When a client begins to lean towards making a change, they may also begin to take a small step in that direction. It may be a 鈥渂aby step鈥� but it is still a step towards change. It is important to acknowledge any movement towards change in a positive way to reinforce more. In addition, it can be good to share, as a clinician, your curiosity about where things may go from here. We want to make sure we are always encouraging more of what we want to hear from the client.
We have to be careful, as clinicians, not to offer any language that supports more ambivalence or sustain talk. A small step by the client may seem like a meager attempt to change behavior. However, we know that for a behavior to be sustainable over time, a good way for it to be integrated is slowly. Miller and Rollnick offer two examples below of MI consistent and inconsistent responses to a client making a small step towards change:
Client: I went 2 days this week without drinking.
MI-Consistent: Really! Good for you. How did you do that?
MI-Inconsistent: So you drank on 5 days this week.
Client: I did get a newspaper this week and looked at the job listings.
MI-Consistent: What did you see that interested you?
MI-Inconsistent: All you did is read the newspaper?
Again, it may seem like a small step taken by the client, but anytime the client is leaning in that direction, or making a small step, we want to make sure we are acknowledging it and encouraging more. It may be unlikely that a clinician would minimize a step towards change made by a client, but sometimes, we may not even be aware that we are doing so, or it may just come out. This can be a very crucial time for our clients when they are transitioning from evoking to planning, so we have to make sure we are listening closely to what they are telling us.
Every step in the right direction is a reason to celebrate with the client. It can also be a time to affirm the client and ask them or remind them of what they did to take the small step. Did they have to prioritize something over something else or did they have to really think creatively about how to take the step that they did.
Taking a small step towards change is a good indicator of readiness. As we continue in this blog series, we will look at more signs of readiness the client may display to help you decide if the client is ready to move from evoking to planning. 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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