{"id":17864,"date":"2025-11-11T14:59:58","date_gmt":"2025-11-11T19:59:58","guid":{"rendered":"https:\/\/www.med.unc.edu\/cfar\/2020\/10\/conversations-about-change-the-role-of-confidence\/"},"modified":"2026-01-09T12:08:50","modified_gmt":"2026-01-09T17:08:50","slug":"conversations-about-change-the-role-of-confidence","status":"publish","type":"post","link":"https:\/\/www.med.unc.edu\/cfar\/2025\/11\/conversations-about-change-the-role-of-confidence\/","title":{"rendered":"The Role of Confidence"},"content":{"rendered":"

When motivational interviewing was initially introduced, it was a way to support clients who perhaps didn\u2019t recognize the importance of changing a behavior. For example, in the case of problem drinking the clinician was oftentimes more aware of the importance. Another situation where MI can be helpful is the situation where the client is aware of the importance of changing but doesn\u2019t have the confidence in making a change. Below are several examples offered by Miller and Rollnick indicating a lack of confidence from clients:<\/p>\r\n

\u201c<\/em><\/strong>I could get a better job if I got a college degree, but it\u2019s been a long time since I was in school and I don\u2019t think I could keep up.\u201d<\/em><\/p>\r\n

\u201cI know that smoking is bad for me, but I\u2019ve tried to quit several times and I just can\u2019t seem to do it.\u201d<\/em><\/p>\r\n

\u201cWe definitely need to communicate better, but I don\u2019t think my family is really committed to trying.\u201d<\/em><\/p>\r\n

\u201cI would like to be healthier, but it hurts too much to exercise.\u201d<\/em><\/p>\r\n

Each of these statements start off with a desire or need (DARN) to change and then there is a \u201cbut\u201d that is followed by a reason as to \u201cwhy\u201d it is not possible. If a clinician hears a statement like this, they can offer support to the client. The place to begin with the statements above is to acknowledge the preparatory change talk by the client. The clinician can reflect back to the client the desire or need and then move the conversation back to the client on how they could contribute to making this change happen.\u00a0<\/p>\r\n

The goal here is to focus on the resources and strengths already available to the client and not looking for anything outside of themselves. After reflecting back to the client the desire or need, a good approach is to ask open ended questions that allow the client to discuss and explore possible ways to address the issue. There are numerous open ended questions to ask a client about how they can make this change happen, and here are a few suggested from Miller and Rollnick:<\/p>\r\n

\u201c<\/em><\/strong>How might you go about making this change?\u201d<\/em><\/p>\r\n

\u201cWhat might be a good first step?\u201d<\/em><\/p>\r\n

\u201cGiven what you know about yourself, how could you make this change successfully?\u201d<\/em><\/p>\r\n

\u201cWhat obstacles do you foresee, and how might you deal with them?\u201d<\/em><\/p>\r\n

\u201cWhat gives you some confidence that you can do this?\u201d<\/em><\/p>\r\n

By asking the client how they could contribute to making this change happen, and for the client to become aware of strengths and skills they possess, it is likely the clinician will begin to hear language that focuses on their abilities and their ideas for how this change could become a reality. It then becomes a process where the clinician and client explore the way forward for the client.\u00a0<\/p>\r\n

Next month, we will discuss additional strategies to address a lack of confidence on behalf of the client. I hope everyone is doing as well as possible and you have opportunities to use and practice motivational interviewing. Take good care!<\/p>\r\n\r\n

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For more information about Motivational Interviewing resources, contact Eunice Akinyi Okumu, by phone (919) 843-2532, or by email, eunice_okumu@med.unc.edu<\/a><\/em><\/p>\r\n<\/figure>","protected":false},"excerpt":{"rendered":"

When motivational interviewing was initially introduced, it was a way to support clients who perhaps didn\u2019t recognize the importance of changing a behavior. For example, in the case of problem drinking the clinician was oftentimes more aware of the importance. 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