ACE CPT Chapter 4: Basics of behavior change and health psychology

ACE Study Guide Chapter 4

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Behavioral theory models

  • The health belief model: This is where the threat of developing health problems motivates individuals to change their behaviors and to start exercising.
    1. Perceived seriousness: The more serious the health threat is, the more likely an individual is to change their habits and start exercising.
    2. Perceived susceptibility: These are the feelings that an individual has about their chances of obtaining a health threat.
    3. Cues to action: Environmental and/or physical occurrences that motivate individuals to take action.
    4. Vocabulary
      • Hypertension
      • Sedentary
  • Self-efficacy: This is the perception that a person has about their own abilities to accomplish/succeed.
    1. Based on past experiences and performance
    2. Vicarious experiences
    3. Verbal persuasion: feedback
    4. Appraisals of physiological states
    5. Mood appraisals and emotional states
    6. Imaginal experiences
  • The trans-theoretical model or TTM for behavioral change and its components. Has to do with how ready one is to make changes.
    1. The stages of change
      • Precontemplation: This is a person who is not even thinking about exercising. Very sedentary.
      • Contemplation: This is a sedentary individual that is considering starting a workout routine as they begin to see the negative outcomes of being sedentary.
      • Preparation: This is a person who works out sometimes and is physically and mentally preparing themselves to start a program.
      • Action: This is a person who has been exercising regularly but for less than six months.
      • Maintenance: This is somebody who has been exercising regularly for more than six months
    2. The process of change (super important): Refer to table 4-1 in manual.
    3. Self-efficacy
    4. Decision balancing: This has to do with the number of pros and cons your client perceives exercise will provide them.

Principles of behavioral change

  • Operant conditioning: This is the process where one’s behaviors are impacted by their consequences.
    1. Antecedents: This is a stimulus that comes before a behavior and commonly signals the consequences of behavior.
    2. Stimulus control: This is when antecedents are controlled within the environment in order to increase the chance of desirable behaviors.
    3. Consequences:
      • Nonoccurrence, presentation or complete removal of a aversive or positive stimulus.
      • Positive reinforcement: Providing positive stimulus that increases the chances that a behavior will happen again.
      • Negative reinforcement: This is avoiding or removing aversive stimulus after an undesirable behavior. Increases the chances that the behavior will happen again.
      • Extinction: This happens when a positive stimulus that used to follow a behavior is taken away. This reduces the chance that it will recur.
      • Punishment: This reduces the chances of a behavior reoccurring.
        1. This decreases enjoyment and increases fear so use very sparingly.
        2. It consists of aversive stimulus after a behavior that is undesirable.
    4. Shaping
      • This is crucial for constructing self-efficacy
      • Gradually increasing the demands for a behavior or a skill after positive reinforcement.
      • The program is too easy = the client will get bored
      • The program is too difficult = client will feel overwhelmed, inadequate and discouraged
      • Both scenarios lead to higher dropout rates
    5. Observational learning
      • Be conscious of the exercise and health behaviors of the people that surround your client. This directly impacts their success.
    6. Behavior and cognition
      • Strategies for replacing irrational thoughts that your client may have with healthier and more productive ways of thinking. (Refer to page 79).

Behavioral change strategies

  • Stimulus control
    1. Changing the environment to increase one’s chances of healthy behaviors.
    2. Willpower: One’s ability to pursue long-term goals even though they may be experiencing short-term discomforts or pleasure.
  • Behavioral contracting and written agreements
    1. Can be used on their own or together
    2. Your client needs an active role in its development
  • Techniques for cognitive behavior
    1. SMART goals
    2. Feedback
      • Extrinsic or intrinsic
      • As your client’s ability and efficacy get better, the trainer should be reducing external feedback so that the clients can start providing their own feedback.
      • It’s possible to have too much feedback.
    3. Decision-making
      • This is where you give clients program participation control
      • As a trainer, you should not micromanage every decision for your client’s program.
      • Part of being a good trainer includes instilling the knowledge into your clients so that they can be successful by themselves.
    4. Self-monitoring
      • Helps to keep clients on the right path with their program participation as well as the progress (or lack thereof).
      • Helps to identify barriers
      • This requires self-reflection as well as honesty from clients
      • Journaling
  • Implementing new strategies
    1. Data and information collection never stops
    2. Take psychological variables into account for minor adjustments
    3. Use communication as well as feedback to overcome barriers and stay aware of changes that may be happening with clients.
    4. Maximize adherence

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  • Jalen O McDonald says:

    Bro.. this is so clutch thank you! I’ve been preparing since November

    • Tyler Read says:

      Hey Jalen,
      I’m glad to hear that this is helping you out a ton. I have been working hard on the study guides for the last year or so, so it’s really good to hear positive feedback. Good luck acing the ACE exam!

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