Lesson Plan—Coaching Session #5

Staying Healthy Through Education and Prevention (STEP)

Examining Our Feelings: How We Think Can Affect How We Act

Introduction

This session involves teaching participants how thoughts and feelings about exercise influence their behavior. The group leader will first review the content of Session 4, and then lead an interactive discussion focused on the connections among thoughts, feelings, and exercise. The session concludes with the group leader handing out and explaining the Session 5 Take-Home Challenge.

Preparation

  • Staff must be familiar with:
    • Content of Session 4 (self-awareness and self-monitoring).
    • STEP physical activity tracking sheet and monitoring of physical activity time.
    • How thoughts and feelings relate to exercise and behavior change.
  • Print/copy the Session 5 Take-Home Challenge.

Session Objectives

In this session, participants will:

  • Review content of Session 4.
  • Discuss how they are doing with the STEP program and becoming more self-aware of their physical activity.
  • Discuss thoughts and feelings and how they influence behavior, specifically, physical activity.

Session Outline

  1. Greeting/Review
  2. Thoughts and Feelings
  3. Thoughts, Feelings, and Exercise
  4. Take-Home Challenge
  5. Questions and Wrap-Up

Session Content and Sample Script

I. Greeting/Review

  • Greet participants as they arrive.
  • Review content of Session 4:
    • Self awareness
    • Self monitoring
    • Overall STEP exercise target of 150 minutes per week of moderate exercise
    • Important distinction between walking time and strength training (class time)
    • Use of the physical activity tracking sheet as a tool for self-monitoring
  • Ask participants to share thoughts about their physical activity for the past week (Are they satisfied with the amount they've done? Do they have mental or motivational barriers to overcome next week?) and how writing down their activities on the tracking sheet helped them. Ask whether they have any problems or questions regarding the tracking sheets. Provide support and encouragement—it requires diligence but is extremely worthwhile.

SCRIPT:

It's pretty clear that you have become much more active over the past few weeks. You have been progressively increasing the number of minutes that you are physically active each week.

Congratulations on making and keeping such a great commitment to your health and well-being! For the past few weeks, you have been recording your physical activity on the tracking sheet. This past week, you increased your focus and began to look closely at your own progress and walking time. What was the main purpose of doing this? [Pause to allow answers.] Great ideas. Another thing I would say is that your tracking sheets help you all become more aware of what you do or don't do on a regular basis. Let's take some time to think about what we found out.

Take a look at the numbers from last week on your tracking sheet and think about a few things: Were you physically active on any of those days? How many days were you physically active? Were you more active on certain days than on others? How different are these numbers from each other and do you remember a reason for the difference? [Encourage people to give examples of the reasons they experienced gaps in physical activity.] It's good to hear these examples because they are the exact issues we're learning about and developing strategies to overcome. I hope this shows how useful it can be to track your activities.

As you continue to increase the number of days (frequency) or the number of minutes (duration) that you are physically active, you will see a progressive increase in your total time doing physical activity. Once you are meeting the program goal of 150 minutes each week of activity (or close to it), you can shift gears and start working to maintain that level over the long term.

II. Thoughts and Feelings

  • Lead interactive discussion on concept of thoughts and feelings and how they can affect behavior.

SCRIPT:

Today we are going to discuss another concept that will assist us in modifying our behavior. You have all recently started to become more aware of your physical activity patterns and how your body responds to exercise. First, does anyone have any questions about the importance of self-monitoring, strategies for self-monitoring, or anything else we discussed last week? [Pause.] Did anyone take some quiet time to practice reflecting on their physical activity? How did it go? What did you notice about the experience?

III. Thoughts, Feelings, and Exercise

  • Lead a discussion on the connection between thoughts, feelings, and exercise.

