectancies, core values and beliefs,
sense of self-efficacy, and previous positive or negative experiences.
4. The consultant works with clients and involves them actively. She helps
clients to have insight, consider alternatives, and make choices. This style
promotes dialogue, uses the client's resources, and supports self-efficacy.
However, it takes time and skill. In addition, some people want information or
direction, which are best facilitated by other counselling styles.

A combined approach is most useful. The experienced, attentive counsellor will use
different styles in different situations, depending for example on the particular client, the
stage of change, and the goals for that counselling session.
An Example
Shiva is a female data entry clerk. You measured her physical fitness as part of an
employee health promotion campaign. You are now meeting with her to explain the
measurements you have made and to interpret her results.

Tester So, that's all of the measurements. You can slip back into your work
clothes, and when you get back we'll discuss your results. (Better than
tester-centred statements such as “So I'll let you get changed, and when
you get back I'll explain your results to you.”)
Shiva returns

Tester Welcome back. Have a seat here, and we'll look at your measurements.
The word measurement is better than test, which implies a judgment.
So how did you find that?

Shiva Pretty good. It wasn't as hard as I thought it was going to be. How did I do?

Tester Well, let's have a look. First, your flexibility in the sitting toe touch is good,
well above average for Canadian women your age.
The tester has chosen to start with the items that she had good
scores on, and conclude with the weakest area, her body
composition.
Your muscle strength and endurance are about average for women your
age.
More detail than this is probably inappropriate at this point.
Your stamina, measured with the stair stepping, is slightly below average.
A discussion of the meaning of VO2 max is inappropriate at this
point.
Finally, your body weight and waist girth are quite a bit higher than women
your age and height.
This is preferable to saying too heavy and too fat, which implies a
value judgment.
 How does that all sound?

Shiva Yes, pretty good. I'm not surprised about my weight. I know I'm way too fat.

So, what would you like to do now? Are there any other areas in particular
Tester that you'd like to explore?

Shiva Yes, tell me more about how bad my weight is and how to lose body fat.
Notice her interest is totally focused on body composition; a detailed
explanation of strength or aerobic power would have been a waste of
time.

Tester Okay. What do you want to know?

Tester resists the temptation to jump in and lecture. Let the client's
questions guide the session.

Shiva What areas should I be trying to lose fat from?

Tester Well, that's a good question, and a difficult question. We cannot really
measure body fat precisely which is why I measured your height and
weight and also your waist circumference. [Slipping in a little bit of
education] This information, along with other test results gives us an
indication of your body composition. The waist circumference attempts to
get an idea if you have too much body fat in the torso, which is particularly
a health risk. Other than that, we cannot determine any specific areas that
have more fat than other areas. Besides, exercise or diet won't make the
fat go away from a specific area. As you reduce body fat it tends to be lost
from areas it was last put on. Does that make sense?

Shiva I'm not sure I understand.

Tester That is quite understandable. As I said that was a difficult question for me
 to answer.

Summary

As a fitness professional, you have probably already made activity an integral part of
your lifestyle and are eager to help other people do the same. At times, you will be
frustrated with the apparent unwillingness or inability of clients to make and maintain
changes. But people can change, and you can help them change. It helps to establish
rapport with the client, to accept him for who he is, to understand his motivations and
current situation, and to be flexible in your approach. A positive, rewarding and fun
fitness atmosphere with a range of activity options enhances motivation toward activity.
Help clients visualize long-term goals. Then, help them set challenging, meaningful,
achievable short-term goals toward the longer-term goals. Setting goals should provide
the inspiration to get going, the reward of reaching a milepost, and the determination to
continue.
All humans communicate, usually without thinking about it. The dedicated fitness
professional, however, will take the time to learn and practice effective communication
skills. Most students and professionals are already quite good at the talking part, but
they may need more work with active listening and the consultant style of communi-
cation. Communication is even broader than writing, reading, talking, and listening. The
effective communicator will use non-verbal communication and physical space to get
feedback from her clients, to reinforce her verbal messages, and to optimize dynamics
for a particular group activity.