15 - Responding To Sustain Talk

Question 1

Is sustain talk typically argumentative / combative?

Answer 1

No. Sustain talk is just the client voicing reasons to keep the status quo.

“She pointed out that we had lumped within “resistance” what we now call sustain talk—the client’s own motivations and verbalizations favoring the status quo. There is nothing inherently pathological or oppositional about sustain talk. It is simply one side of ambivalence.”

Question 2

What is the difference between sustain talk and discord?

Answer 2

Sustain talk is about the target behavior or change. It’s the normal part of their reasons against change.

Discord is about you or more precisely about your relationship with the client—signals of a breakdown in your working alliance.

You can experience discord, for example, when a client is arguing with you, interrupting you, ignoring, or discounting you. *Note the presence of the word “you” here.

Question 3

What are the 3 most common responses in MI to sustain talk?

Answer 3

1) straight reflection
2) amplified reflection
3) double-sided reflection

Question 4

What is the best way to respond to sustain talk and discord?

Answer 4

In summary, the key is to respond in a collaborative, accepting way that honors autonomy and does not invite defense of the status quo.

Question 5

What are the early warning signs of discord?

Answer 5

Defending - One sign that something is amiss is when clients appear to feel the need to defend themselves.

Interrupting

Enemies - you are perceived as an adversary/opponent/enemy rather than an advocate. These have more of a “you” quality to them. They invite you to argue or persuade

Disengagement

The working alliance has DIED