Lesson Plan—Coaching Session #6

Staying Healthy Through Education and Prevention (STEP)

Thoughts and Feelings About Physical Activity

Introduction

This session involves defining "self-talk" and how positive self-talk can help individuals change their behavior, especially as it relates to changing their exercise habits. During this session, participants will review strategies for self-monitoring, including recording their exercise minutes and their feelings before, during, and after exercise. They will also learn questions to ask themselves when examining their thoughts and feelings related to exercise.

This session introduces the concept of "self-talk" and how to change negative self-talk into positive self-talk. It is also a good opportunity to assess participants' engagement in the program. Make sure participants' walking groups or buddies are still meeting regularly, provide updates on any group goals that were set or parties being planned, and solicit feedback on how you can help them stay motivated as the program continues.

Preparation

  • Staff must be familiar with:
    • Content of Session 6.
    • Content of the Session 6 handouts and Take-HomeTake-Home Challenge.
    • The concept and importance of self-talk.
  • Print/copy in-class handouts and the Session 6 Take-HomeTake-Home Challenge.

Session Objectives

In this session, participants will:

  • Review the Session 5 Take-Home Challenge.
  • Discuss the concept of self-talk and how participants can use it to modify their behavior.
  • Review different types of negative thoughts.
  • Discuss and learn how to identify and stop negative thoughts regarding exercise.
  • Discuss the next Take-Home Challenge.

Session Outline

  1. Greeting/Review of Session 5
  2. Using Self-Talk for Behavior Modification
  3. Dealing With Negative Thoughts
  4. Negative Thoughts and Exercise Goals
  5. Wrap-Up/Check-In/Take-Home Challenge

Session Content and Sample Scripts

I. Greeting/Review of Session 5

  • Greet participants and review Session 5 Take-Home Challenge (exercise feeling scale).

SCRIPT:

Last week you learned about your thoughts and feelings, two very important issues that may influence how successful you are at engaging in regular physical activity. I also gave you some handouts to help you monitor your feelings before, during, and after each physical activity session. What was the main purpose of that Take-Home Challenge? [Pause for answers.]

This assignment builds on the concept of self-monitoring (for example, using the physical activity log). Being aware of your thoughts and feelings is another way to self-monitor (for example, taking time for quiet self-reflection or using the exercise feelings log). Why do you think that it is important to monitor our thoughts and feelings? [Pause for answers.]

Take a few minutes to ask your self these three questions:

  • What did you realize about your feelings?
  • Did you see an association between your feelings and your behavior?
  • How do you think that you can learn from this assignment?

Now, would anyone mind sharing what you've learned with the group?

Encourage discussion and ask questions if conversation is slow:

  • What patterns do they see in their feelings?
  • How did these feelings affect their behavior?
  • What time of day did people have the most difficulty?
  • Did they find that even if they felt unmotivated before exercise, they felt satisfied/proud by the end? (We hope this was the case.)
  • Have their feelings about exercise changed as they have progressed through STEP?
  • How should they use this information to help them reach their physical activity goals?

Okay, great discussion. I hope this Take-Home Challenge has demonstrated the link between feelings and behavior. Understanding this link is critical. It's important to recognize that your feelings have a lot of power over your behavior. Luckily, you have a lot of power over your feelings. That is what we're going to talk about today. Now that we understand that negative emotions often lead to negative behavior, we're going to learn how to overcome those emotions instead of letting them sabotage our moods and, of course, our fitness goals. One of the strategies you can use is called "positive self-talk."

II. Using Self-Talk for Behavior Modification

  • Introduce and discuss the concept of self-talk and how it can be used to modify behavior.

SCRIPT:

What is self-talk? We touched on it last time when we discussed keeping an internal monologue with yourself, such as, "I'm hungry," "What a nice phone call I just had," or "Look at all this rain!" That kind of internal monologue is general in nature and often neutral. It can be about your feelings but it can also be a simple observation about the world or the weather. Self-talk is focused on "the self." These are the comments you direct at yourself, as if you were talking to yourself in the mirror. For example, "I need to read that book my friend was talking about. It sounded interesting," "I look tired today," or "I didn't work hard enough in class today. What's wrong with me?"

Sometimes these thoughts are directives—do this! Other times, they can be encouraging or neutral, and often we're all guilty of self-criticism. It is the overly critical, demotivating comments that we want you to learn to recognize and avoid. Actually, we want you to take it one step further—don't just avoid negative self-talk. Focus on positive thoughts and turn negative thoughts into positive encouragement. Increasing the frequency and impact of your positive thoughts will help you feel better about yourself and will make physical activity more enjoyable for you.

Let's take a moment and think about some of the negative self-talk you engage in when you think about physical activity. [Pause and encourage several examples from the group.] For example, what do you sometimes say to yourself when you miss a STEP session or maybe when you want to miss a session but feel obligated to come?

Good examples of negative self-talk. Now let's look at the handout, "Changing Negative Thoughts to Positive Thoughts." We're going to practice turning negative self-talk into positive self-talk. When you catch yourself being negative or critical, we want you to get into the habit of saying something supportive instead.

[Read the handout as a group and discuss the examples. Allow participants to think about more examples of ways to convert the negative thoughts listed into positive thoughts. They will have a chance to generate their own negative/positive pairings later in the session.]

