We started the conversation about the importance of confidence in behavior change. And an example was provided where the client wants to make a change but doesn鈥檛 have the confidence. The first way suggested to support someone with a lack of confidence was by asking open ended questions. This approach asks the client about the ways they could contribute to making this change happen. As well, the client is able to explore skills and resources that may be available to assist in this process.
Other ways to support a client who may not believe they have the confidence in making a behavior change includes using a confidence ruler and giving information and advice. Let鈥檚 take a look at using a confidence ruler first. Many of you may be familiar with these 鈥渞ulers鈥� since they are often associated with both importance and confidence. To increase confidence language by the client, use a confidence ruler. The questions asked of the client are exactly the same as using it for importance, except inserting the word 鈥渃onfidence鈥� wherever you see the word 鈥渋mportance.鈥� See the example below:
How confident are you, using the scale below, where 0 is no confidence and 10 is extremely confident, that you [will be able to take your prescribed medication]? [target behavior]
0 1 2 3 4 5 6 7 8 9 10
Why are you a __ and not a [slightly lower number]?
What would it take for you to move from a __ to a [slightly higher number]?
How might I support you in [taking your prescribed medication]? [target behavior]
By asking these questions, the client will be providing you with confidence language and moving towards making a change that will be right for them. This technique can be helpful for many clients who like to think about things in more concrete terms and giving them the option of exploring behavior change with numbers can make it easier to understand.
The other approach we will discuss in this blog is giving information and advice. As much as we clinicians try to reflect questions we are asked back to the client, there may be times when we simply need to respond. For example, if a client is having a challenging time coming up with their own ideas and asks the clinician for ideas, it can be okay to respond by sharing your thoughts and opinions since the client is giving you permission by asking. If information and advice is offered by the clinician, the recommended way would be to offer a menu of options or more than one idea for the client to select and explore.
Building confidence is similar to many other ways that we eventually feel more comfortable and competent with something. We need to practice. It is just like playing a musical instrument or picking up a new activity. It usually takes some time and repetition and it is also important to have someone like a clinician to offer feedback and support to keep the momentum going in making important changes. Again, it is not easy but it can be so rewarding and meaningful.
Next month, we will discuss additional strategies to address a lack of confidence on behalf of the client. I hope everyone is doing as well as possible and you have opportunities to use and practice motivational interviewing. Take good care!
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