If you feel like a client is ready to move from evoking to planning, the best approach is to ask. We have talked about several ways to get to this point, and then it is time to see where the client would like to go. You will likely have a good sense if the client is ready from your conversations, but you may not know for sure. By asking the client, you are respecting their autonomy and being clear that you are not trying to move them along until they are ready.
An example from Miller and Rollnick of how this conversation may unfold is below. This dialogue is between the interviewer (clinician) and Julia (client). The exchange includes a summary and a key question. Then, we hear from Julia about her readiness to move from evoking to planning:
Interviewer: Well, thanks for all you’ve told me, Julia. You’ve been feeling a lot of turmoil in your life and I appreciate how honest and open you have been with me. Let me just pull together what you’ve told me, and then we’ll see what the next step is. You would really like to start feeling better, in general about yourself, and to feel interested in things again. When you got to feeling bad enough that you cut yourself, that kind of startled you and got your attention, and it helped you decide that it was time to do something about it. You’ve been feeling really bad, like you have been dragging a great weight around with you, and you’re rather tired of feeling like your friends avoid you. Friends are important to you. In the longer run you also want to have an open, warm, and loving relationship with a man. You’re a pretty resourceful person. You moved here from Ireland all on your own and set up a new life for yourself. You’re also a stubborn and persistent person. Once you make your mind to do something it’s likely to happen. You would like to understand what’s been going wrong in your relationships because somewhere down the line you would like to be married, and you also mentioned finding a better job as a longer-term goal. You’ve been through a lot of emotional pain, and you’re eager for a calmer and happier life. So what would you like to do?
Julia: I’m not sure what to do, but I know I can’t keep going like I have been. Something has to change.
Interviewer: It sounds like you’re ready to do whatever it takes to feel better and get on with a new life.
Julia: I am. I don’t want to keep living the way I have been.
Interviewer. Well, shall we talk about some possibilities then?
Julia: Yes, please.
In this session, it is clear that Julia is ready to move into planning. The clinician has provided a summary of the motivations she has expressed in previous sessions and follows it up with a key question. Julia states that she is ready to discuss options related to moving forward and make changes in her life.
Every interaction with a client will be a little different but some key pieces will always need to be present. For example, there will need to be readiness on behalf of the client to move from evoking to planning. Once that readiness is confirmed by the client, planning can proceed. I hope everyone is doing as well as possible and you 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