from training to transforming...• aware of problem but ambivalent about change; still weighing...

2019 Anytime Fitness Regional Vitals Trainings 1

Getting people moving

From Training to TransformingApplying a ”Coach Approach” to Elevate the Member Experience


Learning Objectives

Implement evidence-based coaching techniques and behavior

change strategies, such as motivational interviewing, in order to

facilitate lasting behavior change.

Assess readiness to change and tailor approach accordingly to

influence progress through the stages of change.

Apply effective communication skills, including active listening and

powerful questioning.

Describe a “coach approach” to working with prospects and

members.


Getting to Know YouCrafting Your Personal Mission Statement

In 3-4 sentences, describe your personal

mission and vision for your “best future self” in

your current role at Anytime Fitness.

In your written statement, include

what drives and motivates you,

what you are most passionate about,

what your professional goals are, and

how you feel called to help others “make healthy happen.”


#RealTalk


Why??


Setting the FoundationA framework for adopting a “coach approach”


Traditional Model vs. Health Coach Model

TRADITIONAL MODEL HEALTH COACH MODEL

Professional as the expert Client as expert in own life

Client told what to doWith permission, client offered

information but chooses own solutions

One size fits all solutions Individually-tailored solutions

Extrinsic motivators Intrinsic motivators

Client required to facilitate changeCollaboration and assistance

to facilitate change

Ignore barriers to change Address barriers to change


Centered on Self-Efficacy

An individual’s belief in his or her

capacity to execute behaviors

necessary to produce specific

performance attainments

-Albert Bandura


Rooted in Empathy

The ability to metaphorically “step into the

shoes” of another person, aiming to

understand their feelings and perspectives,

and to use that understanding to guide one’s

actions.


Positive Psychology Provides the Blueprint

The aim of positive psychology is

to begin to catalyze a change from

preoccupation only with repairing

the worst things in life to also

building positive qualities.

-Seligman & Csikszentmihalyi


Put into practice


Take turns sharing your personal mission statements

with one another.

Take brief notes afterward to reflect, describing your

experience both sharing your statement and also

listening to your partner’s share his/hers.

A Practical Interaction

Working in pairs…


Establishing Rapport Through Effective Communication

?

Rapporta relationship rooted in mutual

trust and understanding

Active

listening

Facial expressions

Eye contact

Body language

Powerful,

curious

questions

Open-ended questions commonly

begin with “what” or “how”

Purposeful

statements

Affirmations: statements which highlight client’s

strengths, abilities and efforts

Reflective listening: attempt to empathize, reflect

and clarity the main points and feelings

a member is expressing

Nobody cares how

much you know until

they know how much

you care.

- Theodore Roosevelt

“

“


Affirm action

taking toward

goal attainment

Support member in

recognizing and

celebrating both big and

small actions to create

momentum toward

meaningful change

A Strengths-Based Approach to Behavior Change

Uncover values

and vision for the

future

Utilize effective verbal

communication skills to

determine and

continually reinforce

what is important to

each member

Ask clients to

identify their

character

strengths

Support member in

building positive image

of themselves in order

to help reinforce

behavior change effort

Meet each client

with unwavering

acceptance

Without judgment, see

each member as whole,

resourceful and capable

of change; encourage

them to explore all

possibilities for

improved health


Understanding Motivation and Readiness to ChangeA brief look at models and theories of health behavior change


― One of the most enduring behavior change models that has guided

professionals for more than 35 years

― The term “transtheoretical” means “across theories”

― Emphasizes importance of viewing intentional behavior change as a process

that occurs over time

― Originally developed and studied in application to smoking cessation

― TTM has since been applied to various types of health behavior changes

(e.g., healthful eating and exercise behaviors)

Transtheoretical Model of Behavior Change


Transtheoretical Model of Behavior Change

?

Pre-contemplation

Contemplation

Preparation

Action

Maintenance

Progress

Relapse


Stages of Change

Pre-contemplation

• No intention of changing (e.g., they don’t exercise and do not plan to start)

• May be unaware of risk associated with current sedentary lifestyle or may feel

powerless to begin exercising

• May become defensive with others suggest current lifestyle is dangerous

• Goal is to increase awareness of risks or maintaining status quo and highlight benefits of

making a behavior change

• Validate lack of readiness to change and clarify that the decision is theirs

?


