Change talk is defined as statements by the client revealing consideration of, motivation for, or commitment to change. In Motivational Interviewing, the therapist seeks to guide the client to expressions of change talk as the pathway to change. Research indicates a clear correlation between client statements about change and outcomes. The more someone talks about change, the more likely they are to change. Different types of change talk can be described using the mnemonic DARN-CAT.
Preparatory Change Talk
Desire (I want to change)
Ability (I can change)
Reason (It’s important to change)
Need (I should change)
And most predictive of positive outcome:
Implementing Change Talk
Commitment (I will make changes)
Activation (I am ready, prepared, willing to change)
Taking Steps (I am taking specific actions to change)
Change Talk – Desire Questions
Desire questions most often contain verbs such as want, wish, and like. There are many different ways to ask about desire for change.
Examples include:
- 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?
- How would you like to feel when it comes to your health?
- What are you looking for from this programme?
Change Talk – Ability Questions
Ability questions ask about what a person can do, is able to do, or more gently
(hypothetically) 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 ____ ?
Ability questions can be used by everyone. A parent trying to motivate a child, a teacher
trying to support a student, an employer trying to understand and help their employee.
Change Talk – Reasons
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 ______?
- Finish this sentence.. ‘ things can’t go on the way they have been because….
- What might be the three best reasons for _______?
Change Talk – Need
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_____?
- How serious or urgent does this feel to you
- What do you think has to change?
- Complete this sentence: ‘I really must….’
About the wrong Questions
Words are strong. They have meaning, they make us feel a certain way, especially
questions. Some questions have the power to build resilience, confidence and influence change. Others, however, can do the opposite. So what, then, might be the wrong questions to ask? Even though the following are open questions, they would not be recommended in Motivational Interviewing/ Change Talk.
- Why haven’t you changed?
- What keeps you doing this?
- Why do you have to smoke?
- What were you thinking when you messed up
- Why aren’t you trying harder?
- What’s the matter with you?
- How could you want to go back to _____?
- Why can’t you _______?
Can you hear it? The shaming tone? The ability for these questions to damage rapport and create discord? These aren’t the worst questions but they’re just not the best and I’m sure you can feel why that may be.
Before asking questions always try to consider ‘is the answer likely to be change talk or sustain talk?’ If later, what is your reason or strategy for asking it?
Reference:
Source: Motivational Interviewing, Third Edition by Miller R. William (University of New Mexico, USA)
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