Kelsey Graham by Kelsey Graham
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As a health and fitness professional, it’s easy to feel like your clients’ health behaviors are your responsibility. While you can guide and encourage your clients, lasting behavior change ultimately has to come from within an individual.

To better support clients in creating their own personal goals, utilize motivational interviewing (MI).

Psychologists William R Miller and Stephen Rollnick developed MI as a client-centered counseling style to encourage healthy behavior change. First used in treating those with alcoholism, MI is characterized by its non-directive, collaborative and exploratory approach.

According to the self-determination theory of human motivation, individuals are compelled to engage in behaviors when they have high feelings of competency, autonomy and relatedness to others. MI supports this by putting clients in control of their own behavior change.

Whether you are helping clients adopt healthier eating habits, stress-reduction strategies or regular physical activity, use the following MI strategies to enhance client autonomy and success.

Open-ended Questions

Let clients explore their underlying thoughts, feelings, fears and goals through open-ended questions. These questions require clients to answer with more than a “yes” or “no.” Here is an example of an open-ended question: “So, you’d like to lose 20 pounds in the next five months. What would this weight loss mean for you?”

Open-ended questions can also be used in the face of client ambivalence. For example, if a client says she’s always hated exercise, you might ask, “What experiences have led you to feel so negatively about exercise?” Rather than telling the client her feelings are wrong by expressing how wonderful you think exercise is, this question allows her to explore the reasons underlying her dislike of physical activity.

Non-Judgment

Approaching clients with an accepting and non-judgmental attitude creates a safe space for behavior change to occur. If clients fear being judged by their health coach, they are less likely to be honest about their thoughts, feelings and behaviors, and more likely to commit to things just to please the coach. You can explicitly create a non-judgmental environment by stating something like, “There are no failures here, only learning opportunities. Nothing you do is inherently bad (even binging on a carton of ice cream) and will only teach us more about what factors might lead you to engage in an unhealthy behavior (such as overeating).

Reflect and Affirm

Let clients know that they are being heard by reflecting their thoughts and feelings back to them. This helps clear up any potential confusion and let’s clients know that you are trying to understand and value how they feel. For example, if a client who dislikes exercise goes into a story about embarrassing experiences he had in high school gym class, you could say, “It sounds like your past experiences have really affected the way you feel about exercising. Does this sound true?” This will both clarify your understanding of the client’s feelings and help him recognize thoughts and feelings he has, but may not have paid attention to.

Empower

It can be tempting to dictate health behaviors to your clients. While you may be an expert in fitness or nutrition, you are not an expert in your client’s feelings, lifestyle, needs or goals. Rather than telling clients what to do, help them explore viable healthy behaviors, understand the benefits of these behaviors, and recognize and overcome barriers getting in the way.

Ensure any goal a client sets is both relevant and achievable. Telling a client to jog for 30 minutes five days a week may be adherent to national guidelines, but if it isn’t meaningful to the client and doesn’t fit in the context of his or her life, it’s useless. Present clients with options that meet them where they are. An easy way to gauge the potential efficacy of a behavior is to ask the client. For example, if you and the client work together to come up with a specific goal around eating vegetables, you might ask, “How important is it to you that you eat at least two servings of vegetables at two meals each day?” and “How confident are you that you will stick with this goal every day for the next week?” This way, you and the client can collaborate to create goals that are meaningful to him or her and more likely to be achieved.

As a health and fitness professional, your ultimate goal is to create healthier, happier and more vibrant individuals and communities. Motivational interviewing is an excellent strategy to help you empower clients to develop intrinsic motivation and create meaningful healthy behaviors that last a lifetime.

Looking to expand your knowledge of behavior change and develop physical activity and nutrition coaching skills to empower people to long-term, healthy change? Learn more about ACE’s Health Coach Certification.

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