I’ve been a nutrition coach for a long time now; about 20 years. And, from the very beginning, I’ve always prided myself on client results.
Early on, I helped my clients count calories and macronutrient grams. I analyzed their diets for micronutrient contents. I meticulously tracked body weight, body composition, and even their regional fat distribution via a dozen different skinfold measures. When people seriously interested in results – motivated elite athletes, physique competitors, type A executives – wanted a nutrition coach, they came to see me.
As my reputation spread, I started attracting other clients too. And I noticed a divide growing in my practice. For the clients that did exactly what I said – and I had dozens of nutrition and supplement protocols on the ready for every conceivable scenario – they kicked butt and got crazy results.
However, not every client seemed ready to change everything about their lives on my command. For many of them, my demands were too great. They had other things going on in their lives. And my rigid protocols just didn’t seem feasible in their daily schedules. So they didn’t stay clients for long.
Many of the top coaches in our industry encouraged me to drop these types of clients. Fire them. They’re lazy, they’re not committed. And they make you look bad. They told me to cut my losses and start attracting "better quality" clients.
While a lot of peopled seemed to be doing this, it just didn’t feel right to me. After all, I became a fitness pro to help people, as many people as I could. And I didn’t like the idea of getting rid of every client who didn’t have a Type A personality. Every client who wasn't willing to eat their young to drop a few pounds of fat. So I struggled with what to do next.
It all came to a head when my parents sat me down and asked for help. My Mom and Dad grew up in Italy and, while they love food, they’d never thought much about nutrition. They didn’t believe in supplements. And they hadn’t done much planned exercise in their lives. So, the prospect of loading them up with my protocols seemed absurd.
A drill sergeant coaching style? The “my way or the highway” approach? It wasn’t going to work here. And sadly, I didn’t have much else up my sleeve. No one in the fitness industry was teaching anything else. I was stuck and facing a sobering reality; I wasn’t going to be able to help my own parents.
Enter Motivational Interviewing.
On the recommendation of a trusted colleague, I picked up a book called Motivational Interviewing. She warned me: I’d need to approach the book with a very open mind. But if I did, it would change everything about the way I coached clients.
Of course, I didn’t believe her. However, I was growing frustrated with my inability to help certain clients, so I figured it was worth a read.
If you haven’t heard of Motivational Interviewing, it’s a counseling approach developed by clinical psychologists Dr. William R. Miller and Dr. Stephen Rollnick in the early 1980s. The approach started out as a way to help people addicted to alcohol, cigarettes, and drugs overcome their addictions and make meaningful change in their lives. After several important research studies – and tremendous clinical success – the strategies caught on and people started using them in other fields, notably nutrition and health coaching.
What’s so special about Motivational Interviewing? For starters, it’s non-judgmental, non-confrontational, and non-adversarial. Which makes it pretty much the opposite of the authoritarian, arms-crossed, scare-you-straight coaching done in the fitness industry.
You know how most fitness pros try to brow beat clients into eating better or exercising more with threats of a miserable future and an untimely demise? How they shout motivational slogans and threaten to stick a boot in their clients’ rears if they don’t do 5 more reps? How they try to talk clients into doing “what’s good for them” even if the client doesn’t seem ready or even able to do it?
Well, Motivational Interviewing does none of that.
Instead, Motivational Interviewing assumes that every client already has the reasons and abilities to change within themselves. That all they need is a safe place to consider change. A caring, attentive coach to gently guide them in envisioning a better future. And an increasing self-motivation to actually achieve that future.
To me, this style of coaching was a revelation. It shook up everything I thought I knew about coaching. It forced me to change – and to grow – myself. And it made me an exponentially better coach. So, in this article, I’d like to share the top lessons I learned from Motivational Interviewing.
Lesson #1: Clients Always Experience Mixed Feelings When Trying To Change
I once thought that when a client hired me, they were 100% ready to make a change in their lives. So, if they were ready, I could just hand them their program and they’d go out and follow it with discipline and unwavering intensity. And what if they didn’t follow it? Well, I concluded, it was because they were lazy, incompetent, or simply wasting everyone’s time.
