life-enhancing qualities of physical
enhancing qualities of physical
activity. It may also be appropriate
activity.
to find out how previous attempts at
being active failed to meet the client’s
expectations.
Handout 14.1 outlines how clients can start to tune into intrinsic
rewards of physical activity. In the spirit of MI, ask the client how being active influences mood, sleep patterns, and overall well-being. If your client is unaware of the many intrinsic benefits that are tied to physical activity, ask for permission to share a list. Invite the client to express which intrinsic benefits are important to him.
The term intuitive exercise has been used to describe focusing on how the body feels when physically active and is powered by optimism, self-trust, and the pleasure experienced in seeking adventure with physical
activity (Tribole & Resch, 2012). A good way to help your clients make the shift to intuitive exercise is to invite them to brainstorm enjoyable activities or strategies for changing their current plan to make it more enjoyable.
Emphasizing “fun” naturally changes the motivation to exercise. No longer is the focus predominately on managing blood sugar or fitting into a new pair of jeans; the focus is on spending your time doing something fun that is also physically active.
A client could be encouraged to go for a run or walk in the park on a
spring day when the trees are blooming or grab a friend during a lunch break and power walk while they catch up on each other’s lives. They could also sign up for a fun run/walk fundraiser
with a group of friends, join a run-
In the spirit of MI, ask the
ning club, garden, or simply take their
client in what ways being active
kids outside and join in on a game of
influences mood, sleep patterns,
hide-and-seek, instead of just watch-
and overall well-being.
ing them play. These are just a few of
the many ideas that a community may
offer. Get to know the low-cost and fun activities in your area and make up a circle chart of ideas for your clients to choose from. Tapping into your client’s inner, happy self will make exercise a sustainable and non-negotiable part of life. (See Chapter 3 for more information about circle charts.) Here are some open-ended questions and reflections that could help
your clients consider the intrinsic benefits of physical activity:
Handout 14.1
FItNESS that laStS a lIFEtIME:
INtRINSIC MotIVatIoNS FoR PhySICal aCtIVIty
You’ve probably heard that exercise is good for you, but you may not be aware of the many ways being active can not only improve your health, but improve your life. In fact, there at least 60 documented benefits of physical activity. Some benefits are noticed right away, either during the activity or immediately after.
Researchers have discovered that people who are more aware of the intrinsic motivations (motivations that come from within) are more likely to consistently include physical activity into their week. No medication or pill can provide the long list of intrinsic benefits that you may experience when you simply move your body. Here’s a list of the immediate benefits many exercisers notice.
Being physical y active . . .
• Increases energy levels.
• Produces a sense of accomplishment or empowerment.
• Improves sleep patterns.
• Intensifies hunger signals throughout the day.
• Reduces feelings of stress and anxiety.
• Results in fewer body aches and pains (low to moderate intensity).
• Improves sensitivity to the body’s own insulin, immediately improving blood sugar control.
• Improves self-esteem.
• Improves body image.
• Increases mental focus.
• Increases strength and stamina.
• Decreases depression and stress levels.
• Improves digestion.
• Increases flexibility.
• Al eviates menstrual cramps.
• Enhances coordination and balance.
• Increases range mobility and range of motion.
Overal , being physical y active feels good, improving mood and disposition. Which of these benefits have you already noticed?
____________________________________________________________________________
____________________________________________________________________________
Which of these benefits would you like to pay closer attention to next time you are physical y active?
____________________________________________________________________________
____________________________________________________________________________
Based on Mahle Lutter, Rex, Hawkes, and Bucaccio (1999).
From Motivational Interviewing in Nutrition and Fitness by Dawn Clifford and Laura Curtis. Copyright © 2016 The Guilford Press. Permission to photocopy this handout is granted to purchasers of this book for personal use or use with individual clients (see copyright page for details). Purchasers can download a larger version of this handout (see the box at the end of the table of contents).
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“What do you enjoy about your time walking in the park?”
“How does your body feel when you are active? During? After?”
“Exercise makes you feel energized.”
“You are better prepared to deal with the stress at work on the days
you go to the gym in the morning.”
“You are more in touch with your hunger cues on the days you are
active.”
“You can tell that when you’re active you feel fewer body aches and
pains.”
“How do your blood sugars run on the days when you’re active?”
