Combo with ACE Health Coach Chapter 14 unit 2

Operant Conditioning
Examines the relationship between behaviors and their consequences
Self regulation
Control people exert over their thoughts, feelings and behaviors. Also called self control
Emotional eating can be triggered by what
Negative (I got fired) or positive (celebration) emotions
When is self control the highest
In the morning, diminishes as day moves on
Behaviors followed by a reward are likely to
Be repeated
Behaviors followed by punishment are what
Less likely to be repeated
Self efficacy and self control are similar but self efficacy is what
Always situation and behavior specific
What should you set in the beginning with a new client
Realistic goals that they can obtain
Cognitive restructuring is
Consciously changing the way one perceives or thinks about something
What do behavior changes become
Habits
Abstinence violation effect
Client breaks their own rules about eating and exercise
What is RICE
Immediate treatment for injury that a HC can suggest to the client without going outside the scope of practice
Rest / Ice / Compression / Elevation
One of the big challenges a HC will face
Helping clients stick with their plans
HC helps clients figure out
What lifestyle habits and daily behaviors are problem areas to the client then come up with plans to replace problematic habits with healthy ones
People behave the way they do because
Their behaviors work for them
HC must transition from being an expert to
Cheerleader and guide
Who is ultimately in control of choosing a healthier lifestyle
Client
If a clients cultural background differs from HC what should HC do
Learn about the clients diet, traditions, belief system and family structure
Advice on behavior change will not be relevant without
An understanding of the clients lifestyle and the various ecological levels in which the client operates
For effective weight loss interventions it is essential that the HC
Determine where a new client is in the behavioral change process
What do fitness professionals often assume
That people who come to them for exercise advice are eager to begin an exercise program. This is most often the case, but the person may still just be weighing the pros and cons of change
What should clients perceive as a potential health problem
Obesity that has serious consequences. If they perceive this it can motivate them to change
What is the best option for addressing obesity
Lifestyle modification
SDT motivation category #1 Intrinsic motivation
People engage in an activity because it is inherently interesting or enjoyable to them. They drink tomato juice because they like it, they hike because they enjoy it. It is a form of autonomous motivation and is the most effective type of motivation for behavior change
SDT motivation category #2 Integrated motivation
The behavior and its goals have become part of clients personal self concept. Client see’s themselves as cyclists, runners or weight room regulars
SDT motivation category #3 Identified regulation
People engage in an activity because it helps them reach a meaningful goal, even though they may not actually enjoy it. People go on a hike because they know it will help them control blood pressure. People with this type feels autonomous
SDT motivation category #4 Introjected regulation
People engage in an activity because they think they should, even though they really do not want to. People motivated by this act to avoid feeling guilty or obtain self-worth. People join an exercise class because their spouse bullied them into it. This feels more like controlled regulation. People do not like being told what to do
SDT motivation category #5 External regulation
People engage in an activity solely from external pressure to avoid punishment or gain rewards. It is a form of controlled motivation. Rarely committed to long term change
SDT – Factors that guide human development and influence lifestyle change #1 Autonomy
People like to feel they have choices and are acting in accordance with their own values and wishes
SDT factors that guide human development and influence lifestyle change #2 Competence
People like to feel that they have some skill in the activities they are engaging in. They like to feel competent, or at least like they are improving and doing fairly well
SDT factors that guide human development and influence lifestyle change #3 Connection
People feel a bond to others. As social creatures humans have a basic drive to connect with others. These positive connections are motivational and they help people continue working toward their goals, even in the face of adversity
Self efficacy predicts
How much effort clients will exert in sticking to their program and how hard clients will persist in their behavior change efforts when facing difficulties
What is important in strengthening at all stages of behavior change
Self efficacy
Precontemplators and contemplators tend to have
Low self efficacy
Much of the work of a HC with clients in the precontemplation and contemplation will be focused on
Helping clients believe that they can modify their lifestyles and change problematic behaviors
The more HC and clients can minimize the amount of self control needed what will happen
The more successful clients will be. Clean up your environment (remove and keep from view the candy dish) This removes self control, because there is nothing to control. Its gone
Habits are
Comfortable and require little self control. The quicker lifestyle modifications become habits, the happier and more successful a client will be. People are creatures of habit and find it difficult to change their daily routines
Researchers who study self control believe that
People are able to tolerate only a relatively small disruption in their daily routines before experiencing stress
Coping with stress requires
A certain level of self control. It is more difficult to change a habit when under a lot of stress. Emotional energy that would otherwise be used to exert self control gets used up when a person is dealing with stress
When should you encourage clients to begin a lifestyle program
When stress levels are relatively low
People who exercise in the morning tend to be
Successful in sticking to their program
Contrary to popular belief many overweight people have
Great deal of self control
Failure to lose weight is often attributed to lack of willpower, but it is usually attributed to
Clients diet that was impossible to follow
or
clients totally unrealistic weight loss goals (20 lbs in 1 month)
Changing behaviors becomes easier as
Behaviors develop into habits
Commonly used lifestyle modification among those who have been successful
Physical activity at least one hour each day
Eat low calorie, low fat diet
Eat breakfast daily
Checked body weight regularly
Consistent eating pattern every day, weekends included
What is the most common reason that people abandon their plans to change behavior
Stress
Lifestyle modifications should create as little
Stress as possible
Obesity is a chronic disease
With no quick fix
Client must understanding that achieving perfection is
Impossible
HC can help clients understand that
Lapses are normal in the program. Accept them in stride and not be discouraged. Being discouraged can lead to total relapse
Clients will want to focus on weight loss alone and the HC should help them focus on
Their behavior. They have more control over their behavior than their weight. Behaviors are the means by which the weight loss goal will be accomplished
New behaviors the clients are adopting should
Require as little self control as possible so that they can become habits as quickly as possible
Meal structure decreases the effort required for meal planning and decision making and reduces
Temptation and guesswork. Clients who quickly develop a daily routine for eating will be most successful in modifying their lifestyles
Researchers suggest encouraging people who are overweight to engage in
Activity such as walking, doing yard work and taking stairs. This will give them a sense of accomplishment and not a hard routine to follow
Obesity has been called
An environmental issue. Environmental cues encourage excessive calorie intake and low levels of physical activity
It is the HC responsibility to reinforce
The pleasures and psychological benefits of physical activity
Clients who disclose that stress and negative moods are especially disruptive to their eating habits should be
Referred to a mental health specialist
When is it important to set up systems for self-monitoring food intake and physical activity
Early in the working relationship with each client
Self monitoring systems usually consist of
Written or computer forms that clients can record the behaviors they are working to change
Research has consistently shown that self-monitoring
Self monitoring is one of the most important & successful tools for weight control and weight maintenance. It increase peoples awareness to what they are actually eating each day
Triggers
Variables or factors that influence the client
Cognitive restructuring requires developing a
Mindful awareness of ones automatic thoughts or self talk
HC can guide clients to rephrase automatic thoughts such as I must be perfect in my weight control behaviors to
Nobody is perfect, I am making improvements in several areas and I am getting healthier and stronger each day
Especially harmful attitude
All or nothing. Clients are either on or off their diets, on means perfect, off is I’m a failure.
