"Hello, I’m a Coach, and I am an ACT Practitioner"
My name is Josh Hillis, I coach strength training and eating behavior, and I use ACT with my clients.
When I was a new coach, I always asked myself questions like, “Why don’t we have better tools for behavior change?” and, “Are there more meaningful things we could talk about, other than just weight loss?” I found the answers to those questions in ACT.
The fitness world desperately needs ACT. We’d have a kinder, more professional, and more effective fitness industry if personal trainers, nutritionists, dieticians, health coaches, and health education specialists were all working from ACT principles. In this short article, I’m going to give you a little sense of what it looks like when I use ACT principles with my clients, the problems in the fitness industry that ACT solves, and scope of practice for a coach using ACT.
Scope of Practice
Historically, there have been some concerns about non-therapists using ACT with clients. This is totally valid, and scope has to be considered. When I use ACT it’s always about fitness related behavior change.
As a personal trainer and nutrition coach, my scope is coaching fitness and basic eating behavior. A lot of what I’m doing is helping people get to the gym and get stronger. At the same time, clients also want help with things like how to not eat the chocolate chip cookie just because they’re bored in the afternoon, or how to turn off Netflix and go to sleep on time. These obviously are not clinical mental health issues, but they are habitual behaviors that are really hard for folks to change. That’s where ACT comes in — helping them do the fitness related behaviors that matter to them, that are hard.
Using ACT in fitness coaching looks a lot like brief acceptance and defusion interventions that have been used with cravings and snacking. These brief interventions have been delivered by undergraduate students (Hooper et al., 2012), with 10 minute audio recordings (Lacaille et al., 2013), in short workshop formats (Forman et al., 2013b, Lillis et al., 2009) and in 30 minute small group trainings (Forman et al., 2007). Similarly, ACT based video trainings have been effective for initiating exercise (Moffitt & Moore, 2020). These kinds of brief trainings on acceptance and defusion are totally deliverable by coaches and are effective for things like mindless snacking and starting to workout.
From an ACT perspective, I’m mostly letting people know that their feelings, thoughts, and emotions are normal, that they can notice their thoughts as thoughts, and giving them room to explore their personal values. That provides a really strong foundation for committed action, which is where coaching really shines.
Fitness Coaching Without ACT
The fitness world desperately needs ACT. If you’ve ever hired a personal trainer, or a nutritionist, or follow any fitness influencers on social media, you might have some sense of how the damage the fitness industry often does.
Four problems we run into in the fitness industry:
- Absolute focus on meeting societal standards of beauty
- Blaming the client for issues with behavior change
- Teaching and reinforcing rule-governed behavior around diet and workouts
- Influencers, trainers, and nutritionists pretending to be preternaturally happy and positive, and pushing a “good vibes only” mandate on their clients
Clients who are fused with thoughts and can’t immediately change their behaviors are denigrated. Clients feel like failures both for their inability to change behavior and for their inability to have “good vibes only.”
The diet industry is teaching people rule governed behavior around eating. They’re unable to sort out which contexts it might be more values-congruent to not follow the rule, so they’re caught between things that matter to them and succeeding at rules. They believe so strongly in the magical diet rules that they’re totally insensitive to contingencies. They’re taught similar rule governed behavior around their workout routines.
This regularly puts them at odds with things that matter to them, like social connection, cultural traditions, or when other priorities like work or family might come before fitness. They’re often left with the choice between moving away from their values to follow a rule or moving towards their values and feeling like they failed as a rule follower.
On the flip-side, what’s missing and needed:
- Values work
- Letting clients feel their feelings
- Developing context-based behavioral flexibility
- Giving clients basic tools (acceptance and defusion) for being with the regular stress and emotions that we all feel
I’m sure this seems like the absolute most basic level of ACT, but it’s where I try and meet people in my books, my coaching, on podcasts, and in social media.
Acceptance and Commitment Coaching in Fitness
I help clients with values-based fitness and eating behavior change. We might work on getting to the gym when we don’t feel like it, and how to distinguish between “not feeling it” versus when their body actually needs to skip a workout. We might work on pausing 10 minutes before snacking, or questions that they can ask themselves to help distinguish hunger from cravings. We often use defusion with stress eating. Almost every week, we contrast societal standards of beauty with their personal values. We spend a lot of time untangling rule-governed behavior related to dieting and workouts, and how they can make their own values-based choices.
Every session, we discuss the behaviors that they worked on last week, unpack how it went, and create a new plan for next week. It’s mostly committed action and values work.