“How does being active influence your mood?”
“You’ve noticed being active helps you manage depression.”
In an effort to become more intuitive exercisers, some clients benefit
from keeping an exercise feelings journal (Handout 14.2) for a short period of time. In order to properly complete the log, clients focus on how they feel in the moment. So often, people
No longer is the focus
exercise and disassociate themselves
predominately on managing
from the present moment. It can be
blood sugar or fitting into a
in order to deal with the boredom
new pair of jeans; the focus is
of monotonous movements, numb
on spending your time doing
themselves from aches and pains, or
something enjoyable that is also
to ignore fatigue among other things.
“Zoning out” or “checking out”
physically active.
in an attempt to distract from the
uncomfortable sensations of a specific activity makes it difficult to tune into the positive rewards as well. If a particular activity is only tolerable if distracted from his or her own body, then it’s probably not the kind of activity that fully engages and provides enough intrinsic reward to be sustainable.
In the following example, a health coach discusses exercise with a cli-
ent using motivational interviewing in a way that supports intrinsic motivation and autonomy.
pRactitioneR: How do you feel about being physically active? [open-
ended question]
client: I know I need to exercise more. [change talk] I was going for walks in the afternoon [change talk] but it has been so cold lately, so I’ve stopped. [sustain talk]
pRactitioneR: You’d like to figure out ways to be active that aren’t
influenced by the weather. [simple reflection that emph
asizes
change talk] What other reasons, if any, caused you to stop?
[open-ended question]
Handout 14.2
ExERCISE FEElINgS JouRNal
Use this journal to record your physical activity patterns for a few days. By writing down your activity patterns and associated feelings, you may become more aware of the immediate benefits experienced fol owing a session of exercise. Focus on the physical and emotional sensations you experience before, during and after the activity. Try to identify activities that are engaging, leave you feeling good, and are fun.
Date/Time: May 8th, 12:30 pm
Exercise Description: Brisk walking for 25 min. during lunch break with a coworker
Feelings Before: Mentally exhausted and frustrated
Feelings During: Out of breath at times but not intolerable. Warm sun and fresh air felt good
Feelings After: Less frustrated and eager to make some progress on the mountain of work in front of me
Date/Time: _________________________________________________________________
____________________________________________________________________________
Exercise Description: _________________________________________________________
____________________________________________________________________________
Feelings Before: _____________________________________________________________
____________________________________________________________________________
Feelings During: _____________________________________________________________
____________________________________________________________________________
Feelings After: _______________________________________________________________
____________________________________________________________________________
Date/Time: _________________________________________________________________
____________________________________________________________________________
Exercise Description: _________________________________________________________
____________________________________________________________________________
Feelings Before: _____________________________________________________________
____________________________________________________________________________
Feelings During: _____________________________________________________________
____________________________________________________________________________
Feelings After: _______________________________________________________________
____________________________________________________________________________
From Motivational Interviewing in Nutrition and Fitness by Dawn Clifford and Laura Curtis. Copyright © 2016 The Guilford Press. Permission to photocopy this handout is granted to purchasers of this book for personal use or use with individual clients (see copyright page for details). Purchasers can download a larger version of this handout (see the box at the end of the table of contents).
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MI IN NUTRITION AND FITNESS INDUSTRIES
client: Honestly, it felt like a chore. I would just rather not. [sustain talk]
pRactitioneR: It was something you made yourself do but you
weren’t getting any enjoyment out of it. And now that the weather
is better, you’re finding it hard to get going again. [reflection of
sustain talk]
client: Yes, but I don’t know what else to do. I can’t afford to join a gym. [sustain talk]
pRactitioneR: Money is another factor. [reflection of sustain talk]
Tell me about a time when you enjoyed being physically active, if
that’s ever been the case? [evoking change talk]
client: I used to be very active when I was younger. I’d walk for an
hour in the morning just to get outside and breathe in the fresh air.
pRactitioneR: It sounds like you used to really enjoy your walks.
