Dr. Erin Nitschke, NFPT-CPT, NSCA-CPT, ACE Health Coach, Fitness Nutrition Specialist, Therapeutic Exercise Specialist, and Pn1 is a health and human performance college professor, fitness blogger, mother, and passionate fitness professional. She has over 15 years of experience in the fitness industry and college instruction. Erin believes in the power of a holistic approach to healthy living. She loves encouraging her clients and students to develop body harmony by teaching focused skill development and lifestyle balance. Erin is also the Director of Educational Partnerships & Programs for the NFPT. Erin is an editorial author for IDEA, NFPT, The Sheridan Press, and the Casper Star Tribune. Visit her personal blog at belivestaywell.com.
The Science of Behavior Change (and Why It’s So Important)
Human behaviors, particularly the habits and behaviors related to health, are complex. And changing a behavior requires much more than a simple, “just do it” approach. Change doesn’t work that way, and if it happens to work, it’s for a fleeting period. Real, meaningful and lasting change requires a wholistic process that an individual must experience, embrace and commit to.
As the landscape of the health and fitness industry continues to evolve, we are seeing an increased emphasis on life fitness (not just physical fitness) and we’re working with more clients who wish to pursue goals that are more related to how they feel as opposed to how they look. As health and exercise professionals, we have a duty to engage our clients in a way that promotes and encourages lasting lifestyle changes that ultimately lead our clients toward success. To accomplish this, we must commit to the following three objectives:
- Develop a more robust understanding of the science of behavior change and how our clients experience change
- Focus on the whole person, their values, reality (factors influencing change) and their unique goals. We must work with and support clients wholistically and intentionally, which means coaching clients effectively in setting specific and directed goals that are connected to their “why.”
- Normalize the difficulty surrounding behavior change.
Behavior Change and Applicability of Psychological Models
Describing the concept of behavior change is easier than unraveling the process of how it is accomplished. According to the American Psychological Association (APA), behavior change is “a systematic approach to changing behavior through the use of operant conditioning.” (Note: Operant conditioning is defined as a method of learning that uses rewards and punishments for behavior.) The APA further notes behavior change is “any alteration or adjustment of behavior that affects a patient’s functioning, brought about by psychotherapeutic or other interventions or occurring spontaneously.” Obviously, health and exercise professionals don’t (and shouldn’t) dabble in any activity or interaction that can be construed as psychotherapy or be defined as a psychological intervention. However, the field of psychology offers us a range of frameworks to help us understand how humans act and, more importantly, why they behave the way they do.
The great benefit to examining behavior through various psychological models is that each provides a simplified illustration of the relationships among variables that influence human behavior and mindset. For example, the biopsychosocial model tells us that a person’s health is greatly influenced by biological, social and psychological factors. This model addresses the complexities of health and chronic diseases.
If we take it a step further and examine health behavior through a socioecological lens, we note that a person’s environment has tremendous influence over their individual choices and behaviors related to health and wellness. From this perspective, we can see multiple layers of influence and discover barriers and systems of support.
A third example, and likely the most applicable in the field of health and fitness, is the transtheoretical model of behavior change (TTM). One of the reasons this model is so effective is because it emphasizes the inescapable truth about change: It’s a process rather than a destination or isolated event. The TTM presents five unique stages of change, often depicted as a spiral or winding road, to further underscore the nonlinear nature of what a person experiences as they embark on a change journey. Using this model makes it possible for you to tailor specific interventions to a client’s perceived stage of change.
There are, of course, many more models and theories related to the science of change beyond the three briefly described here. It is worth taking the time to understand the nuances of these models and theories to develop a working knowledge of what change is and what can influence your clients’ progress.
These models allow us to gauge a client’s readiness to change, identify barriers to change, outline social support systems for clients and apply unique strategies to ignite and maintain meaningful change. What these models don’t reveal, however, is how each individual experiences change. All the scientific models in the world will not capture that essence, which is why you, as the professional, must make a conscious and continuous investment in walking with clients through their unique journeys. Often, the best thing you can do is to simply sit with them in the unknown and help them embrace uncertainty, while also lifting them up by empathizing with their experience, unearthing their motivation, respecting their autonomy and acknowledging their capacity for change.
The Essential Practice of Effective Goal Setting
The second area of focus worth investing in is the science of goal setting and how it relates to behavior change. This also includes coaching a client beyond what are initially vague physical goals (e.g., weight loss or lower blood pressure). This is not to say that a physical goal to “increase strength,” “lose weight” or “improve muscle definition and endurance” is not a worthy or valuable pursuit. These types of outcome-based or product goals have value, but they lack a defined direction and set of actions. Goals like these are often not specific, not predictable and lack a clear timetable. They also don’t focus on the process (actions) required to achieve that outcome or product.
A process goal, by contrast, focuses on behaviors and actions clients can take to get to the outcome(s) they desire. At this point, you may be wondering: “Which type of goal should I focus on helping my clients to set?” Before we answer this question, let’s first summarize some of the science of goal setting.
Goals impact a client’s performance (and inspire change) through four mechanisms. Each of the four mechanisms is unique in how they influence progress toward a stated goal:
- Directed attention – Specific goals require focus. Goals help our clients direct their thoughts and actions.
- Mobilized effort – Goals increase clients’ efforts to achieve what they desire. There is a direct relationship between the challenge of the goal and the client’s effort. In other words, a more challenging goal will elicit more effort.
- Persistence – Goals help clients persist longer because they have a target to aim for.
- Strategy – The act of setting a goal encourages clients to examine strategies that will help them make progress.
