13 - Evoking The Persons Motivation Flashcards
What is probably the easiest way to evoke change talk?
Perhaps the simplest and most direct way of evoking change talk is to ask for it.
Ask open-ended questions for which change talk is the answer.
How do you know if you’re using the right strategy to evoke change talk?
Your clients will tell you when you are doing it right. If you hear change talk, do more of what you’ve been doing. If you encounter increasing sustain talk and discord, try something different.
An advantage in learning MI is that once you know what to listen for, your clients will provide immediate, ongoing feedback to help you improve your skills.
What are Desire questions?
Practice 3-5 of them
Questions about what they WANT. Desire questions most often contain verbs such as ‘want’, ‘wish’ , and ‘like’. Examples:
“How would you like for things to change?”
“What do you hope our work together will accomplish?”
“Tell me what you don’t like about how things are now.”
“How do you want your life to be different a year from now?”
“What do you wish for in your marriage?”
“What are you looking for from this program?”
What are Ability questions?
Practice 3-5 of them
Ability questions ask about what a person can do, is able to do, or more gently (in the hypothetical) what they could do (which does not commit them to doing it).
“If you did really decide you want to lose weight, how could you do it?”
“What do you think you might be able to change?”
“What ideas do you have for how you could _________.”
“How confident are you that you could __________ if you made up your mind?”
“Of these various options you’ve considered, what seems most possible?”
“How likely are you to be able to __________?”
What are Reasons questions?
Practice 3-5 of them
Reason questions ask for specific reasons why. They explore ‘if . . . then’ reasons for considering or making a change.
“Why would you want to get more exercise?”
“What’s the downside of how things are now?”
“What might be the good things about quitting drinking?”
“What would make it worth your while to __________?”
“What could be some advantages of __________?”
“What might be the three best reasons for __________?”
How might you use ambivalence to headline and ask for reasons to change?
“Most people faced with a possible change feel two ways about it. You’ve probably got several reasons to keep things as they are, and you probably have considered a few reasons to make a change as well. What are some of the reasons you have considered for making this change?”
What are Needs questions in MI?
Practice 3-5 of them
Need language expresses an urgency for change without necessarily giving particular reasons. Need questions may well evoke reasons (which is just fine if it happens). Again, there are many ways to ask.
“What needs to happen?”
“How important is it for you to X?”
“How serious or urgent does this feel to you?”
“What do you think has to change?”
“Complete this sentence: ‘I really must…’ ”
What is the “importance ruler”?
Using a 0-10 scale to gauge how important something is for the client
“On a scale from 0 to 10, where 0 means ‘not at all important’ and 10 means ‘the most important thing for me right now,’ how important would you say it is for you to ___________ ?”
You’ve asked a client how important it is to make a change on 0-10 scale and they say a 6.
How might you follow up on that?
Note that the righting reflex could prompt one to ask the opposite question, “Why are you at 6 and not 10?” The answer to that question is sustain talk, whereas asking “Why are you at 6 and not 2?” is likely to evoke change talk—the reasons why change is important.
Remember you want them to say change talk, not sustain talk.
How could you use a positive future in your questions?
Helping people envision a changed future is another approach for eliciting change talk. Here you ask the client to tell you how it might be after a change:
“If you did decide to make this change, what do you hope would be different in the future?”
“Tell me, how would you like things to turn out for you in 5 years or so?”
“If you were to have a week off from your symptoms/problems, what would you do first?”
“I can see that you’re feeling really frustrated right now. How would you like things to be different in the future?”
How might you use the future to highlight consequences of inaction?
Ask them to look forward and think what happens if nothing changes:
“Suppose you don’t make any changes, but just continue as you have been. What do you think your life will be like 5 years from now?”
“Given what has happened so far, what do you expect might happen if you don’t make any changes?”
What should you do if you believe the client may just be telling you what you want to hear?
Our inclination is to take people at their word and become very interested in the specifics.
Asking for elaboration, for more detail about why and how, is likely to elicit more specific change talk and can actually transform vague generalities into specific intentions. This exploring is done with a mind-set of supportive curiosity, not criticism.
What is the 5 question MI sample approach?
We developed these five questions in 2006 to give beginners a feeling for the process of MI:
1) “Why would you want to make this change?”
2) “How might you go about it in order to succeed?”
3) “What are the three best reasons for you to do it?”
4) “How important is it for you to make this change, and why?”
(Summarize)
Your friend listens patiently, and then gives you back a short summary of what you have said: why you want to change, why it’s important, what the best reasons are, and how you could do it in order to succeed. Then your friend asks one more question, and again simply listens as you reply:
5) “So what do you think you’ll do?” That’s it.
What are 5 strategies for evoking change talk?
1) asking open questions the answer to which is change talk
2) importance ruler
3) asking about the extremes (best/worst)
4) looking forward/backward
5) exploring values
