Lesson Plan—Coaching Session #4

Staying Healthy Through Education and Prevention (STEP)

Self-Awareness and Self-Monitoring

Introduction

This session involves teaching participants to be aware of their activities and accomplishments and to monitor their physical activity as part of a larger behavior modification effort. The group leader should review the content of Session 3 first, and then introduce self-awareness and self-monitoring skills. This session includes a group activity designed to help participants think about these new skills and apply them to monitoring their exercise with the physical activity tracking sheets. This session concludes with information about combining relaxing activities with self-monitoring.

Preparation

  • Staff must be familiar with:
    • Content of Session 3 (definition of physical limitation and strategies to reduce risk of further decline).
    • STEP physical tracking sheet log and monitoring of physical activity time.
    • Concepts related to self-awareness and self-monitoring of physical activity.

Session Objectives

In this session, participants will:

  • Review content of Session 3.
  • Review their progress in the physical activity program (strength class attendance, total minutes walking).
  • Discuss two key skills: self-awareness and self-monitoring.
  • Discuss feelings regarding their exercise patterns and accomplishments.

Session Outline

  1. Greeting/Review
  2. Self-Awareness and Self-Monitoring
  3. Group Activity: Examining Our Progress in the STEP Program
  4. Self-Monitoring With Relaxing Reflection
  5. V. Questions/Wrap-Up

Session Content and Sample Script

I. Greeting/Review
  • Greet participants as they arrive.
  • Facilitate a brief review of Session 3:
  • Definition of physical limitations
  • Brainstorming about physical limitations (from Session 3 handout)
  • Strategies for reducing risk of further decline (from Session 3 handout)

II. Self-Awareness and Self-Monitoring

  • Define and discuss self-awareness and self-monitoring. Why are they important to behavior change and how can participants benefit from using these strategies?

SCRIPT:

During the past 2 weeks, we have discussed the primary reasons you want to be more physically active. We've focused on the benefits of being active and the concepts of physical limitation and decline. Now, you will begin to learn how to change your behavior so that it will be easier to integrate physical activity into your daily life. One of the first steps in making this important lifestyle change is to know how active you currently are or, in other words, to become More Self-Aware of the amount of activity you are doing. The best way to become more self-aware is to start Self-Monitoring your activities. The best way to self-monitor is to Write Down (or Record) your physical activity every day. Writing it down will enable you to evaluate your activity over long periods without relying on memory. Self-monitoring will also allow you to identify behavior patterns so that you can notice your strengths and weaknesses and modify your behaviors accordingly.

  • Discuss some key strategies for learning how to self-monitor (i.e., recording information in an activity log or using the tracking sheet [link here], making sure that behavior matches up with goals).
  • Discuss the concept of positive rewards and how self-monitoring can help participants know when to reward themselves.

SCRIPT:

Let's talk about ways to self-monitor. First, we have some easy tools that come with the STEP program—we have the physical activity tracking sheet for you to record the time you spend exercising. There's no way anyone can possibly remember all the activities they do each week. Given that our ultimate goal is 150 minutes, it makes sense to record our time, and I have some tools to help you do this. You've all been getting used to this idea over the past few weeks. Is this working well for you? [Solicit feedback.]

Another way to self-monitor is to review your tracking sheets regularly. We do this for the leg strength part of the program so that we know when you're ready to increase your ankle weights. Reviewing tracking sheets for walking can also be helpful week to week so that you can see the changes you're making, give yourselves a pat on the back, and decide how to continue moving toward your long term goals.

Another activity we do to help us self-monitor and become more self-aware is the Take-Home Challenge. These ask you to go beyond "the numbers" and think about your feelings and your satisfaction with the changes you're trying to make and the goals you've set. We'll talk about our most recent Take-Home Challenge in a few minutes so that we can start getting in the habit of self-monitoring.

As you can see, there are many ways to judge success and monitor change over time: the time you spend exercising, heaviness of ankle weights, number of repetitions, RPE; and if you feel stronger and more active, if you feel motivated and able to pursue your interests outside of exercise, etc. The more you pay attention to monitoring your physical activity, the more you will realize how much progress you are making toward your goals.

Another good reason to self-monitor is that it will allow you to celebrate your successes. This is something we'll do as a class and something you should do individually and with your walking or classroom "buddies." Each of you should be proud that you've started this program and you should be proud for each week that goes by. It's up to you how to celebrate—whether you want to give yourself a mental pat on the back or do something more. Celebrations of progress, even small amounts, are an important way to stay motivated. Why? Because sometimes you may not feel successful and you need to be able to bounce back and keep working toward being physically active. One of the ways you can do this is what we call "positive self-talk." We'll be working on this skill in Session 6, so stay tuned until then.

