How do you deal with clients who don't take on self responsibility?

An undying patience can only go so far. This client would be close to seeing my exit sign for the final time. Don't allow clients like this to soil your good name. If you are worth your salt then the fault lies with them. Tell them to give you one week of documented solid effort. If they really put in the work (and you WILL be reviewing this work), then they will undoubtedly see the results of their labor. If the fail to adhere to the plan, point that out and explain why their methods aren't following your expectations. If they still blame you, show 'em the door and spend that time helping someone with more accountability. Tough love... yes, but its love for yourself at least.

Yes, Heather (if I may call you Heather).
It's about education. The minute a client walks through my door, I begin to educate. Not that you are not, or did not, with these clients. But you must do more. In the sense that when someone asks me "how long does it take to lose 30 pounds?" My repsonse, "I don't know." I have no idea how committed this person is to restructuring their life to achieve weight loss.

Do they know that stress (and cortisol) has as much to do with weight loss as does exercise and nutrition?

Do they know that nutrition, what they consume if they are not stressed out, is 80% of the equation, with the rest being a combo of exercise and sleep?

Have you ever tried motivational interviewing to try to have this people adhere to what you are teaching them? I took a course and it's fascinatingly helpful.

Keep on changing people's lives. You have a passion. Pass it on.

Active Concept Training

Review their exercise and food journal REALLY CLOSELY. Ask them the question "if this is a complete and factual account of your week, why do you think you are not loosing the weight?" Then be like Jackie and drop in on them at home or at restaurant and bust them! The reality is you already lost them as a client if they are going to blame you, plus they will not be saying good referral words! So be in the tough love model!

Thanks for the kind words. I have gone through all of that, I believe they just have a few other personal barriers to combat before they will allow themselves to do what they need to do.

Thank you for the information

Any mature, somewhat evolved adult understands that it cannot possibly be someone else's fault (trainer or otherwise) for not achieving personal goals. I'm sure there is something in any Psych 101 textbook that could explain such behavior....

I guess the issue becomes one of "can I still work with this person?"; "is he/she respecting me and my efforts?; "is he/she honestly putting forth the energy and effort required to achieve their goals?".

Have you introduced the following into the conversation?:

-why are you coming to see me only once a week? What do you do the other 6 days to contribute to this goal?
-a food diary (a good quantitative source, if he/she completes it honestly!)
-an understanding of what realistic, healthy weight loss looks like i.e., 1-2 pounds a week
-the energy output necessary to burn the necessary "excess" calories
-the necessary frequency and intensity of "productive" physical activity sessions
-WHY does he/she want to lose weight i.e, is it personally driven or a real or felt external pressure?

Thing is, weight is such a delicate topic. So, as you've probably discovered, so many layers have to be lifted before you may make any real progress. Still, if this person has come to you, he/she must have some degree of motivation...

Best wishes!

One of the other things that I do is bring my ACSM GETP8 directly to the client and allow them to see the science. This was effective with an MD who is a current client.

Hope this helpful.

Ugh Heather I don't envy you. I've had clients/students like this. Recently I told one student who was complaining about her flab to "love your flab and you won't notice it anymore". I know that sounds extreme and careless as a professional, but those people I believe are in need of some serious TLC.

It is ultimately up to the client to make the change in lifestyle the other 23 hours of the day that you don't see them. I make my clients sign an agreement that has them understand that I can show them how to get there but I can't do the work for them. If they aren't ready or serious then cut them loose, it will wear on you.