What changed for you? Why does it feel like a chore now? [open-
ended question]
client: I’m not comfortable like I used to be. I was thin then.
pRactitioneR: Exercising felt good because you weren’t self-con-
scious about your body. [complex reflection] What about going
for a walk makes you feel self-conscious now? [open-ended ques-
tion]
client: I just feel like everyone’s looking at me and thinking about
how much weight I’ve gained. I know I shouldn’t care about what
they think, but it just bothers me.
pRactitioneR: You’ve stopped doing something that you used to
really enjoy because you’re afraid of what people may or may not
be thinking about you. [complex reflection] What do you think
about that? [open-ended question]
client: It sounds stupid. I really don’t even run into people I know
when I go on a walk. [change talk]
pRactitioneR: It doesn’t sound logical to you. [simple reflection] I
wonder if you had something else to think about or focus on while
walking you wouldn’t worry about what other people are think-
ing. When you used to walk, what did you like to think about?
[open-ended question]
client: I just liked feeling strong. I would go out in the morning when the air is crisp and push myself to do more than I did before.
[change talk]
pRactitioneR: You felt powerful during your walks, like you had
accomplished something when you were done. I bet doing it in the
morning set you up for a good day too. [reflection of change talk]
MI in Fitness Counseling 219
client: Yeah, it usually would. I’m far more organized when I get up
in the morning. Plus I sleep better when I have a routine and make
myself get up. [change talk]
pRactitioneR: Working out was never really about how you looked,
but more about how it made you feel. You felt powerful and
accomplished; you got a jump on the day and felt more orga-
nized; plus, you slept better, giving you more energy the next day.
Physical activity did a lot of positive things for you, but now the
thought that people might think less of you is getting in the way of
you feeling good about yourself. [summarizing change talk] What do you think? [open-ended question]
client: I guess so. I just don’t know how to get over that hurdle. It
gets in my way every time. I have really good intentions and then
each time I try to do it, it gets harder and harder. [sustain talk]
pRactitioneR: You’re looking for ways to overcome those hurdles.
[continuing the paragraph reflection, taking a guess at change
talk] I have some ideas if you’d like to hear them. [asking permission]
client: Yes.
pRactitioneR: People tend to feel inspired to exercise when they focus
on the way being active makes them feel. You might find you enjoy
it more when you are more focused on how you feel instead of los-
ing weight. Some things to notice might be your breathing, how
your muscles move, and how your energy level increases. Just like
before, you would smell the crisp air and enjoy your surroundings
in the morning. [provide (giving information)] What do you think
of this information? [elicit]
client: I like that. I think I have been too wrapped up in my head that I’m not enjoying the process. It might even be fun to call up one of
my girlfriends and ask her to go with me. [change talk]
pRactitioneR: Going with a friend can help you get started again.
[reflection of change
talk]
client: I think we’d have a really good time.
pRactitioneR: Having a friend with you will help you enjoy the time
more. [simple reflection] Some of my clients have found that jot-
ting down the feelings they notice before, during, and after an
activity helps them to be more mindful of the process. I have an
activity journal here [Handout 14.2] if that’s something that you
think might be helpful. What do you think? [elicit]
client: Yes, I can take that. I may not fill it out, but it will remind me to pay attention to those things.
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pRactitioneR: You like the idea of shifting your focus to enjoying
the walk with a friend and noticing how being active in that way
makes you feel. The cold weather is a barrier for you in the win-
ter that really robs you of the joy of moving your body. If you’re
interested, we can talk more about indoor activities next time.
For now, you’ve expressed an interest in some regular walks with
your friend paired with mindfulness of your emotions and energy
before, during, and after each walk. [summary]
control ed Motivation
Exercise goals made from controlled motivation reflect an outward gain or payoff. This payoff or reward could be external, like attempting to lose 5
pounds because you believe doing so will impress former classmates at a high school reunion. However, it could also be internal, such as going to an exercise class to avoid the anxiety or guilt about choosing not to attend.
What makes these two examples similar is the sense that the person is not making the decision free from pressure or negativity. An individual motivated primarily by controlled motivation exercises to avoid feelings of guilt, compete with others, or to reach a certain calorie burn or dress size (Deci
& Ryan, 2008).
An exerciser acting from controlled motivation might:
• Compete in a sport in order to win and impress other people.
• Choose a certain series of abdominal exercises for the sole purpose
of muscle definition.
• Buy herself a coffee drink as a reward for going to the gym all week.
Motivational Interviewing in Nutrition and Fitness Page 29
