#5 Motivational Interviewing Change Talk & Sustain Talk. #6 Strategies for Precontemplation Stage of Change. #7 Strategies for Contemplation Stage of Change
#5 Motivational Interviewing Change Talk & Sustain Talk
Oct 13
10 pts
#6 Strategies for Precontemplation Stage of Change
Discussion Topic
#6 Strategies for Precontemplation Stage of Change
Nov 3
10 pts
#7 Strategies for Contemplation Stage of Change
Discussion Topic
#7 Strategies for Contemplation Stage of Change
Nov 10
10 pts
#8 Strategies for Preparation Stage of ChangeB
Discussion
#9 Strategies for Action Stage of Change
Discussion Topic
10 pts
#10 Strategies for Maintenance Stage of Change
Discussion Topic
Eliciting Change Talk
Eliciting change talk is the consciously directive strategy on the part of the counselor for resolving ambivalence. If OARS (open questions, affirmations, reflective listening, and summarizing) were the only skills used by the counselor, it would be quite possible for the client to remain stuck in ambivalence.
Instead of the counselor advocating for change, which often puts the clients in the position of defending against it, motivational interviewing takes a different approach. The idea is to have the counselor facilitate the client’s expression of change talk, that is, for the client to present the arguments for change.
Four Categories of Change Talk
Recognizing disadvantages of the status quo: “This is more serious than I thought.”
Recognizing advantages of change: “I’d probably feel a lot better.”
Expressing optimism about change: “I think I could do that if I decided to.”
Expressing intention to change: “I’ve got to do something.”
Methods for Evoking Change Talk
Asking evocative questions: “What worries you about your current situation?”
Using the importance ruler (also use this regarding a client’s confidence to change): “How important would you say it is for you to ____? On a scale of zero to ten, where zero is not at all important and ten is extremely important, where would you say you are?”
0 1 2 3 4 5 6 7 8 9 10
Not at all Extremely
important important
Exploring the decisional balance: “What do you like about your present pattern?” “What concerns you about it?”
Elaborating: “What else?”
Querying extremes: “What concerns you most about ___? “What are the best results you could imagine if you made a change?”
Looking back: “What were things like before you ___? What has changed?”
Looking forward: “How would you like things to be different a year from now?”
Exploring goals and values: “What things are most important to you?”
Giving Advice
Intent of advice-giving in Motivational Interviewing
Not an attempt to convince the person of the folly of his or her ways
An opportunity to express concerns and help the individual make an initial commitment to the process of change
Can be thought of as helping with decision-making
Advice-giving: a few thoughts
It’s okay to express concerns
There are many ways people change
Help the person to evaluate options
Offer advice, don’t impose it
If the person is not ready for change, set the stage for when she or he might be
Suggested methods
Ask permission: “Is it okay if I share something with you?”
Then make a statement of concern: “Your situation concerns me and here’s why…”
List concerns in a non-judgmental manner
“You’ve told me that you’ve been drinking a half gallon of vodka a day. The doctor has informed you that your liver is in trouble and you’ve noticed the physical changes. You also told me your partner is pretty frustrated with your drinking.”
Recognize and affirm that it is the individual’s decision to make. “Of course, it really doesn’t matter what I think, because this is your decision to make.”
Inquire about the client’s thoughts. “I wonder what you think.”
Emphasize change statements, provide affirmations and statements of hope.