Decisional Balance Approach

This series of blogs has been focusing on counseling with neutrality and not guiding the client in any one direction. The clinician is allowing the client to make their own decision even if the process brings up a great deal of tension for both clinician and client. One approach that can be helpful for the clinician and client in the decision-making process is the use of a decisional balance. This approach simply evaluates the pros and cons of a possible decision.

The reason this decisional balance can be helpful is because it offers a tangible way to see if the pros outweigh the cons or vice versa. This may be able to assist in resolving any ambivalence by the client and allow the client to decide. If the pros and cons appear to be evenly split, it can validate the client in the difficult choice they are trying to make. And even if it is a difficult choice, and the pros and cons are equally balanced, the client may still be motivated to make a decision one way or the other.

A decisional balance can be an effective way to evaluate the pros and cons of any decision. For some clients, it can be helpful for them to actually see the pros and cons written down. It can be an excellent visual exercise and the pros and cons can remain on the paper to review later. This approach can also provide a framework for the clinician to remain neutral. By using an activity like this, the clinician can facilitate a process for the client and allow the client to go over all the pros and cons related to the decision.

And like it was mentioned in the last blog, an affirmation offered by the clinician can be extremely beneficial to remind the client of their inherent worth regardless of the decision being made. Expressing to the client their strengths during a challenging process can often be welcomed and needed by the client. Simply stating to the client that you will continue to work with them and support them can be profound. You can remind them that you know they will be able to get through this situation.

In next month’s blog, we will begin exploring the concept of “developing discrepancy” and how it is used in motivational interviewing. I hope everyone is doing as well as possible and you have opportunities to use and practice motivational interviewing. Take good care!