Chapter 2: Principles of Adherence and Motivation


What you will learn:

  • As trainers how to demonstrate excellent communication and teaching skills thru all stages.
  • How to develop and empathetic understanding of your clients while maintaining professionalism.
    1. Introduction

      1. Motivation: the psychological drive that gives behavioural direction and purpose.
      2. To adopt a lifestyle change on must break old habits and develop new ones.
        1. The client, individual, is the main factor
        2. Transtheoretical Model of Behavioral Change (TTM): a theory of behavior that examines readiness to change.
        3. Stages of change:
          1. Pre-contemplation
          2. Contemplation
          3. Preparation
          4. Action
          5. Maintenance
        4. Factors that motivate them to start are not the same factors that motivate them to stay.
        5. 2.5 hours of moderate exercise per week.
        6. 2+ days of moderate-high intensity muscle strength training for all major muscle groups
        7. 50% of those who start a new program drop in 6 months
          1. Talk to clients that actually stay and find out why they stay. The reasons.
  1. Factors influencing exercise participation and adherence

    1. Personal Attributes
    2. Demographic Variables
      1. Lower levels of activity: people who are older in age, have fewer years of education and lower in income.
      2. Client age has no relevance. It spans through all age groups.
      3. Men have greater activity levels than women
    3. Biomedical Stats
      1. Health conditions including obesity and cardiovascular disease
      2. Does Not play a major role in determining if a client who suffers from it, will want to workout.
    4. Activity History
      1. Most important and influential variable for the client
      2. Personal Trainers must gather as much activity history as they can
        1. helps PTs develop exercise programs
        2. helts PTs know what challenges they have faced
        3. helps PTs know what keeps them going and what leads to a relapse of inactivity.
    5. Psychological Traits
      1. personality and psychological attributes of the client
      2. self-motivation helps with exercise adherence
        1. what makes them and keeps clients motivated
        2. what pushes them away and un-motivates them
    6. Knowledge, Attitudes and Beliefs
      1. Health perception
        1. poor health: clients are unlikely to start a program or perform at very low intensity with little or no results
        2. Locus of control
          1. People associate results to internal factors like their efforts and ability to accomplish something.
          2. external factors: luck or others actions
  1. Environmental Factors

    1. Access to facilities
      1. If gyms/exercise facilities are close to the clients work or home, they are more likely to adhere to the program.
      2. Time
        1. the #1 excuse for not starting or dropping an exercise program
        2. When clients don’t have enough time to exercise, it means they have a lack of interest in the program, will not be committed and don’t enjoy being active. The also maybe unmotivated.
        3. PTs should help the clients set attainable goals and motivate them.
    2. Social Support
      1. A clients family, friends, co-workers and especially spouse/partners play a big role in helping them adhere to an exercise program
      2. If a client lacks support, PTs must work to establish a network of support within the exercise environments, starting with themselves.
  2. Physical-activity Factors

