We all have them: Clients who frequently miss or cancel appointments; clients who sabotage their goals with unhealthy eating habits; clients who make plans to work out more and eat better but don't stick to their stated intentions. And these same clients complain about not reaching their health and wellness goals, but they don't do what it takes to succeed. Of course, we somehow feel
responsible for it. What's going on here? Are these clients just unmotivated? Are we not doing our job correctly? Should we write off these clients as a waste of time and "divorce" them completely?
There are definitely reasons to stick with these clients and even ways to succeed with them. They are not unmotivated; they are simply suffering from a blend of good intentions and bad timing. You, as their chosen fitness professional, have a responsibility to understand how your non-adherent clients got into their current predicament. By doing so, you have the opportunity to help them move out of the cycle of poorly timed good intentions and subsequent self-sabotage.
Case in Point
Tim is a 40-year-old, overweight man with high cholesterol who was told by his doctor that in order to reduce his risk for a heart attack, he had to start exercising. So, Tim called you, the fitness trainer, because he has never worked out and doesn't even know where to begin. You meet with him and create a plan to see Tim three times a week at the gym. He shows up for every session and does the workouts you create, but he does no cardiovascular exercise on his own (as you recommended), continues to drink too much alcohol and has not changed his high-saturated fat diet at all. You talk to Tim about changing his diet, but he's not enthusiastic about it. Tim is doing what you tell him to do during your three sessions per week, and he feels he is doing what his doctor has asked of him. Is Tim defying you by his actions outside of your sessions, or is he just not ready to change them?
In fact, Tim's doctor may have realized that he could not ask Tim to change all of his unhealthy behaviors at once, so he chose the behavior he felt would be the most beneficial (or the one to which he felt Tim would be most likely to comply). But as his fitness trainer, you see how intimately connected all of his habits are to his health outcomes.
Changing the Position of Behavior
Tim, however, is only in the action stage (where clients begin to change their behaviors based on their chosen plan) for only his workouts with you. He has not tipped the decisional balance in favor of changing his other unhealthy habits. Each habit has its own set of factors that make it more or less difficult to change. In order to not drive yourself crazy focusing on all of the things your clients could be doing to make their health better and faster, realize that they need to move from precontemplation (where clients have no clear intention of changing a behavior) to action for all of their habits on their own time. It might not happen in a linear, logical fashion. But your job as a fitness professional is to focus your time and energy on the work for which they have come to you.
You can, however, measure which stage of change (see the fitness fact for all stages) clients are in for each of their other habits so you have a better understanding of their intentions and reasons for their seemingly self-sabotaging behavior. You can even ask questions that might help them move closer to action. By listening to your clients' answers to the question, "How do you feel about changing (each behavior)," you can measure those against each stage of change and decide for yourself where your clients really stand in changing their behaviors. Now, how do you bring about change in their behaviors?
Tackling the Precontemplative Stage
Let the conversation lie. No nagging, no suggestions, nothing. The best thing to do here is mention in an informational, non-judgmental tone the health benefits of changing their health behaviors. Then stop talking about it unless they ask for more information. The ball must stay in your clients' court.
Tackling the Contemplative Stage
Give your clients information that will help them weigh the pros and cons of their current behavior against the pros and cons of the new behavior. This will give your clients the ammunition they need to pull the trigger when they are ready.
Getting Ready for the Action Stage
Finally, no matter which stage your clients are in, one of the most effective things you can say to them is: "When you feel ready to make more changes, let me know what I can do to help you." Ask them, "What do you feel you need from me in order to be successful?" This will help your clients see that their choices are their responsibility, not yours. Successful action always requires a lot of productive thought. By asking them this question, your clients will begin to realize that they have a stake in what happens to their health; their choices have the potential to create either negative consequences or positive outcomes. And you are the right person to turn to when they are ready to trade one for the other.
Now that you understand where your clients stand within the stages of change for their unhealthy, sabotaging behaviors, you can understand your clients better and stop getting frustrated with their lack of action. Instead keep letting them know, "I'm here for you when you need more information or feel ready to tackle more changes."
Until your clients move into the action stage for their other behaviors, which could take months or years, your job is to keep them successful and motivated in the actions they ARE taking. By focusing on their successes, increasing their session challenges and congratulating them on achieving the goals they are meeting, you increase the likelihood that your clients' self-efficacy, regarding healthy choices, will spill into and affect their other habits. And by reinforcing the notion that you are ready to help them with other things as they arise, you increase the likelihood that your clients will come to you for help in those areas as well.
Sara Hauber's continuing education course, "Essentials of Coaching for Wellness Professionals," was designed to help health and fitness professionals apply coaching techniques in their current practice. For more information, visit www.sarahauber.com or email her at firstname.lastname@example.org.