Communication, Motivation, and Behavior Change
The human side of training
Adherence - not program design alone - determines outcomes. Older adults bring unique motivators (independence, social connection, health) and barriers (fear, transportation, cost, health literacy, isolation).
Key concepts:
- Motivational interviewing (MI): collaborative, client-centered approach using open questions, affirmations, reflections, and summaries (OARS). It builds intrinsic motivation rather than directing.
- Stages of change (precontemplation → contemplation → preparation → action → maintenance): match your strategy to the stage; don't push action on someone still contemplating.
- Self-efficacy (Bandura): build confidence through mastery experiences, modeling, verbal persuasion, and managing physiological states.
- Goal setting: SMART goals, collaboratively set, with short-term wins.
- Health literacy and communication: plain language, teach-back, visual cues, repetition; address hearing/vision needs.
- Social support: group classes and family involvement boost adherence.
Traps
Questions may equate motivation with "telling the client what to do" - MI is the opposite. Another trap is applying action-stage strategies to a precontemplative client. Also watch for assuming older adults are unmotivated; the issue is often barriers, not desire.
Rule of thumb
Ask more than you tell: a client who articulates their own reason for exercising is more likely to continue than one who is lectured.