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Table 4 Students’ reflections on the counselling session

From: Evaluating the effects of behavior change training on the knowledge, confidence and skills of sport and exercise science students

Dimension 1. Looking back...Thoughts, feelings and evaluation of the session

Theme

Strategy

Exemplar quote

Engage

Open questions

“I made good use of open questions. I feel like this increased my understanding of how the client felt, along with making the client feel understood.” (Student 6)

Staying silent

“Sometimes I interrupted or clipped the end of the client’s sentences which is a personal weakness …” (Student 11)

Summarising

“I thought in particular that my use of summaries was effective as they added to what was already said as opposed to just repeating what had been said.” (Student 7)

Reflection

The use of simple reflections also allowed me to yield more information (Student 15)

I failed to use any reflections in order to dig a bit deeper into her lack of physical activity which may have yielded more insight (Student 14)

Asking permission

“However, I failed to ask permission, when focusing on physical activity rather than diet, and in general failed to ask the client’s opinion on the direction of the conversation.” (Student 9)

Guide

Provide rationale

“I feel I appropriately requested permission before extending rationale for the change. However, I should have been less vague and provided more comprehensive reasoning.” (Student 8)

Opportunities for input

“I thought I explored her options with her in a manner that supported her autonomy in so far as she was often the one coming up with the suggestions herself with me as the practitioner providing guidance more than anything.” (Student 7

Autonomy supportive behavior

“I feel suggestions were flexible and offered alternatives. Time and space to explore and have autonomy over their choices was given.” (Student 4)

“Instead of letting him decide if he wanted to set a goal I asserted we will set a goal.” (Student 15)

Plan

Goal-setting

“I feel like our discussion was quite vague and I’m questioning if we should have come up with a more concrete plan. I’m unsure as to how well I strengthened my client’s commitment to the plan and feel this is a skill I need.” (Student 6)

“I feel I could have done better regarding planning. Although I discussed the “when” of the client’s short-term goal of looking into exercise classes, I failed to address the specificity and objectivity of the overall goal of increasing physical activity, meaning the client still lacked a clear plan.” (Student 9)

Identify barriers

Potential barriers were not mentioned and client understanding was not present (Student 12)

Problem-solving

“But the client should have had more involvement. I think I was too quick to suggest solutions and the client would have benefited from an open question leading them to investigate ways around the barriers.” (Student 8)

Dimension 2. Looking forward...what would they do differently?

Theme

Strategies

Exemplar quote

Engage

Open questions

“Next time I would use more open questions as opposed to closed ones especially towards the beginning of the conversation, allowing the client to lead the conversation.” (Student 14)

Summarising

“In future, I need to summarise what the client is saying more regularly during the interview to ensure we are on the same wavelength and avoid any miscommunication about the situation.” (Student 5)

Reflection

“Open questions and summaries were used effectively but I think that in the future I should use reflections more.” (Student 7)

Asking permission

“I need to remember to ask permission before offering advice, so that the client sees it as a suggestion rather than a decision that is forced upon them.” (Student 4)

“There were a number of occasions where I gave advice and didn’t ask permission which is something that should be improved for the future.” (Student 13)

Guide

Opportunities for input

“however in future I should allow the client to provide more input.” (Student 2)

“In the future I think it would be best not just to ask the client if they were ok with what I suggested, but also if they had anything to add.” (Student 6)

Autonomy supportive behavior

“I think that in the future, it is important to try and evoke the client’s own motivation for change rather than me trying to offer a reason for them to do it.” (Student 5)

Plan

Goal-setting

“In future, I think the client needs to be more involved in the goal setting process, I was telling him, rather than him suggesting how to do it. If he chooses a specific goal it will lead to increased commitment.” (Student, 7)