ACSM-EP Behavior Change & Client Communication 3 — Questions and Answers
Question 1: A client reports feeling embarrassed exercising in public. Which behavior change strategy is MOST appropriate to address this barrier?
- Advise the client to ignore their feelings and push through
- Use cognitive restructuring to challenge negative self-perceptions (Correct answer)
- Switch immediately to a home-based exercise program without discussion
- Refer the client to a psychologist before continuing exercise sessions
Correct answer: Use cognitive restructuring to challenge negative self-perceptions
Cognitive restructuring helps clients identify and replace distorted thoughts about self-image with more accurate, positive perspectives.
Question 2: Which communication approach is BEST when a client resists a recommended change in their exercise routine?
- Firmly insist on the change to ensure client safety
- Roll with the resistance and explore the client's perspective (Correct answer)
- Avoid discussing the issue to preserve the therapeutic relationship
- Document the resistance and discontinue the session
Correct answer: Roll with the resistance and explore the client's perspective
Rolling with resistance is a core motivational interviewing principle that avoids confrontation and invites the client to explore their own ambivalence.
Question 3: In operant conditioning, which strategy involves removing an unpleasant stimulus to increase exercise behavior?
- Positive reinforcement
- Negative reinforcement (Correct answer)
- Positive punishment
- Extinction
Correct answer: Negative reinforcement
Negative reinforcement increases behavior by removing an aversive stimulus, such as exercising to relieve stress or back pain.
Question 4: A client with low exercise self-efficacy would MOST benefit from which initial intervention?
- Prescribing a high-intensity interval training program
- Setting modest, achievable goals to create early success experiences (Correct answer)
- Encouraging the client to observe elite athletes for inspiration
- Providing written educational materials about exercise science
Correct answer: Setting modest, achievable goals to create early success experiences
Mastery experiences — achieved through small, attainable goals — are the most powerful source of self-efficacy according to Bandura's Social Cognitive Theory.
Question 5: Which element of active listening involves paraphrasing a client's statement to confirm understanding?
- Empathy
- Reflection (Correct answer)
- Summarizing
- Open-ended questioning
Correct answer: Reflection
Reflection involves restating or paraphrasing what the client said in slightly different words to confirm the exercise physiologist's understanding.
Question 6: A client says, 'I've tried exercising before and always quit.' Which response BEST demonstrates motivational interviewing spirit?
- 'You just need more willpower this time.'
- 'What was different about the times when you did stick with it?' (Correct answer)
- 'Let's set a stricter schedule so you don't quit again.'
- 'Most people struggle with consistency, so don't worry about it.'
Correct answer: 'What was different about the times when you did stick with it?'
Asking about past successes elicits 'change talk' and helps the client recognize their own capacity for sustained behavior change.
Question 7: Which concept from the Theory of Planned Behavior MOST directly influences whether a client will follow through on their intention to exercise?
- Perceived susceptibility to disease
- Perceived behavioral control (Correct answer)
- Intrinsic reward salience
- Social comparison processes
Correct answer: Perceived behavioral control
Perceived behavioral control — the belief in one's ability to perform the behavior — is a direct predictor of intention and behavior in the Theory of Planned Behavior.
ACSM-EP Behavior Change & Client Communication 3
A client reports feeling embarrassed exercising in public.
Which behavior change strategy is MOST appropriate to address this barrier?