Strengthen Your Personal Training Career By Helping Exercise Referral Clients

Exercise referral patient: Somebody who is diagnosed as ‘inactive’ (getting less than 30 minutes of moderate intensity activity per week), has one (or more) of 11 diseases listed here and is referred to a fitness instructor for supervised exercise.

If you possess the knowledge to train this very specific type of client, not only can you help limit the UK’s spread of chronic disease but you can also add another robust string to your personal training bow.

And in turn, you will add another healthy revenue stream after completing your personal trainer courses.

Gaining that knowledge isn’t easy - and that’s why only the most committed personal trainers excel in this specialist branch of the industry – but it’s not impossible.

You need to have an understanding of all common referral conditions, you need to know how to mould a training programme around each and, most of all, you need to shift up a gear in terms of professionalism.

As with any client, it is vital to establish a rapport and gain their genuine trust. However, referral patients can be vulnerable people. It can be much more challenging to gain (and maintain) their trust.

But, again, it’s not impossible.

There is a Health and Fitness Education (HFE) programme, solely focused on becoming an exercise referral instructor. With over 170 pages of course information, including mock exercise schedules for each illness – it’s one of the best scholastic resources out there.

The 7 Step Journey of an Exercise Referral Client

In the HFE course, there is a chapter on the ‘Stages of Change Model’ and this refers to the patient’s training status.

The model was first created by Prochaska and DiClemente in the 1980s. We’ll view the seven stages here in their most basic form and how you can help your client progress through them all:


When a patient is hesitant to even consider a more active lifestyle, encouraging them can be a delicate task. It requires a great level of understanding on your part – not to mention persuasiveness.

Still, if you’re a good communicator and have the knowledge behind you from HFE, then ushering patients beyond this phase should never be too uncomfortable for you.


As soon as your client expresses some level of interest in becoming more active, this is when you can use your knowledge of their condition to sell the benefits of exercise, specifically to them. This personalised ‘sell’ plays a key part in establishing trust between you and the patient.

If they need a little extra persuasion, you can always highlight the consequences of the patient not making the lifestyle change too.


This is still a very formative stage of the process. Your client will be engaging in more physical activity but they won’t be performing to the level required. It’s up to you to motivate them, at a pace fitting with their personality, to push through this stage for their own benefit.


This is effectively the ‘probation period’, when your client is meeting the duration and intensity requirements, which you have set out. Your role here is to keep them motivated for the next three months.


An extension of the Action phase – your client now just needs to keep it up for a further three months (six months total) and they can safely move into the final stage of the model.


After the six months, your client will be well into the routine and if they can successfully integrate it into their regular lifestyle, then you’re job is done. This is when the client will start to see and experience the benefits of the entire programme.


But that’s only six stages.

Number 7 can occur at any time and it’s your responsibility to minimise the chance of it ever happening. It’s known as ‘relapse’ and is pretty self-explanatory. If your client falls down a stage, that’s a relapse.

It’s important to remember that the lowest stage of the model is pre-contemplation and there are proven ways to help clients progress from here. It is also important for you and the patient to understand that ‘minor relapses are inevitable’.


For a full run through of the Stages of Change Model and its accompanying questionnaire scoring system (which makes it easy for you to determine the status of each client), sign up to for the personal trainer courses from HFE.

The booklet goes on to explain how to set achievable goals, monitor exercise over different periods of time and deliver the best type of training for each different type of referral patient.

Have you got any more resources to share on this? Do you have any exercise referral success stories of your own? Feel free to drop some knowledge in the comments section.