Good Communication is Key to Exercise Adherence
Have you ever been in a conversation with a client thinking you knew exactly where it was going? Instead of listening did you launch into giving a bunch of information only to find out that was not at all where the client wanted to go with the conversation and that all the information you just gave was inappropriate to the situation?
Effective communication is often the difference between success and failure of the relationship between a personal trainer and a client. Effective communication requires an attitude of honoring each client’s perspective and a genuine interest in getting to know people. Effective communication starts at the beginning of the relationship and continues throughout the relationship.
Motivational Interviewing Skills
Motivational interviewing, also sometimes called Listen First, is a respectful style of communication that is based on the principal of listening. Listening allows us to gather information so that we can proceed in a direction that is appropriate for the client versus what we may think is appropriate. It allows the client to makes choices and decisions based on their needs and wants versus what we think is right or wrong.
Motivational interviewing is effective in helping client’s feel supported, understood, and comfortable in an environment that may be uncomfortable. Asking the right questions, reflecting information that was heard, summarizing those reflections and affirming your client help maximize them feeling supported and help them connect to you. That connection is what leads to adherence to an exercise program.
Asking questions
Closed ended questions can be answered with one word which in general doesn’t make them very effective For example, personal trainer: did you workout yesterday? Client: no. Closed ended questions don’t give us the necessary information. With this closed ended question we aren’t able to understand why the client didn’t work out and what got in the way for them.
Although closed ended questions can be important, for example, ‘what’s your name’, open ended questions allow clients to give more information. Open ended questions cannot be answered with a number, a place, or a simple yes or no. They require your client to elaborate. Open questions are very important for building collaborative relationships with your client because they invite discussion. They allow clients to express personal fears, barriers, failures, and successes. An opposing open ended question to ‘did you workout yesterday’ might be ‘what did your workout look like yesterday’? Changing a few words will allow your client to expand on their explanation and will give you a better understanding of the situation.
Reflecting
Reflections are statements that express the meaning of what was just heard. For example, client: I had a long workday yesterday and couldn’t get a workout in. Personal trainer: it sounds like yesterday was an exhausting day and you weren’t able to work out. Reflections are rarely used in conversations but they are both subtle and powerful. They express caring, show that you are listening, communicate understanding, encourage elaboration and build collaboration. Reflections are an opportunity for you to make sure that you accurately understand what your client has said and it gives your client an opportunity to ensure they have communicated what they thought or felt.
If reflection is new to you, reflections might seem like they come across as patronizing. It may feel like you are repeating every word your client says or going over information already covered. As reflection becomes more fluent, the client naturally adds more information to what has been reflected. When done skillfully, the conversation between you and your client will flow and all of the information will come from your client as you reflect.
Listening
When we listen, it is our responsibility to ask the right questions, take in information and clarify it ensuring that we are clear on the most appropriate direction for the client. In a listening framework, the client talks 75-80% of the time.
Motivational interviewing skills support listening. Listening is more than having good communication skills. It is about having an attitude, or general spirit of honoring and seeking a client’s perspective and a genuine interest in getting to know your clients. This is what makes motivational interviewing a good model of communication to use with your clients.
How we talk to our clients makes a big difference. Traditionally we focus on content, the what, of communication. Typically we pay very little attention to how we say things. Yet how we communicate with others is as important, if not more so, as what we are trying to say. How we communicate affects how people feel, and this affects the choices they make.
Listening in communication is not about convincing a client to do something, selling a program, or providing the right information. It suggests that we seek to be respectful, that we care for clients, and that we desire to form partnerships or collaborative relationships with them. Instead of having the goal be to communicate information, our goal should be to build a relationship with our client. This requires an attitude of honoring each client’s perspective and a genuine interest in getting to know people. It is more important to communicate understanding than to provide the right information.
Next Wednesday I will continue this conversation by talking about affirmations, asking permission to open certain conversations and how to offer options to your client in a way that invites them into the conversation versus feeling like an outsider in their own health & exercise program.
Happy Wednesday!
Dr. Michelle
