When a practitioner works with a client, the practitioner can significantly influence how much change talk (movement towards changing behavior) and sustain talk (movement towards maintaining current behavior) they will hear. And the difference is not when the practitioner is just being nice to the client, but rather, from strategic approaches that actually evoke change talk.
There are many ways to evoke change talk, and our clients will let us know if we are doing it right. How? If we, as practitioners, are hearing change talk from the client, we are doing it right and should continue doing more. And if we are hearing sustain talk, we should try another strategy since we are not moving in the direction of change.
One of the easiest and most straightforward ways to evoke change talk is to simply ask for what you want to hear. For example, asking open ended questions where the response is related to change talk. To get this process started, the DARN acronym (of DARN C) can be helpful. You may be familiar with these questions and it is best to start with exploring the possibility of change versus talking about making a plan for change too early. I have found it helpful to take my time with a client and allow the client to guide me as to the pace of moving into action steps.
Some thoughts about evocative questions and examples from Miller and Rollnick are below:
Desire: Questions usually include words such as want, wish, and like.
Example questions:
- How would you like for things to change?
- How do you want your life to be different a year from now?
- What do you wish for in your relationship?
Ability:ÌýQuestions usually include what a client can do, is able to do, or could do.
Example questions:
- If you did really decide you want to lose weight, how could you do it?
- What do you think you might be able to change?
- Of the various options you’ve considered, what seems most possible?
Reasons:ÌýQuestions usually ask about specific reasons why a client may consider making a change.
Example questions:
- Why would you want to get more exercise?
- What’s the downside of how things are now?
- What might be the good things about quitting drinking?
Need:ÌýQuestions usually ask about an urgency for change to happen.
Example questions:
- What needs to happen?
- How serious or urgent does this feel to you?
- What do you think has to change?
By asking these types of questions, you may be surprised by how much change talk you will hear. And a good rule of thumb is to think about the response you would like to hear since the ratio of change talk to sustain talk is a predictor of change actually occurring. And next month, we will continue with additional ways of evoking change talk.
For more information about Motivational Interviewing or related services, contact Eunice Akinyi Okumu, by phone (919) 843-2532, or by email, eunice_okumu@med.unc.edu.