In a conversation about change with our clients, we are attempting to guide them towards making meaningful change in their lives that is sustainable. And as we all know, there will be some ambivalence along the way that needs to be worked through for this change to occur. How are we aware of this ambivalence? When we hear our clients using 鈥渟ustain talk鈥� or wanting to maintain the status quo or wanting to keep making similar choices related to certain behaviors. For example, a client may want to continue smoking because it 鈥渃alms them down鈥� even though they may also want to quit smoking because of a recent heart attack. So, even though we know there will likely be continued sustain talk throughout the session, what shifts in a session is the ratio of change talk to sustain talk. Basically, what will happen in a skillful session is that the amount of sustain talk becomes less frequent in the conversation.
Therefore, when we hear change talk, like a Desire to change, an Ability to change, a Reason to change, a Need to change, and/or a Commitment to change (DARN C), we want to respond to the client by reflecting back the change talk and encourage more exploration with an open-ended question. By responding in this way, the conversation will likely continue and the client will begin to share their own motivations and ideas for creating the change they want to see in their future.
Below, please find an example of statements made by clients, a reflection, and an open-ended question:
This is one strategy to keep the conversation going and to hear from the client about their own motivations for change, as well as, ideas they have for implementing change. Again, there is not a specific response when we hear change talk from the client, but if we acknowledge the statement made by the client and follow it up with an open-ended question, it is likely to keep the conversation moving in the direction of change and much less likely in the direction of the status quo.
Give this technique a try and let us know about your experiences.聽 And next month, we will focus on responding to sustain 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.