When it appears there is little motivation on behalf of the client or you are not hearing much change talk, one strategy is to hear from them what it is that they do want. By opening up the conversation in this way, it provides an opportunity to not only build rapport but to also become aware of their goals and values.
Once we have a better sense of their goals and values, we can ask the client more about why they are important and how they are playing out in their lives. It can be helpful to write them down and it also gives us the chance to see where their behaviors may not be aligned with their goals and values. It is often the case that the clinician does not need to point out the discrepancy because it is usually quite obvious to the client.
An example from Miller and Rollnick is below. A client has identified smoking as a behavior they would like to change and some questions a clinician may ask after learning more about their goals and values:
鈥淗ow does smoking fit in with each of your most important values? Do you think it helps you achieve them, conflicts with them, or maybe is irrelevant? Have a look at the values that you have identified and tell me what you think.鈥�
This process can be extremely engaging and can often begin to evoke change talk. And as it was mentioned earlier, the clinician usually does not need to bring up the discrepancy to the client because it is so apparent. What the clinician does need to be aware of is avoiding the 鈥渞ighting reflex鈥� and allowing the client to make these connections. This strategy can be very helpful with a client who does not appear to be experiencing much motivation and it can be a great way to build rapport.
In our next blog, we will focus on client autonomy and discuss how even with our best intentions and efforts, the ultimate decision to change is up to the client. I hope everyone is doing as well as possible and you 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
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