Stages of Change

Contemplation

• Thinking about possibly making a behavioral change sometime in the next six

months (e.g., may currently be sedentary but thinking about becoming more active in the

near future)

• Aware of problem but ambivalent about change; still weighing pros and cons of

becoming active

• Often have little understanding of how to go about changing

• Goal is to encourage evaluation of pros and cons and identify and promote new, positive

outcome expectants and boost self-confidence


Stages of Change

Preparation

• Has decided to change and is preparing to begin within the next 30 days (e.g., may

have recently become a member or signed up for a small group training session)

• Understands benefits of engaging in the behavior (e.g., regular physical activity), but

may have unrealistic expectations for the changes they hope to make

• Goal is to collaborate in setting realistic goals and implementing an individualized

behavior change program tailored to the individual’s abilities, interests and lifestyle


Stages of Change

Action

• Has begun incorporating behavior change plan into their daily life, but has been doing

so for less than six months (e.g., exercising regularly but new behavior is still fragile and

likelihood of dropout can be high for some individuals)

• Goal is to support member in establishing behavior as a habit, to include identifying

social support and increasing awareness of inevitable lapses in order to bolster self-

efficacy


Stages of Change

Maintenance

• Been engaged in the target health behavior for six months or more (e.g., exercising

regularly)

• May be seeking professional guidance on further developing other lifestyle behavior

changes (e.g., managing stress) to more effectively address their health and wellness

goals

• Goal is to support member in maintaining interest and avoiding boredom and burnout

• Reinforce need for increased intrinsic motivation as a means to enhance adherence


Put into practice


Working with a partner,

you will step into the “character”

of this prospect/member in the context of the

‘qualifying’ stage of membership sales or the

‘collect the story’ stage of the fitness consultation.

Your partner will take a “coach approach”

using active listening and powerful questioning to

attempt to identify and effectively respond to the

prospect/member’s current stage of change.

Assessing Readiness to Change

Describe a prospect or member

you have worked with in the past.

*No* identifying information, please.

Note the stage of change that person was

in at the time of your encounter.

Write down key characteristics that

exemplify that specific stage of change,

such as why they came in, what steps they

were taking toward changing, etc.


Sample Readiness to Change Questionnaire

Which of the following statements best describes your current exercise engagement?

I currently do not

exercise, and do

not intend to start

an exercise

routine in the

next six months

I currently do not

exercise, but am

thinking about

starting an

exercise routine

in the next six

months

I currently

engage in some

exercise, but not

on a regular

basis (less than

five days per

week)

I currently exercise

on a regular basis

(most days of the

week, for a total of

30 minutes or more

per day), and have

been doing so

consistently for less

than six months.

I currently exercise

on a regular basis

(most days of the

week, for a total of

30 minutes or more

per day), and have

been doing so

consistently for

more than six

months.

1 2 3 4 5


Decisional Balance

Evaluating Pros and Cons of Change

Particularly important for individuals in the

contemplation stage of change

Balance of “pros” and “cons” of change shift

as journey through the stages

As an individual moves through the stages of change, they

way they feel about the target health behavior will change


Processes of Change

Influences on progress through stages of change

Movement through the stages does not always occur in a linear fashion

Cognitive processes, which result in new ways of thinking

that reinforces motivation to change, may include:

• Receiving information on the benefits of changing a specific behavior

(e.g., exercise is beneficial for mental health)

• Having an emotional change of heart to ignite a drive for change

(e.g., family member experiences health scare leads to

re-evaluation of one’s own behavior)

• Considering how one’s behavior affects others (e.g., how one’s own

physical inactivity may affect a child’s health behavior)


Behavioral processes, which support the behavior change process,

may include:

• Using substitutions that replace old risky behaviors with health-

promoting behaviors (e.g., taking the stairs instead of elevator

when at work)

• Recruiting and nurturing social support systems (e.g., talking with

one’s spouse about why exercise is important to them)

• Employing stimulus control (e.g., setting out workout clothes the

night before an early morning workout)

Processes of Change

Influences on progress through stages of change (con’t)

Movement through the stages does not always occur in a linear fashion


Self-Efficacy

Assessing confidence to change

• Concept originally described by

Albert Bandura as part of social

cognitive theory (SCT)

• A person’s self-efficacy is

related to whether he/she will

engage in an activity; a person’s

engagement in an activity also

influences self-efficacy


Strategies for Improving Self-EfficacySkills for supporting sustainable change

Bandura proposed several factors which influence self-efficacy:

Mastery experiences – Accomplishing a task or acquiring a new skill (and/or feeling

successful) creates a mastery experience which increases self-efficacy

Motivational models – Seeing people similar to oneself being successful at a task

the individual is trying to master increases self-efficacy

Persuasive messages – Providing individuals with positive, genuine encouragement

and reinforcement (must be perceived as realistic and sincere) increases self-efficacy

