Motivational Interviewing provides a foundation for assisting individuals with developing the rationale for beginning change in their lives. This resources provides basic information about the process of eliciting change talk and providing advice of motivational interviewing.
Motivational Interviewing: The Basics, Eliciting Change Talk and Giving Advice
(Adapted from handouts by David Rosengren and from Miller & Rollnick, Motivational Interviewing, 2nd Edition, 2002)
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
- 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?”
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
- 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.