III. Dealing With Negative Thoughts

  • Present "Joe's Story" (below) as an example of how negative thoughts can result in negative behaviors that undermine our best intentions and our larger activity goals.

SCRIPT:

Talking Back to Negative Thoughts

We have all had negative thoughts at some point. Negative thoughts often lead to unhealthy behaviors, which may keep you from living a healthy, active lifestyle.

Let's take a look at a hypothetical person's experience with negative thoughts.

Joe is 74 and, up until recently, was coming to the exercise and group sessions on a regular basis. Several weeks ago, he missed 3 consecutive days of activity and stopped completing his exercise/activity on the tracking sheet.

On Sunday Joe thought: "I'm tired of working so hard. This STEP program is more than I bargained for."

  • Result: On Monday, Joe took an afternoon nap and did not go to STEP class or do any walking. Joe watched television all day and felt lethargic and tired.

On Tuesday Joe thought: "I really should go to the store and wash my car today, but I am tired and hopefully it will rain in a few days."

  • Result: Joe napped off and on all day and when he woke up it was getting too dark to wash the car. He ran out quickly to grab a hamburger and came back to watch the game. He was up until 12:30 a.m.

On Wednesday Joe thought: "I have STEP class today, but I have not done any of my work and I have not exercised since Sunday. I can't go now; everyone will know that I've failed. I'll go next week when I've had a chance to get back on track."

  • Result: Joe did not return the next week and dropped out of the STEP program completely. He is now inactive and is starting to experience declines in energy, mobility, and mood.

Let's take a minute to think about where Joe went wrong.

  • What could he have done differently in order to maintain his physical activity program and happiness?
  • Where did Joe go wrong?
  • What are some things that Joe could have done differently?

IV. Negative Thoughts and Exercise Goals

SCRIPT:

Negative thoughts regarding exercise may result from setting goals that are not realistic. If you continue to feel like you are not meeting your physical activity goals, you may need to reevaluate them and come up with new, more realistic goals that you'll be able to meet and still benefit from physically. This is why each time you set a goal, you should take a step back and make sure that the goal is realistic and fits well with your overall abilities. If you ever have a question regarding goal setting, please feel free to ask it during the classes, or anytime you see staff and have questions.

Remember, goals can be constantly reassessed and changed based on your changing needs. If you find that the goals you have set are just not working for you, change them.

Now, let's learn some strategies that will help us talk back to negative thoughts. Let's look at the Session 6 worksheet "Practice Changing Negative Thoughts to Positive Thoughts." [Read the instructions as a group/to the group.] Let's take a moment to think of some fitness goals that seem out of reach and some negative thoughts you've had related to physical activity. You can say them aloud or just write them on your page. [Pause if people want to share ideas.] Once you've written down at least three, go back to the first one. Is everyone ready? Okay, say that negative thought in your head and then let's all say, "Stop!" [Count to 3 if people feel embarrassed so that everyone says, "Stop!" simultaneously.] Stop that negative thought. Don't give it another minute to penetrate your brain and make you doubt yourself. Reframe that negative thought in terms of something positive—a goal you can reach, a phrase of encouragement, whatever response best addresses that concern but counteracts the negativity.

Let's look at the handout with the large box that says, "Practice Changing Negative Thoughts to Positive ThoughtsStrategies for Talking Back to Negative Thoughts." This sheet is a summary of everything we've talked about today. I want you to take this sheet home and refer to it. Put it on your refrigerator, by your bed, in your STEP folder, wherever you'll be able to refer to it easily. Make sure you look at it regularly. If you catch yourself being critical or allowing your mind to dwell on negative thoughts, I want you to pull out this sheet and go through every step as a way to "reset" your thinking. This will help you break the cycle of negative thoughts that feed negative behaviors. Let's go through the steps together. [Go through the steps and ask for questions or comments.]

V. Wrap-Up/Check-In/Take-Home Challenge

  • Answer any questions related to the session material.
    • Review the next Take-Home Challenge (Increasing Positive Self-Talk) and ask for questions. Participants are asked to write down four positive affirmations related to their fitness goals and their commitment to leading healthier lives. Ideally, they can look to these affirmations for encouragement when they find themselves unmotivated or resistant to exercise.
  • Check-In:
    • Encourage participants to continue walking on a regular basis and remind them to record their strength class participation and minutes of walking in the activity log.
    • If you have set group goals related to a party or "walking destination" on a map, this is a good time to update the group on its progress. You want participants to succeed and be able to celebrate after Session 9, so remind them about these secondary goals and make sure they are doing what it takes to reach them.
    • Make sure people are still engaged in their walking groups or meeting with their walking buddies. If some of these arrangements have dwindled, help participants resurrect their groups or form new ones. (This is also a good time to add a new walking course or change an existing one, if possible. Your participants have been involved for 6 weeks and may be struggling to stay motivated.)
    • Congratulate them on 6 weeks of involvement. Solicit feedback and encourage people with suggestions to meet with you outside of class or leave an anonymous note for you. Their success depends entirely on their level of engagement and commitment to the program.
    • Reiterate to participants that the STEP program consists of both walking and strength training components, with walking as the main part of the program.
  • Remind them that the next session will cover mental barriers and problem-solving skills and will meet: Date and Time: _______________________________
Current as of February 2011
Internet Citation: Lesson Plan—Coaching Session #6: 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/stepcoach6.html