Motivational Interviewing taught me that this attitude was completely off-base. One of the core beliefs of this coaching method is that all clients come to coaching scenarios with something called ambivalence. While many people assume ambivalence means that a person doesn’t care, that’s a misuse of the word. Ambivalence means mixed feelings. It means that you want to do something, but you don’t. All at the same time.
Someone experiencing ambivalence may feel like: “I really want to improve my diet and get healthier. But I’m afraid to change what I eat because my friends and family will give me a hard time about eating all these weird foods.” Or they may feel like: “I want to start an exercise program. But I’m worried I’ll have to give up another hobby of mine to make time for all this exercise.” Because of these mixed feelings, they’ll often get stuck in a place of inaction. Or they’ll do seemingly strange and illogical things. Like hiring a nutrition coach and personal trainer but ignoring their advice and blowing off workouts.
Motivational Interviewing taught me that clients aren’t lazy (or crazy) because they may feel two, seemingly oppositional, things at once. In fact, it taught me that we all feel ambivalence about some things in our lives.
It also taught me that one of my roles as a coach can be to help clients get unstuck. To overcome ambivalence and increase their commitment to change. In fact, the entire Motivational Interviewing coaching process is designed to reduce resistance to change while enhancing a client’s confidence in their own ability to make changes in their lives. Amazing stuff.
Lesson #2: Clients Have To Be Willing, Able, and Ready To Change
We often think that there’s only one requirement for change – readiness. And that readiness for change is accomplished when a client puts their money down and schedules their first appointment. However, Motivational Interviewing presents a different view.
For clients to make meaningful changes in their lives, they first need to be willing to change. Willingness to change means that they feel a gap between what they’re doing now and what they want for the future. And that the gap – called a discrepancy – is large enough for life to be a little uncomfortable. When a client feels this discomfort, change becomes important to them. And that sense of importance is considered willingness to change.
Willingness to change isn’t enough, however. In addition to importance, clients also have to feel confident that they can change. They have to feel like the change is big enough to be meaningful but small enough to be possible. If they don’t feel confident, well, that's a problem since willingness alone isn’t going to take them very far.
Finally, in addition to importance and confidence, clients need readiness. Amazingly, even if someone is willing to change, and able to change, they might not be ready. This usually comes out in comments like “This is really important to me, but I’ll start after the holidays.” Or on Monday.
My main takeaway here was that even if a client enrolls and begins showing up for sessions, they still might need some help working through the early stages of the change process. They may need to develop a deeper sense of importance, or more confidence.
Moreover, I learned not to assume that these were exclusively up to the client. In fact, the Motivational Interviewing process actually provides strategies for helping clients increase their willingness to change, the confidence in their ability to change, and their readiness to get started. And these strategies are critical. Without a coach’s help, clients may spin their wheels in ambivalence or inaction for a long time. With a coach’s help, within a few short sessions, they could be on their way to results.
LESSON #3: People Are Never Unmotivated
In fitness, when clients miss workouts or don’t follow their diet plans/nutrition habits we often suggest that they’re unmotivated. But Motivational Interviewing teaches that no one, except individuals experiencing deep depression or some other pathology, is truly unmotivated. Rather, everyone is completely motivated toward something. And the trick is to find out what we're motivated toward.
The chart below, taken from page 16 of the second edition of Motivational Interviewing, shows an alcoholic client's list of the pros and cons of cons of continuing to drink, as well as the pros and cons of stopping drinking.
The first thing you should notice is how easy it is to feel ambivalent; to want to quit drinking but not want to quit at the same time. There are some pretty significant pros and cons on each side of this balance sheet.
More important to this discussion, consider that a client struggling with the “motivation” to quit drinking might simply be *more* motivated by the benefits they're getting from continuing to drink.