SCRIPT:

Today, we are going to start talking about your thoughts and feelings and how they relate to exercise. You may ask, "My thoughts? What do they have to do with exercise?" Actually, thoughts are extremely important to behavior, in part because we do not realize that we keep a running dialogue with ourselves all day. In other words, you talk to yourself! For instance, have you ever said things like this to yourself? "Gee, I sure liked that spaghetti last night." Or, "I feel like going to the beach today." You also have a running dialogue regarding your physical activity and activity programs. In fact, you may have noticed certain thoughts regarding exercise before, during, and after you participate. For example, have you ever said the following things to yourself about physical activity before a session? "I know that I should be exercising, but I just don't feel like it." Or, "I am really looking forward to today's workout!" If you have had these thoughts (like we ALL have), you aren't lazy or undisciplined or unable to be active. In fact, you were probably trying to motivate yourself—acknowledging how you did not feel up to exercising but telling yourself to go to class or to walk anyway! And that is the key concept I want to emphasize here: your thoughts and feelings affect your motivation and so they ultimately affect your behavior.

Really, there are only two ways feelings can influence our behavior: in a positive way or negative way. So, how you talk to yourself can be a powerful tool or a huge barrier, depending on how you use it. When it comes to physical activity, you probably have constant thoughts about walking, strength class, and these behavior sessions. Most of the time, these thoughts are probably about whether you want to do these things or not and whether you have time or not. It's okay; it's only natural. We need to understand how we think and feel about physical activity in order to increase our motivation for modifying both our thoughts and behaviors.

Therefore, it's time to start examining your thoughts and feelings AND how they affect your exercising behavior. You may have noticed certain feelings regarding exercise before, during, and after you participate [Give or ask for examples]. If you're feeling good, how does that affect your exercise behavior? (Whether you go for a walk, come to class, etc.) If you're feeling bad, how does that affect your exercise behavior? [Pause for responses.] What about when you're at home and not necessarily thinking about exercise? If you wake up feeling good, do you get more accomplished that day? The same as usual? When do you tend to feel better or worse (in terms of your health, energy, or emotions)? Are these good times to exercise for you or bad?

I hope you're starting to get a sense of all the questions we can ask ourselves to monitor our feelings. And to review, what's the purpose of monitoring? [Give or ask for responses.] It's to understand. To seek information that we can use to help reach our goals. The time we spend talking about thoughts and feelings and the time you spend on your own analyzing your thoughts and feelings are very important. We need to understand how we think to ourselves and how we feel about physical activity in order to increase our motivation for modifying both our thoughts and behaviors.

IV. Take-Home Challenge

SCRIPT:

Now, we would like you to consider another strategy: focusing on how you feel about physical activity and exercise, as well as on how exercise makes you feel. So, let's take a look at the Exercise Feelings Scale. Just like you keep track of your exercise minutes every week, this week I also want you to keep track of your exercise-related feelings. One of the most common thoughts that people have before physical activity is: "I know that I need to exercise, but I just don't FEEL like it today." But then, after they start their physical activity session, they start to think, "Boy, I do feel better now that I have started!" It is precisely these kinds of feelings that have profound effects on how you act.

In keeping with the process of self-monitoring, we want you to notice and record how you feel before, during, and after physical activity for the next week. You should also write down what the activity was (walking or strength class) so that you will be able to identify whether you have more positive feelings about one versus the other. Finally, please take some time to write down the thoughts you have on the lines provided. It only takes a minute and is very important to seeing how our feelings influence our actions. You can write things as simple as, "I don't want to go," or you can record the thought and the reason. Next week, we will discuss this information and build on it when we discuss positive and negative self-talk and how we can break the chain of negative thoughts leading to negative behaviors. Good luck—I know you're all up to the challenge!

In the meantime, please continue to record your walking and other physical activity on the tracking sheet. We will continue to review your sheets each week in order to help keep everyone motivated and active!

V. Questions and Wrap-Up

  • Answer any questions that participants may have regarding the assignment and wrap up the session.
  • Remind them to keep walking!
  • Remind them to complete the Take-Home Challenge before the next session meets: Date and Time: _______________________________
Page last reviewed February 2011
Internet Citation: Lesson Plan—Coaching Session #5: 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/stepcoach5.html