Behavior Change, Accountability, and Communication
Domain 3 covers adherence and communication. The exam tests whether you can match coaching style to readiness, build accountability without control, and communicate clearly in asynchronous channels.
Behavior-change models
- Transtheoretical model: precontemplation, contemplation, preparation, action, maintenance. Match strategy-raise awareness in contemplation, build concrete plans in preparation, reinforce cues and self-monitoring in action.
- Self-determination theory: support autonomy (choice), competence (early wins, clear progress), and relatedness (familiarity, responsiveness).
- Goals: specific, measurable, achievable, relevant, time-bound; add implementation intentions (“If it is Tuesday at 7 a.m., then I walk after coffee”) and habit stacking.
Communication and accountability
- Motivational interviewing uses OARS: open questions, affirmations, reflections, summaries. Elicit change talk; avoid the righting reflex-arguing for change while the client argues against it.
- Set response-time norms, check-in cadence, and channel boundaries in writing. Use shared logs and brief weekly reviews.
- Escalate red flags such as disordered-eating signals, depression symptoms, or injury to the appropriate professional.
Worked example
A client misses two sessions and says, “I’m lazy.” The coach reflects: “You’re frustrated that the plan isn’t fitting your week.” She asks what got in the way, learns the client works late Mondays, and moves the session to Tuesday with an if-then plan. No lecture. Reasoning: reflection lowers defensiveness, the barrier is structural, and a specific plan supports autonomy and competence.
Traps
Lecturing or shaming; overpromising results; relying on willpower; ignoring readiness; inconsistent check-ins; letting boundaries blur with 24/7 messaging.