Pros vs Cons--Motivational Interviewing; Ways to Elicit Change Talk
MOTIVATION NEWS
Published by Cathy Cole, MSSW, LCSW Motivational Interviewing Network of Trainers December 2004 http://www.cathycoletrainging.com \"What People Need is a Good Listening To\" Mary Lou Casey
MOTIVATION NEWS MAIN FEATURE Pros/Cons as a method of Eliciting Change Talk How this might look with a client.
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Welcome to Motivation News, a newsletter devoted to clinical information on the use of a Motivational Interviewing (MI) approach to change. The authors of this approach, William Miller, PhD and Stephen Rollnick, PhD define MI as a 'client centered, directive method for enhancing an intrinsic motivation for change by exploring and resolving ambivalence\". This collaborative approach to working with clients has wide application in coaching, mental health, addictions, health care and health education. Information in this newsletter is taken from various source material from the Motivational Interviewing Network of Trainers and specifically from the book Motivational Interviewing, Preparing People for Change; Miller and Rollnick, 2nd edition, 2002, Guilford Press.
Pros vs Cons; Advantages vs Disadvantages; Good Things vs Not so Good Things...................
..................... language to use in assisting a client to look at both sides of a concern that has ambivalence attached to it. In the November MI News, we looked at the Ruler Exercise. Now let's take the same client scenario and employ this method of eliciting change talk.
I is for interviewer; C is for client.
So let's say you have a client who is 65, lives alone, uses eating out as a way of increasing social contact. You are the nutritionist focusing on overall health, managing blood pressure, diabetes, and heart disease as risk factors for this relatively healthy person. Let's say, for the sake of this exercise that you know the client eats mostly in fast food places and mostly foods high in fat and few vegetables; has milkshakes and frozen desserts that are low in cost; she is on a small, fixed income and uses coupons for discounts. You have summarized what you know and with permission, offered some concern over the high fat, low vegetable diet. The client says she is aware of this information but is still not certain about making any changes.
You might start the conversation this way: I-- 'Thanks for continuing to look at this with me. You are a pretty healthy person and we want to reinforce that. Of course, you will be the only one who can decide on making any changes. So, just for us to focus on this in a slightly different way, What might be some disadvantages for trying a lower fat diet?
C--Well, food doesn't taste so good to me now and the burgers, fries, and shakes, I can at least taste!
I--So, the higher fat has better taste; and what else, just list all that might be on this side of the list.
C--Okay. I have a hard time digesting stuff like salads and I think those things cost more. That's it I think.
I--So, disadvantages...taste not as good, digestion harder, and higher cost. And what about advantages for the lower fat diet?
C--Hmmm, that is harder. I know it is healthier for me; even though it tastes better, I am more sluggish later and don't stay as active. My daughter would get off my back!
I--So, heathier, easier to stay active and your daughter....tell me about that.
C--Well, she is always on my case about what a poor example I am to my grandchildren, you know, not wanting them to eat only junk food and then they see Grandma doing it....even at their house..chips, cookies.
I--Hmm, so disadvantages are taste, digestion. and cost. And advantages.. healthier, more energy/more active and really importantly to you, a good role model for your grandchildren!
C--I think the grandchildren are the most important reason.
And from here we would continue with a summary and perhaps with evocative questions about change.....but we'll leave that for January. Note that disadvantages are elicited first then advantages and they are summarized in that order.
A simple example to illustrate this one concept. Try this out with a client of yours and let me know what happens!
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Cathy Cole, MSSW, LCSW is an educator and clinician.
She received her Masters of Science in Social Work from
the University of Tennessee and has maintained a varied clinical and
education practice throughout her career. Since her training in
Motivational Interviewing in 1995, she has provided extensive training.
For more information on Cathy visit http://www.cathycoletraining.com
To contact Cathy, use cathy@cathycoletraining.com
cathycoletraining Mission: to provide excellent education and coaching with a specific focus on the use of Motivational Interviewing for exploring and resolving the natural ambivalence for change. Training in the use of Motivational Interviewing is offered on site or via teleconference. Contact Cathy at cathy@cathycoletraining.com for more information or visit http://www.cathycoletraining.com
For more information on Motivational Interviewing, visit the web site http://www.motivationalinterview.org
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