Conducting An Exercise Consultation

In 1995, Loughlan and Mutrie published guidelines for health professionals on conducting an exercise consultation (Loughlan and Mutrie, 1995). This intervention was originally aimed at sedentary healthy individuals. However, more recently it has been adapted for use with clinical populations, including people with Type II diabetes and CR participants (Hughes, et al., 2003; Kirk, et al., 2004a). This section describes the components involved in delivering the exercise consultation to cardiac rehabilitation participants.

Counselling skills

A key element of the intervention is that the consultation is client-centred, which means that individuals should consider their own reasons for being active and should choose their own activity goals. Individuals may be more likely to achieve their goals if they have devised them. In addition, the activity goals should be tailored to the individuals' needs and lifestyle. Good interpersonal skills are essential, which consist of communication (verbal and non-verbal), active listening and expressing empathy. Correct non-verbal communication can be achieved through an open posture (e.g. avoid crossing arms or legs), leaning towards the client, use of appropriate eye contact and a relaxed style to put the participant at ease and to convey interest and atten tion.Active listening shows the individual that the consultant has listened carefully and understands what he or she has said. This can be demonstrated by 'parroting' (i.e. repeating the key words and phrases that the client used) and paraphrasing (i.e. summarising what the participant has said in your own words). Empathy involves showing individuals that you understand what it is like to be in their world. Empathy can be expressed using examples of other patients who have been in a similar situation to the individual.

As the exercise consultation is a client-centred approach, the consultant should try to avoid preaching, lecturing or providing solutions for the client. The consultant can offer suggestions, such as how to overcome a certain barrier to activity, but this is best achieved by using examples of how other individuals overcame this barrier. Further information on the client-centred approach and the interpersonal skills involved in behaviour change counselling is provided in guidelines on exercise consultation (Loughlan and Mutrie, 1995), and there is also a variety of books on this topic (Rollnick, et al, 1999; Miller and Rollnick, 2002).

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