Stress arousal – Stress is associated with decreased self-efficacy; important to

provide member with non-judgmental and supportive environment


Self-Determination Theory

• Broad framework for the study of

motivation and personality

• Examines both intrinsic and extrinsic

motivation

• Three basic psychological needs which

influence motivation:

o (1) autonomy

o (2) competence

o (3) relatedness

Autonomy

Self-Determination Theory

CompetenceRelatedness


Listen carefully

to member’s self-

determined goals and

personal ‘why’

Putting Theory Into Practice

Support member

in moving from viewing

exercise as something they

“should” do to avoid feeling

guilty to something that

helps them reach their

personal goals in a

meaningful way

Empower member

to help guide program

development in appropriate

ways, offering choices and

freedom


Structure movement

experiences

to build self-efficacy,

increasing member’s

sense of competence

Putting Theory it Into Practice (cont.)

Employ effective

communication skills

to nurture meaningful

connections with prospects

and members

Assist clients with

building connections

within the learning environment

(e.g., other members of the

club, programming options) as

well as outside the learning

environment (e.g., family,

friends, support/interest groups)


“Walk the Talk”15-minute movement break


Skills for Supporting Sustainable ChangeAn introduction to motivational interviewing


• Described as a client-centered, collaborative conversation style for

strengthening a person’s motivation and commitment to change

• Stems from belief that confrontational methods only strengthen

unwillingness to change

• Employs a guiding style to encourage, support and assist clients

in the process of change

o Empowers clients to find their own way, awakening them to solutions

within through self-directed learning

• Strong evidence base (over 200 RCTs and 25,000 citations to date)

• Especially effective for clients ambivalent about change

Motivational Interviewing (MI)


Evoking Clients’ Motivation to Change

If you are arguing for change

and your client is arguing against it,

you have got it backwards.

- Bill Miller

““


Core Skills of MI

O

A

R

S

= Open-ended questions

= Affirmation

= Reflective listening

= Summarizing


― Typically begin with the word “what” or “how”

― Starts (and keeps) conversations member-centered

― Invites members to share more pertinent information to help inform

collaborative program development and progression

― Builds rapport as members sense genuine interest, and in turn feel more

trusting working with a professional

― Can help to begin developing discrepancy between where he or she is

presently and where he or she wants to be in terms of health and fitness

― Invites members to explore pros and cons associated with behavior change

Open-Ended Questions


Put into practice


Take a moment and write down 3-5 of your “go-to” open-

ended questions that you regularly use during the ‘qualifying’

stage of membership sales or the ‘collect the story’ stage of

the fitness consultation.

Switch papers with partner (preferably someone you have

not yet worked with) and provide one another feedback on

the questions listed in addition to adding 3-5 of your own go-

to questions to their paper that truly capture the spirit of a

strengths-based “coach approach”

Crafting Powerful Questions


• What does being healthy look like to you?

• What needs to change in order to turn your vision of wellness into a reality?

• How can I best support you?

• What do you think would be a good first step?

• How would you like me to hold you accountable?

• How important is it for you to make this change?

• What strengths do you feel will be most useful to make progress toward

your goal?

Examples of Open-Ended Questions


• Statements which reinforce members strengths, intentions,

accomplishments and efforts

• Must never be empty praise; rather should refer to specific situations and

actions which accentuate character strengths and positive progress

• Statements are best when they are member-focused, using the word “you”

more than “I” to build autonomous motivation

• Helps members shift from a deficit mentality to a strengths mentality

• Enables members to create a more positive perception of their abilities by

recognizing and leveraging their own strengths

Affirmations


• Also known as active listening; combines verbal and nonverbal responses to

indicate interest and understanding and to encourage the speaker to

continue

• Demonstrates the professional has truly heard what the member has said

• Involves professional taking a best guess at the meaning behind what the

member has shared, trying to perceive and understand the feels that the

words convey

• Metaphorically is like “holding up a mirror” to a member, providing an

opportunity for him or her to think more deeply about what they have said

Reflective Listening


• Simple reflections: Rephrasing or repeating what the member has said in a

brief and concise way

• Complex reflections: Guessing the underlying meaning of what the

member has said

o Amplified reflections: Providing a direct and more exaggerated form of what the

member has stated

o Reframing: Putting another lens on the member’s story

o Double-sided reflections: Exploring the member’s ambivalence by highlighting

reasons he or she has given both for and against change

Types of Reflective Statements


• Opportunity to emphasize and pull together the most pertinent aspects of the

conversation

• Recaps key points that direct tie into member’s stated goals and objectives

• After providing a concise summary, it is important to allow an opportunity for

the member to comment to confirm accuracy or correct any

misunderstanding

• Demonstrates to the member that they are truly being heard and valued

• Helps to keep sessions on track in terms of time and focus

Summarizing


Processes of Motivational Interviewing


• Establish a trusting relationship (rapport)

