We know that adopting new behaviors, or changing old ones, can result from motivation (importance) and self-efficacy (confidence) as well as an individual’s personal characteristics and social and environmental factors. Exploring these factors with a client allows us to learn about facilitators and barriers and can help us guide the client towards change and make it easier to tailor an appropriate action plan.
The power point slides below provide the sequencing of questions that can be extremely useful. The example refers to medication adherence.
The first question asked:
“To help me understand how important this is to you, on a scale from 0 to 10, with 0 being not at all important and 10 being very important, how important is it for you to take your pills every evening before bed right now (or insert another topic)?”
0 1 2 3 4 5 6 7 8 9 10
This question allows the practitioner to understand where the client believes they are related to how important it is for them to take their medications. The question is helpful but it is really the follow-up questions that provides the practitioner with the information that can help us learn about the facilitators and barriers to change.
If the client selects the number 7 on the scale, the next question could be:
Why are you a (7) and not a (3)?
This question allows us to understand what helps the client (facilitators of the behavior) to do this.
The follow-up question could be:
Why are you a (7) and not a (9)?
This allows us to understand what gets in the way for the client (barriers of the behavior) to do this.
The last question in this sequence could be:
What would it take for you to move from a (7) to a (9)?
This allows us to understand what may be included in an action plan for behavior change.
By using scales like the ones above, or creating one that is more appropriate for the client or topic, a great deal of valuable information can be obtained from the practitioner, and much exploration can occur for the client. Try using these scales and let me know how it works, or if you tweak them to make them more useful for you and your client, it would be great to hear about too!
Next month, we will continue with additional ways of evoking change talk.
For more information about Motivational Interviewing resources, contact Eunice Akinyi Okumu, by phone (919) 843-2532, or by email, eunice_okumu@med.unc.edu.