Natalie Digate Muth, MD, MPH, RD, is the ACE senior consultant for healthcare solutions, a practicing pediatrician and registered dietitian. Recognized as a Certified Obesity Specialist, Natalie has written for more than 50 publications and, in 2012, published her first book, 'Eat Your Vegetables' and Other Mistakes Parents Make: Redefining How to Raise Healthy Eaters.
Coaching Behavior Change: Improving Client Outcomes by Cultivating Social Support
Health and fitness professionals recognize that social support is one of the strongest predictors of whether a client will make—and, more importantly, sustain—a behavioral change.
Consider the case of two middle-aged women, both attempting to lose weight and increase physical activity in response to a recent diagnosis of prediabetes. One has a supportive spouse who agrees to make the changes with her. The other has a spouse who wishes her well, but makes no changes of his own and frequently buys and eats soda, chips and desserts. How will their outcomes differ? Or consider a child who struggles with childhood obesity. His parents are both completely on board with making changes to the home environment, but it turns out the child spends the day under the care of his grandmother, who is adamant that she spoil him with food and, in particular, sweets.
Clearly, social supports (or lack thereof) affect the outcome of a given intervention or program. What can a health and fitness professional do to help a client who has unsupportive family and friends or who does not have a strong network?
It turns out that research has identified a few effective ways to help a client strengthen his or her social supports, which can be boiled down to a four-step approach (Latkin and Knowlton, 2015):
Step 1. Take the time to identify and name key influencers in the client’s life. This could be family, friends, neighbors, coworkers or others. Determine if each influencer is currently a source of positive support, negative support or neither; identify those whose influence is particularly strong. A few questions to begin to generate names include: “Who do you talk to about personal topics?” or “Who do you really trust?” or “Who in your life is healthy? Who is not healthy? How influential are they?”
Step 2. Engage with the client to understand key potential sources of support and how they could be best engaged to help a behavior change stick. For positive supports, work with the client to identify specific steps he or she can take to strengthen the influence of the positive supports. If the support is negative, work with the client to troubleshoot challenges and develop a plan for handling the influence of a given person. Role-play challenging situations and take steps to ensure that each support does not undermine the client’s self-efficacy or autonomy, or set up a situation in which the client feels a sense of indebtedness to a person.
Step 3. Become a source of support. As a trusted trainer or coach, you can serve as a strong source of support for your clients. This can be effectively accomplished through affirmations, modeling healthful behaviors and discussing behavior change in a way that builds self-efficacy, strengthens autonomy and avoids discord or reactance. Do this through motivational interviewing and other client-centered communication techniques.
Step 4. Connect a client to new sources of support. Help clients build a stronger support network. With permission, consider linking a new client with a current or former client who was in a similar situation and has since been very successful. Identify support groups or positive networks on social media that could help a given client, and consider creating a venue for clients to work together, such as through facilitated group classes or a weekly walking group.
By taking a proactive approach to helping a client cultivate and strengthen a positive social network, and weaken a negative one, health and fitness professionals take an important step in helping a client to make health behavior changes that will stick.
Latkin C.A. and Knowlton A.R. (2015). Social network assessments and interventions for health behavior change: A critical review. Behavioral Medicine, 41, 3, 90-97.
Earn an ACE Behavior Change Specialty Certification
No matter how you work with clients and patients, effective coaching can further heighten the impact of your program. As an ACE Behavior Change Specialist, you will possess the knowledge of behavior-change philosophy and emotional intelligence and, most importantly, the practical, hands-on skills to put it to use. Our comprehensive learning experience incorporates expertise from renowned experts and pioneers in psychology and coaching to help you learn how to develop rich, productive relationships and guide people toward sustainable change in one-on-one, group and virtual settings.