• Avoid common “traps”

o Assessment trap

o Expert trap

o Premature focus trap

o Labeling trap

o Blaming trap

Engaging


Setting the agenda

Focusing

Clear direction (member already has specific aim)

Choices in direction (use ‘agenda mapping’)

Unclear direction (use OARS skills to help ID focus)


• Using OARS to highlight ‘change

talk’ and respond to ‘sustain talk’ to

help the member discover and make

his/her own arguments for change

• Empowers member to work through

ambivalence

Evoking

The heart of MI


Change Talk

D

A

R

N

= Desire (“I want to…”)

= Ability (“I could…”)

= Reasons (“It would help me to…”)

= Need (“I must…”)


• Curious, powerful open-ended questions can be used to evoke members’ desires,

abilities, reasons and needs for change

• Examples of questions you can use in working with a member who expresses

interest in, and ambivalence toward, exercise:

o ”What would you like to change about your current level of activity?” (desire)

o ”How might you go about adding more movement to your day, if you decided to?”

(ability)

o “What are your top three reasons for wanting to exercise regularly? (reasons)

o ”How important is it for you to exercise more consistently?” (need)

Evoking Change Talk


• Using the importance ruler (“On a scale of 1-10 how important is it to you

to make this change?”)

• Querying extremes (What is the best-case scenario (if change is made)?

What is the worst case scenario (if not made)?)

• Looking forward (Envision what life will be like once the change is

successfully made; “What could be the positive results of changing now?”)

• Exploring goals and values (Serves as an anchor for change and source

of motivation)

Responding to Change Talk


Put into practice


― Working in groups of three, identify one person to serve as the member or

prospect, one person to serve as the professional and one person to serve as

the observer.

― The session will begin with the member expressing ambivalence about either

joining the club or beginning an exercise program.

― The professional will then utilize the four skills of motivational interviewing

to guide the conversation. The observer will tally how many times the “coach”

utilizes open-ended questions, affirmations and/or reflections versus during the

mock session, taking note of how the types of questions and statements utilized

influences the conversation and elicitation of change talk.

Eliciting Change Talk


Signs of readiness for ‘planning’

Mobilizing Change Talk

C

A

T

= Commitment (“I will change”)

= Activation (“I am ready to change”)

= Taking steps (“I have started”)


The planning phase of MI begins as

members move through ambivalence and

arrive at a point where they are ready to

move forward in taking action toward

change.

Goal setting is key as this time, as studies

have found that one of the most common

features of effective programs to improve

health behaviors is proper goal setting.

Planning


Preparing for Action with SMART Goals

S

M

A

= Specific

= Measurable

= Attainable

R

T

= Relevant

= Time-bound


• Goals should be in alignment with member’s values and vision for improved

health

• Collaborate with members in devising goals that challenge them to new areas of

opportunity; however, goals established must be perceived as achievable by the

member

o This combination boots confidence and competence, fostering a commitment to

consistent action

• Support goal-setting process with use of scaling question to assess confidence

o Ensures goals strike the right balance between being motivating and feasible and sets

foundation for a specific and realistic plan of action to emerge

Considerations for Goal Setting


Collective DebriefGroup discussion to translate information into action


“We cannot teach people

anything, we can only

help them discover it

within themselves.

- Galileo Galilei


• Visit www.acefitness.org/anytimefitness

• Review a copy of these slides, which will be available to you online

• Explore a sample of ACE’s wide range of behavior change content, such as:

o Eight lessons learned from a year of lifestyle change

o Mindset matters: how your thoughts affect your health

o From chore to choice to desire

• ACE contact: [email protected] for special pricing and information

for current and upcoming programming, products and services for Anytime

Fitness employees

Next steps you can take

http://www.acefitness.org/anytimefitness

https://www.acefitness.org/education-and-resources/lifestyle/blog/6915/8-lessons-learned-from-a-year-of-lifestyle-change

https://www.acefitness.org/education-and-resources/lifestyle/blog/7119/mindset-matters-how-your-thoughts-affect-your-health

https://www.acefitness.org/education-and-resources/lifestyle/blog/7113/from-chore-to-choice-to-desire

mailto:[email protected]

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