According to research, programs should last
16-26 weeks to foster success (4 months-6 1/2 months)
Help clients understand
It is human to make mistakes and that self forgiveness is the correct response to those mistakes
Some people relapse because of the mistaken belief that behavior change programs are
All or nothing
HC can help clients see that lapses are
Solvable problems and not indicators of failure
Research suggest that lifestyle and weight management groups tend to be more effective
Than individual consultation
Groups provide
Valuable support, motivation and information to one another
tend to have low efficacy in terms of weight management
precontemplators & contemplators
role models
people of similar age, gender, background who exercise regularly
health coach has the most influence in this part of ecological perspective
interpersonal
health coaches to need to consider
(exercise, diet, weight history0 biological, environmental, social, stress level
parts of socio-ecological model (ecological perspective)
individual, interpersonal, school, community, public policy
the risk of weight gain increases when…
friends and family gain weight; 57% friend
what effects the perception fatness and acceptable body size
friends and family..
stages of change TTM
precontemplation contemplation preparation action maintenance
what model suggests that a person’s health beliefs influence decision about behavior change; best used assessing obese clients
health belief model
what is the best option for addressing obesity?
lifestyle modifications and perceive obesity as a health threat
Theory that people need to feel competent, autonomous, and connected to others in the many domains of life; people are naturally motivated to pursue activities and goals they enjoy and they respond to external forces
self determination theory
people feel they are acting as a result of their free doing, because they want to (SDT)
autonomous motivation
people are doing something because they are pushed by an external force (SDT)
control motivation
people engage in an activity because it is interesting and enjoyable to them; most effective
intrinsic motivation
behavior has become integrated into a person’s self concept (they see themselves as ‘runners’)
integrated regulation
engage in the activity because it helps them to reach a goal even though they may not enjoy it
identified regulation
engage in activity because they think they should, even though they do not want to. avoid guilt.. feels like being controlled; appease others
introjected regulation
engage in activity solely from external pressure to avoid punishment
external regulation
What are the principles of lifestyle modification?
1. Self-determination theory and motivation to change
2. self -efficacy (operant)
3. Limited Self control
4. false hope/planning fallacy
5. relapse prevention
6. stress management (-) mood
3 factors that guide human development
1. autonomy
2. competence
3. connection
self efficacy predicts…
1. effort of client
2. persistence
the 4 principles of limited self control
1. limited resource
2. habits are comfortable and require little control
3. coping c stress requires more control
4. renewed daily
social factors that influence life style modification
friends, family, coworkers
avoid feelings of… when lapses occur
guilt and failure
tend to have low efficacy in terms of weight management
precontemplators & contemplators
role models
people of similar age, gender, background who exercise regularly
health coach has the most influence in this part of ecological perspective (socio-ecological model)
interpersonal
cognitive restructuring
consciously changing the way a person perceives/ thinks about something
self control
the control one exerts over their own feelings, thoughts, behaviors
people’s tendency to set unrealistic goals
false hope syndrome
people consistently underestimate the time, energy and resources needed to complete a task
planning fallacy
short term disruption in life style mod program
lapse
return to the former behavior.. “given up”
relapse
environmental cues
Biggest triggers of food intake and activity
health coaches to need to consider
(exercise, diet, weight history0 biological, environmental, social, stress level
most common reason someone abandons program
stress (decreases self control, decr self eff, decr energy/motivation)
one of the most important components of successful weight management
self monitoring
To help increase self-efficacy, HC should focus on _____ and a_____ early on
participation and adherence
9 Lifestyle Modification Strategies…
1. Strengthen AM to change (learn hopes, dreams)
2. Increase readiness to change (educate info and motivate)
3. Realistic Goals (adherence)
4. modify environ cues
5. increase self eff
6. social support (social, logistic, partner, programs)
7. manage stress
8. Self monitoring systems
9. problem solve and constructive restructuring
3 Benefits of getting “hooked” on exercise
1. participating in PA program
2. decr stress
3. incr energy for self control
4 Benefits of self monitoring….
1. increases self awareness (mirror)
2. forges a link btw client and HC
3. tool for evaluating triggers
4. + reinforcement and incr self eff