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April 2012

The Art and Science of Enhancing Your Clients' Well-being

 

By Michael R. Mantell, Ph.D.
Among the many goals that prompt potential clients to seek out personal training or lifestyle and weight management coaching, the desire to ultimately live with a greater sense of well-being is often near or at the top of the list. And yet the term itself—well-being—is somewhat elusive, and not often considered by trainers and coaches. It could be argued, however, that understanding the concept of well-being—and being able to enhance your clients’ sense of it—should be a primary goal of all fitness professionals. 

The aim of this article is to equip you with an understanding of the elements of well-being and provide you with the tools you need to enhance your clients’ sense of wellness of body, mind and soul, while helping them make positive lifestyle changes.

The Basics of Well-being
The basic temperament of an individual is largely inherited; however, many experts believe it is possible for individuals to exert control over their own well-being and level of happiness. Sonja Lyubomirksy, Ph.D., a psychologist at the University of California at Riverside, estimates that happiness is 50 percent inherited, 40 percent under our own control depending on our lifestyle choices, and 10 percent is due to life circumstances (e.g., job, home, mate) (2005).

Clients with a healthy sense of well-being may demonstrate:
• A genuine and deep sense of contentment in life

• A joy for living and the ability to laugh and have fun
• Resilience in dealing with day-to-day stresses and life’s pressures
• A sense of purpose and meaning
• An interest in new and different activities
• A healthy work-life balance
• An ability to maintain fulfilling relationships with people
• High self-acceptance and self-esteem, and a clear self-concept

Knowing the events and situations that precede (the antecedents) and follow (the consequences) your clients’ exercise or weight-management behaviors may offer you direction in helping them increase or decrease certain behaviors—and thus, their sense of well-being. Here are five commonly recognized antecedents and consequences, along with examples of each:

• Environmental – media, access to exercise facilities, safety, time, weather, advertisements
• Social – friends, family, media role models
• Cognitive – thoughts, beliefs, values, attitudes, emotions, self-efficacy, self-acceptance
• Physiological – gender, fitness, pain, ability, health, fatigue
• Personal – health history, education, income, personality, traits, status

Feeling good (i.e., having a sense of greater well-being) after a training session, for example, will likely increase the frequency of that behavior. When exercise no longer results in a reinforcing consequence, adherence to exercise becomes more unlikely.

This type of thinking is grounded in an area of behavioral science known as “stimulus-response” or “behavior theory,” an early theory of behavioral change. Cognitive behaviorism and stage theories are other notable and useful ways of conceptualizing exercise and weight-management behavior change (see sidebar, below).

This contemporary and highly useful approach extends behavior modification (focusing largely on stimulus and response) to include client self-talk, or cognitions. The trainer or coach identifies limiting self-talk (e.g., “I can’t stick to an exercise plan”) and helps the client, through questioning, education and example, to think more accurately (e.g., “I haven’t yet stuck to an exercise plan, but that doesn’t mean I can’t ever do so”).

Trainers, psychologists and coaches often use theories that assign individuals into a category, or stage, with specific behavioral characteristics in an attempt to best describe where clients are at in a given moment in time. The Transtheoretical Model of Behavior Change, which moves from precontemplation through to maintenance, is one noteworthy example.

The Link Between Self-esteem and Well-being
Well-being may be understood to mean your client has a greater amount of positive affect than negative affect, more favorable thoughts and greater satisfaction with life. Freedom from self-limiting beliefs, which are based on a host of factors including childhood messages, other people’s views, a lack of self-acceptance, and invented fears and anxieties, enhances well-being.

Risk factors that may compromise future well-being:
• Poor social connections
• Side effects of medications

• Substance abuse
• Early negative experiences or traumas that lead to a sense of helplessness
• Illness that is chronic or interferes with daily life

As a trainer or coach, how much thought do you give to “hearing” your clients' inner self-talk? For example, suppose a client’s basic world view is grounded in “I must do well and win the approval of others for my performances or else I am no good.” The obstacles to exercising regularly or the “all-or-nothing” thinking that often accompanies weight-management failure are often grounded in this type of belief, which interferes with well-being. For example, a client who believes: “I must do well in this exercise or weight-loss program and it’s terrible if I don’t,” should be encouraged to shift his or her thinking to: “I want to do these exercises and weight-loss strategies well, but I don’t have to. It’s bad if I don’t do them well, but not terrible.” This important shift in thinking can go far in helping the individual create a healthier sense of self-esteem and well-being. See “10 Common Cognitive Distortions” for more insight on limiting beliefs that could be hampering your clients’ success.

