Client Relations and Behavioral Coaching
Behavior-Change Models
The transtheoretical model describes readiness: precontemplation (no intention), contemplation (considering within six months), preparation (intending within 30 days and taking small steps), action (recent change), and maintenance (sustained change). Match strategy to stage; action planning fits preparation and action. Motivational interviewing uses OARS - open questions, affirmations, reflections, summaries - to elicit change talk and reduce sustain talk. Roll with resistance rather than arguing; the “righting reflex” increases discord. Self-determination theory emphasizes autonomy, competence, and relatedness; social cognitive theory emphasizes self-efficacy and modeling.
Goals and Adherence
Write SMART goals - specific, measurable, achievable, relevant, time-bound - that the client owns. Use self-monitoring such as food and activity logs, stimulus control, implementation intentions (“If it is Tuesday at 6 p.m., I walk”), and relapse-prevention planning. Celebrate process goals, not only outcomes.
Worked Example
A client says, “I know I should eat better, but I don’t know if I ever will.” This is contemplation. Do not hand over a meal plan. Reflect ambivalence, ask what would make change worth it, list pros and cons, and ask about one small experiment next week. Move to preparation only when the client voices intent.
Traps
Assuming knowledge equals readiness; labeling a client “noncompliant”; front-loading education; setting goals for the client; ignoring barriers such as cost, shift work, or family norms.