  • Review the physical activity tracking sheet that participants can use to record their activity.
  • Make a clear distinction between walking time and strength training (class) time, and reiterate that activity goals for the program involve both components: class time for strength training and walking time. Activities that involve "puttering around," such as cooking and running errands, are certainly encouraged but don't count toward walking minutes.

III. Group Activity: Examining Our Progress in the STEP Program

  • Have participants look over their tracking sheets and start a discussion about their progress:
    • What do you notice about your physical activity minutes?
    • What do you notice about your attendance at weekly strength/coaching classes?
    • If you fell short of your walking goals or didn't attend as many classes as you planned, what happened? What changes can you make that will help you succeed this week?
    • Remember that this is a long-term process (the story of the Tortoise and the Hare is particularly relevant here).

IV. Building on the Idea of Self-Monitoring With Relaxing Reflection

  • Discuss the importance of taking the time to be aware of accomplishments, not only in terms of activity time but also in daily physical and mental function.

SCRIPT:

It is also important to increase our awareness not only of how much activity we are doing but also of the physical and mental changes that we experience as a result of being active. Think about the changes related to physical limitations that you mentioned at the beginning of the session. What's the difference between BEING more active and FEELING more active? You have all started to BE more active; how does FEELING more active change your thoughts or behaviors? [Note: Examples might include feeling more able to do things, feeling happier in general, feeling motivated to try new things or satisfied with the amount they're doing.] Also, think about the goals you identified in our second session when we asked about your main motivation for becoming more physically active. How has physical activity become an important way to accomplish those goals? [Encourage discussion.]

Great ideas, everyone, and thank you for sharing. Being aware of these changes is the essence of self-monitoring.

So when do you have time to assess your feelings? Class is a good opportunity but you might want to do this outside of class too. One way to increase self-awareness is to practice relaxation techniques. To do this, sit in a quiet, relaxing room, turn on some soft music if you'd like, and just start to focus on how you have felt since joining the STEP program. Let your mind wander as you think about all the positive changes that you have experienced by being active on a regular basis. Continue to explore your thoughts about your accomplishments for about 5 minutes. This strategy will help you to increase and maintain your motivation and confidence for becoming more physically active without taking up a lot of your time. Of course, feel free to spend more time assessing your feelings and progress—it's up to you.

You can also set aside some quiet time with one of your buddies and take turns discussing particular goals, feelings, challenges, and strategies. Take advantage of these relationships. The more you can incorporate what we're learning into your daily life, the more likely you are to succeed in making a permanent change in your activity levels.

  • Refer to the Take-Home Challenge from Session 3 and discuss/review/reflect on responses. Examples you may encounter:

SCRIPT:

Some of you mentioned that you noticed an increase in your ability to get to and from meals more easily. Others mentioned that they noticed that they were feeling more happy and full of spunk. As we noted before, being aware of these changes is the essence of self-monitoring. What else did you experience or notice? Did you find that the physical activity log was an effective way to be more aware of your activity? This tool helps you better understand your physical activity and gives you a continuous way to monitor your activity. In fact, you have already been recording your exercise time since you started the STEP program, so we're off to a great start. In order to stay motivated to increase our physical activity, we're going to keep talking about self-monitoring in class and I would encourage you to take time to reflect at home as well.

V. Questions/Wrap-Up

  • Briefly summarize the material and concepts that you covered in the session and provide an opportunity for participants to ask questions and express concerns.
  • Remind them that their Take-Home Challenge is to be diligent about completing their tracking sheets and to come ready to discuss their progress at the next class on:
    Date and Time: _______________________________
  • Let them know that in Session 5 you will talk about additional self-monitoring techniques, discuss feelings about exercise, and learn strategies for dealing with negative thoughts.
  • End the session on a positive, enthusiastic note and tell participants that you look forward to the next meeting.

SCRIPT:

For the next group session, instead of a Take-Home Challenge, we will review your progress using the exercise tracking sheets. I look forward to discussing how much more self-aware you have become and how well you're doing with self-monitoring!

Page last reviewed February 2011
Internet Citation: Lesson Plan—Coaching Session #4: Staying Healthy Through Education and Prevention (STEP). February 2011. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/education/curriculum-tools/stepmanual/stepcoach4.html