Of course, this doesn’t just apply to drinking. It applies to improving nutrition habits, getting to the gym, reducing stress, and every other behavior in life. Clients are never unmotivated. They just may not be motivated to do what you want them to do, what you consider the correct thing to do. And this brings up the next key lesson I learned from Motivational Interviewing...
Lesson #4: To Help Clients, Help Them Uncover their Own Reasons for Change
As discussed earlier, Motivational Interviewing believes that your clients already have the reasons (and abilities) to change. Of course, as coaches, we do have considerable expertise, but it's important to recognize that our clients are the experts on their own bodies and lives. They live in their bodies and experiences 24-7. We don’t.
This means that our job isn't to be the all-knowing experts who tell clients what to do and lecture them until they do it. (In Motivational Interviewing these are called "the expert trap" and "the lecturing trap," respectively).
Rather, our job is to help clients find their reasons and abilities and to develop them. When a client can identify their own limiting factors and then — more excitingly — propose their own solutions, we have a recipe for sustainable, long-term behavior change.
As with all the other lessons discussed so far, this was a huge wake-up call for me. With my extensive training (and not underdeveloped ego), I assumed that it was my job to confidently and expertly push clients in the direction I felt was best for them. However, Motivational Interviewing showed me that this was often a recipe for failure. Especially for those clients whose reasons for changing had nothing to do with my own.
By listening (in a non-judgmental way) to why they wanted to change, and then asking how they've accomplished similar changes in other parts of their lives, I learned to help find the persons reasons (why) and abilities (previous successes). From there, it's an easy path to co-creating a set of nutrition or exercise recommendations that clients are willing, able, and ready to do.
Lesson #5: Stop Arguing for Change (It Just Makes Clients Argue Against It)
There’s an interesting paradox at work when talking to clients about change. Whatever position you argue for, clients will often argue the opposite.
For example, an overweight client comes in and asks for help with weight loss. You, as the expert, start arguing for change. You say things like: “Well, based on your diet record you’ll need to drink less pop if you want to lose weight.”
By all accounts, you’d hope the client would simply take your expert advice and follow it. However, instead, they say something like: “Yes, I know I should, but I really like pop. Plus, the caffeine helps keep me alert during the day. And I don't see the big deal with a few glasses of pop.”
Notice what happened there. You started arguing for change. And the client took the opposite approach, arguing against change. Not good.
The Motivational Interviewing approach shows that when clients argue against change like this, they’re much less likely to follow your advice. No matter how much you beg and plead. No matter how firm you are. No matter how much you want them to stop drinking the pop.
This lesson was jaw-dropping for me. When learning about this phenomenon, I was struck by the fact that, after talking with me, some of my clients were leaving *less* likely to change. Despite my good intentions. How embarrassing.
By teaching me how to avoid this coaching trap of arguing for change - which causes the client to argue against it - as well as a host of other coaching traps (including: assuming the expert role; criticizing, shaming, blaming; and labeling), I became aware of my main shortcomings as a coach.
Further, by teaching me how to apply a host of other techniques (including: expressing empathy, developing discrepancy, rolling with resistance, and supporting self-efficacy), I walked away with a host of new tools to help clients successfully progress through the stages of change. This helped me to become an effective change agent, instead of another roadblock in the path to a client’s change.
In the end, learning the principles of Motivational Interviewing was one of the greatest things I've ever done for my career. These principles have not only helped me see my work in a whole new - and much more positive - light. They've also helped me boost my skill set so that I can now help every type of client; not just the highly motivated ones that would have probably succeeded anyway.
If you’re a fitness or nutrition coach, I highly recommend picking up a copy of Motivational Interviewing and starting to experiment with the strategies outlined in the book. If you do, I can promise big improvements in your effectiveness as well as your reputation. Even better, you'll enjoy a big surge in your love for this industry as you'll feel more equipped than ever to make a meaningful difference in your clients' lives.
Recommended Reading
Miller, W.R. & Rollnick, S. (2002). Motivational Interviewing: Preparing People for Change, 2nd ed. NY: Guilford Press.