Listen for evidence of the following 10 “cognitive distortions,” or limiting beliefs, which can interfere with the establishment of your clients’ sense of well-being and success in exercise and weight-loss programming (Burns, 1980).

1. All-or-nothing thinking: They look at things in absolute, black-and-white categories.
2. Overgeneralization: They view a negative event as a never-ending pattern of defeat.
3. Mental filter: They dwell on the negatives and ignore the positives.
4. Discounting the positives: They insist that their accomplishments or positive qualities “don’t count.”
5. Jumping to conclusions: (a) Mind reading—they assume that people are reacting negatively to them even when there’s no evidence for this; (b) Fortune-telling—they arbitrarily predict that things will turn out badly.
6. Magnification or minimization: They blow things way out of proportion or they shrink their importance inappropriately.
7. Emotional reasoning: They reason from how they feel: “I feel like an idiot, so I must really be one.” Or “I don’t feel like doing this, so I’ll put it off.”
8. “Should” statements: They criticize themselves or other people with “shoulds” or “shouldn’ts.” “Musts,” “oughts,” and “have-tos” are similar offenders.
9. Labeling: They identify with their shortcomings. Instead of saying “I made a mistake,” they tell themselves, “I’m a jerk,” or “a fool” or “a loser.”
10. Personalization and blame: They blame themselves for things they weren’t entirely responsible for, or they blame other people and overlook ways that their own attitudes and behaviors might contribute to a problem.




The Connection Between Emotional Well-being and Exercise
Enhancing your clients' emotional well-being should be a key component of your exercise strategies and weight-management programming. After all, common benefits of cardiovascular and resistance exercise are a reduction in negative emotions, an increase in positive emotions, and improved self-acceptance and cognitive functioning, all of which work together to create a greater sense of well-being. Additionally, a growing body of research has demonstrated the positive effects of exercise on a wide range of factors related to psychological well-being, including stress reactivity, anxiety, depression, self-esteem, body image and sleep.

The coaching relationship established through the application of the ACE Integrated Fitness Training® (ACE IFT®) Model is based on a positive, sensitive and respectful connection, or rapport, between client and trainer or coach. Creating a sense of well-being in clients is an essential managed consequence of both the relationship and the client’s exercise and weight management−behavior goals.

The evidence clearly demonstrates that physical activity, in addition to providing increased enjoyment and energy and improved physical health, plays an essential role in elevating mood and reducing anxiety and depression, all of which are key elements of well-being (Fox, 1999). One area trainers and coaches may not be aware of, however, is the maturing field of “positive psychology” and what it offers in helping individuals create and enhance well-being. In the most contemporary view, well-being rests on creating PERMA:
P: Positive emotion
E: Engagement (e.g., being “at one” or “in flow” with the music, the exercise or the coaching activities)
R: building Relationships
M: finding Meaning and purpose in activities
A: feeling a sense of Accomplishment

Being able to recognize that feeling a sense of accomplishment or finding a purpose for the activities you recommend may be important to a client’s enjoyment of, and adherence to, the exercise program is essential for increasing his or her engagement and satisfaction with the lifestyle changes you are recommending he or she make. Adding this awareness of PERMA in every training and coaching session, combined with the benefits of physical activity previously discussed, will go a long way toward enhancing your clients’ feelings of well-being (Seligman, 2011).


To build well-being, be sure to recommend that your clients:
1. Get enough rest

2. Learn about, and practice, healthy nutrition

3. Use proper stress and relaxation methods daily

4. Get a healthy daily dose of sunlight

5. Limit alcohol and caffeine, and avoid cigarettes and other forms of drugs

6. Practice self-control and self-discipline

7. Be a lifelong learner by taking classes, reading, traveling, being creative and productive; volunteer to positively help others

8. Take time to smell the roses—take a stroll through a garden or on a beach, admire art— anything that appeals to the senses (e.g., music, massage, aroma)

9. Use the “New GPS System”—gratitude, positivity and sensitivity with oneself and with others

10. Eliminate negative, irrational, illogical thinking (worry) by questioning themselves for the evidence for their thoughts—and to remember that thoughts are just thoughts.