Taken together, these four mechanisms tell us that in the absence of a well-established goal, clients will lack clarity, be without direction, invest less effort and remain unconscious to those essential strategies that will help them move forward. No specific, directed goal equals no sustainable behavior change. Goal setting is essential to igniting and supporting behavioral change in our clients.
As you coach your clients, remember that goals are influenced by five basic factors:
- Commitment – This relates to the connection the client has to the goal. The stronger a client’s commitment, the more motivating the goal will be. Clients need a goal that is perceived to be freely chosen and personally meaningful for there to be a connection to their effort.
- Importance – If the goal is higher in importance to a client and aligned with their values, they will feel a greater sense of motivation for progress and change.
- Self-efficacy – The higher the client’s level of self-efficacy, the greater their level of persistence will be toward achieving the goal when faced with difficulty.
- Feedback – Clients who receive consistent and valuable feedback are more likely to continue their efforts forward and feel more motivated in the face of challenges.
- Task complexity – There is a direct relationship between complexity and the number of strategies a client will need along their journey. The more complex the goal, the greater the number of strategies that will be required. This is where helping clients set both product goals and process goals is valuable.
Putting Theory Into Practice
Let’s look at a case study example so we can connect these points.
Julie is your new client, and she sought your services as a health and exercise professional because she “wants to lose weight to look better.” You initially observe that Julie equates weight loss (a physical product goal) with looking better (also a physical product goal). You also observe that “looking better” and “weight loss” are both nebulous in that they do not have specifically identified components.
As is natural, you wonder: How much weight is considered successful to Julie? What does looking better feel like or mean to her? How important is this goal? What has she done in the past to help her achieve health goals? What are the factors affecting her commitment to movement, stress management, sleep, nutrition, etc.? As you can see, there is much to be uncovered.
Using motivational interviewing techniques, you and Julie discuss what looking better means to her. You ask open-ended questions to determine the level of importance and motivational factors related to this expressed desire. In this conversation, you come to understand that it ultimately is not about an aesthetic goal but that it is about feeling more energized so that she isn’t craving an extra boost of caffeine in the afternoon, and so she has energy to take her kids to the park after school. Julie also reveals that she doesn’t really know where to begin with exercise but that she is interested in being more active up to four times a week. She also discusses some of her food goals, which include adding more vegetables to her existing eating plan and being more prepared each week so that meal planning becomes a component of her weekly efforts.
With your help, Julie outlines initial process goals: “I will exercise four times a week for 30 minutes, add two servings of vegetables to my existing eating plan at lunch and dinner, and use Sunday afternoons to plan dinners for the week.” These process goals focus on three specific actions or behaviors that, if done consistently, will likely result in the initially expressed outcomes: weight loss and looking better.
Circling back to the initial question of “Which type of goal should I focus on helping my clients to set”? The answer: Include both but curiously seek the “why” behind the goals.
In addition to collaborating with clients to identify goals (which will most likely be in the form of a product goal), ask yourself: “What is the why behind the goal or goals my client has expressed?” and “What behaviors do they currently engage in that will support (or detract) from this outcome?”
Uncovering a client’s why might seem simple enough, but like change itself, unleashing the “why” behind a goal is multifaceted because the nature of goal setting is also multidimensional.
Clients will often come to us with some initial idea (loosely identified) that is related to what they want to accomplish (as we saw with Julie). What clients don’t often express, without an intentional conversation, is what motivates them to achieve those physical objectives. By applying motivational interviewing skills, you can lead a client on a path of self-discovery and help them reveal a deeper, more connected rationale for pursuing change. This “why” often looks like, “I want to feel better and have more energy to engage in activities with my family,” or “My father died of heart disease in his early sixties, and I want to change that trajectory.” Once a client’s unique why is uncovered, it can be used as leverage to enhance motivation and remind them of their greater purpose in pursing lifestyle changes.
Normalizing the Challenge of Change
The third area of focus for you is developing the ability to acknowledge and normalize the difficulty of behavior change. Clients will regularly become frustrated, experience a dip in motivation and feel as if their progress isn’t enough, or, at the very least, isn’t fast enough. It’s O.K. (and advised) to allow your clients to share their feelings and process them with you. Reinforce the fact that change is neither linear nor easy, and frustration is to be expected and is normal. In fact, if a client doesn’t become frustrated or experience a “Why am I doing this moment?” you might need to ask how meaningful the goal truly is.
Change is often difficult because of how it is perceived: Is it a giant monster or an all-or-nothing entity that must be conquered? In actuality, small changes lead to big results. This is, again, why setting goals is so critical for clients. Achievable, early wins nurture motivation.
Another reason change is so “dreaded” is because we tend to focus on what we must give up versus what we stand to gain. This requires a mindset shift. As the professional, you can help clients understand that the benefits outweigh the barriers.
Finally, change is difficult because it requires effortful actions that can be thrown off course because, well, life happens. Our clients experience stressful events, even tragic ones, or they may fall ill or become injured. Any number of life events can threaten progress. Again, this is normal. When collaborating with clients to set specific goals, be sure to identify high-risk situations, as well as strategies for addressing those issues should they arise. Further, take time to outline a set of external resources the client can leverage as support. For some, this might be a social media group related to your gym or studio, while for others it might be a trusted friend or colleague to encourage and aid in accountability. Additionally, self-monitoring techniques can help bring a level of self-awareness to your client’s behavior.
The journey of change is never easy, but it is always worthwhile. You know this, but it can be challenging to try and awaken clients to their own potential and empower them throughout their unique experience. You can do this by developing a strong foundation of knowledge related to the science of behavior change. You can also help clients focus on their most personally meaningful goals as well as comfort them when they perceive the journey to be difficult. Normalize the experience and reinforce that a transformational lifestyle change is possible.