Skip to Main Content

We have a new app!

Take the Access library with you wherever you go—easy access to books, videos, images, podcasts, personalized features, and more.

Download the Access App here: iOS and Android



After reading this chapter, you will be able to:

  1. Discuss how health and fitness professionals can strengthen important factors in behavior-change models to help clients change health behaviors.

  2. Describe the communication skills that are most helpful to health and fitness professionals when working with clients.

  3. Assess a client's readiness to change.

  4. Suggest possible approaches to discussing behavior change with clients who are resistant to or ambivalent about changing.

  5. Create effective behavior-change goals and action plans.

  6. Teach behavior-change skills.

  7. Discuss common ethical challenges that arise when working with clients who are trying to change their health behaviors.


image Erica works in a cardiac-rehabilitation department at a busy hospital. Most of her patients are recovering from either a recent heart attack or revascularization surgeries, such as angioplasty or bypass graft surgery. Erica is an exercise physiologist by training, but in addition to prescribing exercise for patients, she also talks with them about how their other behavior-change efforts are going while they walk on the treadmill or indoor track or use other exercise equipment. Most of Erica's patients have met at least once with the dietitian and with a psychotherapist. Erica gets reports and recommendations from those professionals and then works with patients as they strive to implement new lifestyle behaviors.

Erica's department head has recently hired a consultant to work with all staff members to improve their communication skills so that they can work more effectively with patients. "This must be mostly for the doctors," Erica thinks. The surgeons are especially notorious for having no people skills. She feels that she communicates well with her patients already and presumes the mandatory workshops will be a waste of her valuable time. "What is there to learn? The recommendations for patients recovering from heart attacks and surgeries are pretty cut and dried," she says to herself. "Sure, changing diet, exercise, and maybe quitting smoking and managing stress are a lot for most of these patients, but what choice do they have? Lifestyle change works, and patients need the information to get with the program."image

Chapter 1 presented information on the most common health problems found in North America and around the world, emphasizing that a majority of these relate to health behaviors. Behaviors often cause the problem, as when smoking causes carcinogenic changes in lung cells or the destruction of the alveoli seen in emphysema. Sometimes a number of behaviors contribute to a disorder, as with type 2 diabetes. Health professionals often recommend lifestyle changes to reduce the negative effects of chronic health problems, such as heart disease, and to improve longevity and quality of life. Health researchers and policy makers alike agree that people must develop healthful lifestyles to prevent, delay, and treat the major threats to health and wellbeing (Freudenberg & Olden, 2011).

It is impossible to ignore the urgent need ...

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.