Abstract

In an earlier column, I explored the idea of the transtheoretical model which describes how clients move through stages of change; we covered the first stage, precontemplation, and appropriate success strategies. This column begins with the second stage. Contemplation: Contemplators may be thinking about starting an exercise program but have difficulty making the decision. They may know the benefits of a healthy lifestyle, proper nutrition, and exercise, but they resist taking action toward change. In order to change behaviors, contemplative individuals have to understand how negative behaviors affect their health and what they can do to change. A success strategy for this goal would include asking questions to identify what is holding them back, and the use of an excuse list. Label 3 columns on a piece of paper with the following headings: Excuses (What’s holding you back?), Benefits, and Consequences. Have your clients list their excuses or perceived barriers to exercise. Next, help them identify the benefits if they do exercise, and the consequences if they do not. To help clients understand the process, ask questions such as: “If you didn’t exercise, are you willing to accept the negative consequences you outlined here?” Notice their reply. If clients are still resistant or deny there is a problem, they may still be precontemplative, so ask them: “If not now ...WHEN?” Questions like these will make contemplative individuals evaluate their ability to make a commitment to change. Once they make the decision, the next step is to prepare them for action. Preparation: Clients in the preparation stage often do not succeed on their own because they lack a plan. They may not know how to take their good intentions and put them into action. They may lack self-confidence, or knowledge about exercise, or their old habits keep getting in the way. A commitment contract is a success strategy that can lead clients in the preparation stage to the action stage. A commitment contract outlines the goals of the program and how those goals will be reached. Explain to clients what they can expect out of each session and what you expect of them. Have the clients commit to at least one S.M.A.R.T. (specific, measurable, attainable, relevant, time-bound) short-term goal that can be achieved in 2 to 3 months. The commitment to an initial short-term goal is imperative because individuals in this stage are at risk of dropping out. Enhance your clients’ feelings of success by pointing out their wins each week. This will help reinforce positive behaviors and enhance their feelings of self-efficacy. By rewarding your clients with positive verbal and nonverbal feedback for successful close approximations to the targeted goal on a weekly basis, they will develop more confidence in their ability and will strive to make fitness a part of their life. Textauszug