Acceptance, defusion, contact with the present moment, and self-as-context show up during obstacle planning. We might talk through a few defusion metaphors, they pick one, and then they try it out over the next week. Or we talk about how normal their feelings are, and if they would be willing to feel those feelings, given what matters to them. In their skill tracker, they track how many times they worked through the situation, using that particular ACT skill, in that week. In the next session, we discuss how it went.
The flexibility inherent to values often blows clients’ minds. By bringing in values and context sensitivity, they get an entirely new way to relate health behavior; they can consider each situation, and their values, and make different decisions in different situations.
So, that’s a brief look at what coaching with ACT looks like with my clients and in the group programs I lead. First I’m teaching clients to check in with themselves, about how they feel in their bodies during workouts and checking in with their own hunger and fullness cues. Second, I’m teaching them to check in with their values and to make their own decisions in light of each situation that they’re in. It’s behavior first, using ACT and RFT principles as the foundation for making hard changes. I strongly believe that the fitness industry would be more human and more effective using brief and scope-of-practice appropriate ACT.
About Me!
I originally found ACT reading Foreman et al. (2013a), a randomized controlled trial that compared acceptance-based behavioral treatment versus standard behavioral treatment for obesity. It completely blew my mind. Now, I’m the treasurer for Rocky Mountain ACBS and I’m active in the ACBS Coaching SIG.
I’m a National Academy of Sports Medicine (NASM) certified personal trainer and certified nutrition coach. I also write and fix questions for the NASM’s Certified Personal Trainer exam.
I’m attending Metropolitan State University of Denver, studying psychology, and doing research on how intuitive eating, rigid dietary restraint, and moderation predict well-being. I won the psychology department’s “promising teacher of the year” award as a TA.
My latest book Lean & Strong: Eating Skills, Psychology, and Workouts won the Benjamin Franklin Book Award silver medal for psychology. My books and I have been in USA Today, Men’s Health, The Los Angeles Times, and The Denver Post. I developed the curriculum for and am the head coach of GMB Fitness’ Eating Skills program.
References
Forman, E. M., Butryn, M. L., Juarascio, A. S., Bradley, L. E., Lowe, M. R., Herbert, J. D., & Shaw, J. A. (2013). The mind your health project: a randomized controlled trial of an innovative behavioral treatment for obesity. Obesity (Silver Spring, Md.), 21(6), 1119–1126. https://doi.org/10.1002/oby.20169
Forman, E. M., Hoffman, K. L., McGrath, K. B., Herbert, J. D., Brandsma, L. L., & Lowe, M. R. (2007). A comparison of acceptance- and control-based strategies for coping with food cravings: an analog study. Behaviour research and therapy, 45(10), 2372–2386. https://doi.org/10.1016/j.brat.2007.04.004
Forman, E. M., Hoffman, K. L., Juarascio, A. S., Butryn, M. L., & Herbert, J. D. (2013). Comparison of acceptance-based and standard cognitive-based coping strategies for craving sweets in overweight and obese women. Eating behaviors, 14(1), 64–68. https://doi.org/10.1016/j.eatbeh.2012.10.016
Hooper, N., Sandoz, E. K., Ashton, J., Clarke, A., & McHugh, L. (2012). Comparing thought suppression and acceptance as coping techniques for food cravings. Eating behaviors, 13(1), 62–64. https://doi.org/10.1016/j.eatbeh.2011.10.002
Lacaille, J., Ly, J., Zacchia, N., Bourkas, S., Glaser, E., & Knäuper, B. (2014). The effects of three mindfulness skills on chocolate cravings. Appetite, 76, 101–112. https://doi.org/10.1016/j.appet.2014.01.072
Lillis, J., Hayes, S. C., Bunting, K., & Masuda, A. (2009). Teaching acceptance and mindfulness to improve the lives of the obese: a preliminary test of a theoretical model. Annals of behavioral medicine : a publication of the Society of Behavioral Medicine, 37(1), 58–69. https://doi.org/10.1007/s12160-009-9083-x
Moffitt, R., & Mohr, P. (2015). The efficacy of a self-managed Acceptance and Commitment Therapy intervention DVD for physical activity initiation. British journal of health psychology, 20(1), 115–129. https://doi.org/10.1111/bjhp.12098
The ACBS Coaching SIG is interested in increasing visibility to all ACT practitioners who might not be psychotherapists, in the service of inspiring more people to use ACT. The Coaching SIG is launching a monthly column series titled "Hello, I'm a ... and I am an ACT practitioner."