As the health conversation shifts from expert pontification to a collaborative, person-centered approach, fitness professionals can increase their impact and relevance by learning how to help clients make meaningful and lasting behavioral changes. Fitness professionals can get a good sense of how ready a person is to change their behavior by using motivational interviewing’s “readiness ruler.” The ruler includes two questions aimed at understanding how important change is to a client and how confident the client is that he or she can make a change.

  1. “On a scale of 0 to 10, how important is making this change to you?”
  2. “On a scale of 0 to 10, how confident are you that you can make this change?

The answers offer insight into a client’s readiness to change. When answers indicate low importance and low confidence, the client may be in the precontemplation stage. That is, she is not considering a change. The goal is to help the client consider change. At this stage, providing information (with permission) is effective in many cases.

When answers indicate moderate importance and moderate confidence, the client may be in the contemplation stage. This person may be weighing the pros and cons. This is where motivational interviewing is key. Follow-up questions might include, “Why is your confidence a 5 and not a 3?” This helps to bring about “change talk,” where the client articulates the reasons why change is possible.

When answers indicate moderate to high importance and moderate to high confidence, the client may be in the preparation stage. The person is ready to change. The goal is to help him envision what life would look like if he made changes, and to develop an action plan. This client may already be in the action stage, however. Help him establish very easy initial goals—and celebrate those successes.

People move into and out of the various stages; it is not always a neat, linear process. Not everyone is in the action stage of change, and thus, it’s important to resist the urge to move immediately into goal setting.

To read more about how you can inspire clients to create lasting change in their lives, “The Secrets to Behavior Change: Principles and Practice” in the online IDEA Library or in the July-August 2015 print issue of IDEA Fitness Journal. If you cannot access the full article and would like to, please contact the IDEA Inspired Service Team at (800) 999-4332, ext. 7.

Natalie Digate Muth, MD, MPH, RD

"Natalie Digate Muth, MD, MPH, RDN, FAAP, is a board-certified pediatrician and obesity medicine physician, registered dietitian and health coach. She practices general pediatrics with a focus on healthy family routines, nutrition, physical activity and behavior change in North County, San Diego. She also serves as the senior advisor for healthcare solutions at the American Council on Exercise. Natalie is the author of five books and is committed to helping every child and family thrive. She is a strong advocate for systems and communities that support prevention and wellness across the lifespan, beginning at 9 months of age."

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