Emotion vs. Mood
To avoid confusion in language, it is important to distinguish emotion from mood in discussing the psychosocial aspects of coaching and training, particularly as it relates to well-being. When we use the term "emotion," we refer to immediate responses to specific stimuli mediated by cognitions. You have heard the phrase, “Seeing is believing.” This is not accurate. In fact, the reverse is true: “Believing is seeing.” What you think determines and influences what and the way you see. For example, when you encourage your client to add 10 percent more weight, or do five more reps, and the client’s immediate response is, “I can’t do that,” that is an emotional reaction.

Conversely, a "mood" is a more personalized feeling, though also formulated in cognition. For example, anxiety, depression and anger are common negative moods, and tend to be longer lasting than emotions. It may be easier for you to identify the antecedent cause of an emotion, which is typically more intense and variable than a mood. Moods, however, may come and go without an easily identifiable behavioral cause.

Putting It All Together
To be an effective trainer or coach, you must be able to take into consideration myriad factors that shape and determine each client’s motivation to make positive lifestyle changes. These include personality factors (underlying, consistent structures and processes that shape a client’s actions and reactions to his or her environment over time and across situations), self-esteem, body image, stress reactivity, moods such as anxiety and depression, and cognitive self-talk. Additionally, understanding “why” a client wants to begin a fitness regimen or a weight-loss program will make it easier for you to identify the roadblocks to his or her achieving a greater sense of well-being. Taking these steps and listening to what your clients tell you—and themselves—will make it possible for you to offer genuine and meaningful help to your clients, and build the kind of enviable relationships that promote not only adherence among your clients, but the depth of personal satisfaction that originally inspired you to become a fitness professional.

References and Recommended Reading
Burns, D.D. (1980). Feeling Good: The New Mood Therapy. New York: William Morrow.

Cohen, T. and Esther, M. (1993). Depressed mood and concern with weight and shape in normal young women. International Journal of Eating Disorders, 14, 223−227.

Fox, K.R. 1999. The influence of physical activity on mental well-being. Public Health Nutrition, 2, 3a, 411−418.

Grant, J.R. and Cash, T.F. (1995). Cognitive-behavioral body-image therapy: Comparative efficacy of group and modest-contact treatment. Behavior Therapy, 26, 69−84.

Hasenblas, H.A. and Fallon, E.A. (2006). Exercise and body-image: A meta-analysis. Psychology and Health, 21, 33−47.

Lyubomirsky, S., King, L.A. and Diener, E. (2005). The benefits of frequent positive affect: Does happiness lead to success? Psychological Bulletin, 131, 803–855.

McAualey E. and Rudolph, D. (1995). Physical activity, aging and psychological well-being. Journal of Aging and Physical Activity, 3, 67−96.

Miller, C.T. and Downey, K.T. (1999). A meta-analysis of heavyweight and self-esteem. Personality and Social Psychology Review, 31, 68−84.

Scully, D. et al. (1998). Physical exercise and psychological well-being: A critical review. British Journal of Sports Medicine, 32, 111−120.

Seligman, M.E.P. (2011). Flourish. New York: Free Press.

U.S. Department of Health and Human Services (1999). Mental Health: A report of the Surgeon General. Rockville, Md.: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration
______________________________________________________________________
Michael R. Mantell, Ph.D., earned his doctorate at the University of Pennsylvania after completing his M.S. degree in clinical psychology at Hahnemnann Medical College, where he wrote his thesis on the psychological aspects of obesity. He coaches world-class athletes and fitness enthusiasts for performance enhancement. He is Senior Consultant for Behavioral Sciences for ACE, on the faculty of the Equinox Fitness Training Institute, a national Community Ambassador for Experience Life magazine’s health initiative, appears weekly on San Diego’s CW channel 6, is a consultant to Les Mills International, writes for IHRSA, is a member of the Sports Medicine Team at the Sporting Club of San Diego and the La Jolla Sports Club specializing in fitness psychology, and writes the “San Diego Fitness Psychology” column for examiner.com. He is also a writer and consultant to the Total Gym company. Dr. Mantell has written two best-selling books and appears regularly on radio and TV.


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