    1. Intensity
      1. High (vigorous) intensity: the client dropout rate is very high. Almost twice as much as moderate-intensity programs
      2. Moderate intensity: almost 6x as many women and 2x as many men begin and adhere to these programs.
      3. Heart rate reserve (HRR)
        1. reserve capacity of the heart
        2. the difference between the maximum heart rate and the rest heart rate.
        3. the hearts ability to increase rate for maximum intensity activities.
      4. Ratings of perceived exertion (RPE)
        1. a scale developed to measure the exercise efforts put forth by a client. Old scale measure from (6-20) Modified to a (0-10) scale
    1. Understanding Motivation
      1. Introduction
      2. Personality traits come from within a person
      3. Peoples guidance and support play a big role in motivating a person.
      4. Ideas, things and events also help motivate people
      5. Unmotivated clients are generally very difficult to work with and have many excuses on why they CAN’T adhere.
      6. Intrinsic and Extrinsic Motivation
        1. Intrinsic: people who are physically active and workout because they truly enjoy doing it. They want to be there.
        2. Extrinsic: people who are physically active and workout because of external factors
          1. Weight loss
          2. Improving health
          3. Making their spouse/partner happy
          4. Looking good
        3. Most people fall in between the two. You never have too many people on either end.
        4. Feedback is a big motivating factor. Providing consistent and clear feedback will motivate the client to continue staying in the program
          1. allow the client to also provide feedback on their own progress
          2. teach clients independence to self-motivate and be able to adhere to it even if you are not present
          3. proves to keep clients coming back.
      7. Self-efficacy
        1. Positive thinking and belief in their own capabilities to exercise and stay healthy.
        2. Directly related to motivation
        3. design workouts that are achievable and build on those accomplishments
        4. clients are more likely to stay motivated when they consistently accomplish short term goals.
    2. Feedback
      1. Extrinsic: PTs provide encouragement, exercise correction and reinforcement to help client through the program
      2. Intrinsic: clients provide their own feedback on the program and their own progress
      3. Knowledge of results: Known simply as feedback on progress
    3. Leadership Qualities
      1. PTs are leaders who positively influence the way a client thinks, feels and behaves.
      2. A personal trainer can be viewed as a coach working with an athlete to achieve set goals.
        1. As a PT you aren’t just an exercise program designer but are part of the entire process and experience along with the client
      3. A PT should demonstrated professionalism
        1. they should be clean and have a non-threatening look
        2. they should be in great shape and lead an active and healthy lifestyle. Preach what you teach.
      4. Maintain the client-trainer trust relationship at all times
      5. Part of being a leader is to be a good Listener
        1. customize your programs based on clients feedback
        2. bring innovative ideas and methods to the table
        3. include the client in all aspects of the program and adhere to their likes and dislikes
    4. The Personal Trainers Role in Building Adherence
      1. Program Design
        1. A PT must be able to successfully design a safe and effective physical-activity program.
        2. make sure to keep client preferences in mind
          1. time and money can both be factors
      2. Role Clarity
        1. PTs should clearly and accurately define expectations from both parties to avoid any misinterpretations, assumptions or disagreements.
          1. The trainer and client roles should be identified and agreed upon in writing.
      3. Goal Setting
        1. Initial goal setting with the client helps behavior change.
        2. SMART guidelines
          1. Specific
          2. Measureable
          3. Attainable
          4. Relevant
          5. Time-bound
        3. Avoid setting too many goals
        4. Avoid setting difficult goals
        5. Avoid negative goals
          1. ex: I wont miss any trainings  → I will come to every training
        6. Set short and long term goals along with outcome and performance based goals.
        7. Revisit and modify or add to the goals regularly
      4. Contracts / Agreements
        1. The PT should create written documents defining; client expectations, program details and rationale for program design
          1. This will give the client clarity and purpose
    5. Strategies to maintain client motivation
      1. Relapse prevention
        1. The trainer should discuss with the client strategies to prevent a relapse into in-activity.
        2. Many reasons can trigger a relapse
          1. unexpected events
          2. schedule changes (work/family)
          3. illnesses / injuries
          4. vacations
          5. time
          6. finances
          7. support issues
          8. program dissatisfaction
        3. Plan ahead for long term adherence to the program
      2. Social Support
        1. A client’s support network is crucial in preventing relapses
          1. friends/family and co workers involvements help keep them motivated
        2. There is an increased adherence to programs by clients whose spouse/partner’s support is there.
          1. in the form of joint participation: spouse is also exercising and shares similar goals
          2. in the form of a positive attitude and encouragement toward their participation
        3. Trainers should work on creating a support system within the exercise environment
          1. other gym goers
          2. trainers and staff
      3. Assertiveness
        1. An honest, straight-forward expression of thoughts, feelings and beliefs.
        2. Trainers should help clients be assertive with their own progress, struggles and accomplishments.
        3. Non-assertive clients lack self-confidence and feel vulnerable to failures.
      4. Self-regulation
        1. Personal Trainers should teach clients to self-regulate their own behaviors, schedules, times and priorities.
          1. Clients who are self-regulated are more likely to adhere to the program for its duration
          2. Clients can deal with barriers and struggles much easier.
      5. High-risk Situations
        1. Trainers should identify them and be prepared to deal with them in a safe and effective manner.
        2. Trainers need to be understanding, supportive and empathetic to the clients needs, wants and progress.

I apologize for the lack of organization in my nested bullets above. This is what WordPress currently offers and I am researching plugins and css code to figure out a more efficient and organized way of displaying the notes.

Go on to: Chapter 3: Communications and Teaching Techniques 

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