It is always the hope that when we meet with our clients, that they will be motivated to create the needed changes in their lives. However, as we all know, this is not always the case. Many clients would prefer to maintain the status quo and keeps things the way they always have been. So what are some strategies that may be helpful to facilitate our clients in exploring change? Miller and Rollnick have come up with several approaches presented below and they are called querying extremes, looking back, and looking forward. Let’s take a closer look:
Querying extremes:
This approach asks the client to consider the extremes of both the worst and best consequences.
For worst consequences:
“What concerns you the most about your high blood pressure in the long run?”
“Suppose you continue on as you have been, without changing. What do you imagine are the worst things that could happen?”
For best consequences:
“What do you think could be the best results if you did make this change?”
“If you were completely successful in making the changes you want, how would things be different?”
It can also be useful to have the client remember the time before a particular issue was present…and compare the two.
For example:
“Do you remember a time when things were going well for you? What has changed?”
“What were things like before you started using drugs? What were you like back then?”
Looking Forward
Another approach is to have the client think about what the future may look like after making a change:
For example:
“If you did decide to make this change, what do you hope would be different in the future?”
“If you were to have a week off from your symptoms/problems, what would you do first?”
Using these questions to elicit change talk can be very beneficial. Allowing the client to explore the best and worst case scenarios of making a change, looking back before a particular issue was present, and looking forward at what the future may look like can provide a great deal of information. In addition, asking these types of questions keep the client focused on change talk, and as we all know, the more there is talk about changing, the more likely it is to happen.
The process of using querying extremes, looking back, and looking forward are a few strategies for encouraging more change talk from the client. They can elicit a great deal of information by the client and increase the likelihood of change to occur. Next month, we will continue with additional strategies to increase change talk and in supporting the client discovering their own motivations for change. I hope you all have a great month and have opportunities to use and practice Motivational Interviewing!
For more information about Motivational Interviewing resources, contact Eunice Akinyi Okumu, by phone (919) 843-2532, or by email, eunice_okumu@med.unc.edu.