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In a therapeutic counseling setting, there can be times when the client does not appear motivated to change their behavior. Therefore, it can be a natural instinct on behalf of the clinician to try to educate and persuade the client in order for change to occur. What we know, however, is that if we try this approach, it will likely lead to the client maintaining the status quo or going in the opposite direction.

One way that may be useful, in working with this type of client, is to ask them what they already know about a particular behavior. For example, if you are working with a problem drinker, smoker, or someone with a serious illness, they will often already know the consequences of some of their behaviors. The difference is that the clinician is asking the client what they already know, and in most cases, the client greatly appreciates being asked and not told. This approach starts with respect and collaboration and will likely create the foundation for a meaningful conversation.

What is interesting is that when you ask the client a question like, 鈥淲hat do you know about liver disease and drinking?鈥� it can lead to a lot of change talk being expressed by the client. If the conversation is set up in this way, it can flow into the clinician offering some information with permission. Some questions below offered by Miller and Rollnick can also include aspects of autonomy for the client to disregard the information shared:

鈥淚 don鈥檛 know if this applies to you or not鈥︹��

鈥淲ould it be alright if I told you a little about what new research is finding on this?鈥�

鈥淭his may or may not concern you鈥︹��

鈥淐ould I fill in a piece or two that I notice you didn鈥檛 mention. Do you mind?鈥�

Sharing information that is relevant to the client鈥檚 specific situation is key. Regardless of what information is exchanged, it is important to do in the spirit of MI that includes partnership, acceptance, and compassion. In addition, reinforcing the client鈥檚 autonomy can lead to continued exploration and possible change. By asking a client what they already know about a topic, and then sharing information in a respectful way, can be a great way to not only offer information but also create the conditions for further exploration. 聽

In our next blog, we will continue discussing strategies in talking with a client who may be less motivated to change. The approach we will talk about next time involves asking the client what someone, who is important to them, is noticing or concerned about related to their behavior. I hope everyone is doing as well as possible and you have opportunities to use and practice motivational interviewing.