One of the best outcomes in our work is when a client talks themselves into the change they want to see in their lives. It is often the case that when someone hears themselves speak about change, and when they are in the presence of another, that they are more committed to making it happen. And our role as clinicians, is to support the client in a non-judgmental, accepting, and affirming way as well as facilitate the conversation about change in an intentional way to evoke and explore change. We know that if a client talks more about making changes in their life than keeping the status quo, change is more likely to happen. Therefore, if you are hearing the client talk about change, continue what you are doing, and if you hear the client talking about keeping things the same, try a different approach.
One of the most productive ways to discuss change with the client is to ask them directly. By asking the client open ended questions about changes they want to consider in their lives, the clinician is inviting the client to explore this possibility. The DARN acronym (Desire, Ability, Reasons, and Need) can be a great place to start and please see below some examples from Miller and Rollnick:
Desire:
How would you like for things to change?
How do you want your life to be different a year from now?
Ability:
What do you think you might be able to change?
Of these various options you鈥檝e considered, what seems most possible?
Reasons:
Why would you want to get more exercise?
What鈥檚 the downside of how things are now?
Need:
What needs to happen?
How serious or urgent does this feel to you?
The intended outcome of asking these open ended questions is to receive responses where the client speaks about changes they would like to consider making. We know that if there is more change talk than sustain talk that change is more likely to happen. At the same time, if we hear sustain talk, it is respected, acknowledged, and included in the overall landscape of the conversation.
Again, if we can ask questions that facilitate our clients in talking themselves into the change they want, we are well on our way to achieving the desired outcome. This approach is consistent with the research that suggests the relationship between more 鈥渃hange talk鈥� than 鈥渟ustain talk鈥� produces more actual change. Next month, we will continue with the process of Evoking and discuss more strategies to support the client in discovering their own motivations for change. I hope you all have a great month and have opportunities to use and practice Motivational Interviewing!
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.