{"id":17898,"date":"2025-11-11T14:58:42","date_gmt":"2025-11-11T19:58:42","guid":{"rendered":"https:\/\/www.med.unc.edu\/cfar\/2022\/03\/conversations-about-change-facilitating-discrepancy-and-exploring-others-concerns\/"},"modified":"2026-01-08T10:29:49","modified_gmt":"2026-01-08T15:29:49","slug":"conversations-about-change-facilitating-discrepancy-and-exploring-others-concerns","status":"publish","type":"post","link":"https:\/\/www.med.unc.edu\/cfar\/2025\/11\/conversations-about-change-facilitating-discrepancy-and-exploring-others-concerns\/","title":{"rendered":"Facilitating Discrepancy and Exploring Others\u2019 Concerns"},"content":{"rendered":"

There may be many reasons why a client wants to maintain the status quo and not change their behavior. The client may be very clear as to why they do not believe making a change is in their best interest. In some situations, there also may be little or no ambivalence about change. How do we, as clinicians, work with these clients? One approach that has been effective, is to explore with a client whether they are aware of how their behavior may be affecting other people who are significant in their lives.<\/p>\r\n

Oftentimes, coming at this situation from a different perspective can be helpful. To discuss with the client how they think their behavior is impacting other people may allow them to let go of their current \u201cstance\u201d and consider things in a new way. An example of a session with a client provided by Miller and Rollnick give some insight into how this conversation may unfold:<\/p>\r\n

INTERVIEWER: Why do you imagine your wife is worried about your drug use? What do you think concerns her?<\/p>\r\n

CLIENT: She\u2019s someone who always comes down on the safe side of every issue. But my drug use is my choice, and it\u2019s none of her business.<\/p>\r\n

INTERVIEWER: She\u2019s not as much of a risk taker as you are.<\/p>\r\n

CLIENT: That\u2019s definitely true. She doesn\u2019t like anything that\u2019s even remotely risky, and I guess she thinks my drug use is risky.<\/p>\r\n

INTERVIEWER: Why do you suppose she thinks that?<\/p>\r\n

CLIENT: Well, for one thing it\u2019s illegal. She\u2019s worried I\u2019ll get caught and get in trouble or lose my job or something.<\/p>\r\n

INTERVIEWER: But that\u2019s really none of her business.<\/p>\r\n

CLIENT: No, now there I can see where she has some grounds for concern, losing my job and all. That would affect her.<\/p>\r\n

INTERVIEWER: So if it could affect her negatively, it\u2019s reasonable for her to worry.<\/p>\r\n

CLIENT: Yes, I guess so.<\/p>\r\n

INTERVIEWER: But if it\u2019s just affecting you negatively, that\u2019s not her concern.<\/p>\r\n

CLIENT: Well, she\u2019d be worried about that, too.<\/p>\r\n

INTERVIEWER: Because\u2026<\/p>\r\n

CLIENT: Because she cares about me. She\u2019s our family smoke alarm.<\/p>\r\n

INTERVIEWER: Of the two of you, she\u2019s the one who watches out for things that might hurt you, even before it\u2019s serious. She\u2019s cautious.<\/p>\r\n

CLIENT: And I\u2019m not. I\u2019m a go-for-it kind of guy.<\/p>\r\n

INTERVIEWER: You\u2019re opposite in that way.<\/p>\r\n

CLIENT: Yeah, I guess opposites attract, you know.<\/p>\r\n

INTERVIEWER: It\u2019s one of the things you appreciate about her.<\/p>\r\n

CLIENT: But I don\u2019t think she appreciates my risk taking.<\/p>\r\n

INTERVIEWER: Like using illegal drugs.<\/p>\r\n

CLIENT: Yeah<\/p>\r\n

The clinician is essentially using all open-ended questions and reflections. By using these basic MI skills, the clinician is able to facilitate the client in seeing things not only through his eyes but also through the eyes of someone that he cares about, and who cares about him. This conversation between clinician and client also begins to produce some change talk by the client that will hopefully lead to some behavior change.<\/p>\r\n

In our next blog, we will continue talking about strategies that may be effective in working with a client who may be less motivated to change. We will discuss asking the client what they want their lives to look like and how it relates to their goals and values. I hope everyone is doing as well as possible and you have opportunities to use and practice motivational interviewing.<\/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":"

There may be many reasons why a client wants to maintain the status quo and not change their behavior. The client may be very clear as to why they do not believe making a change is in their best interest. In some situations, there also may be little or no ambivalence about change. How do … Read more<\/a><\/p>\n","protected":false},"author":103351,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"layout":"","cellInformation":"","apiCallInformation":"","footnotes":"","_links_to":"","_links_to_target":""},"categories":[386,333,310],"tags":[],"class_list":["post-17898","post","type-post","status-publish","format-standard","hentry","category-conversations-about-change-developing-discrepancy","category-mi-core-skills","category-motivational-interviewing-blog","odd"],"acf":[],"featured_image":false,"featured_image_medium":false,"featured_image_medium_large":false,"featured_image_large":false,"featured_image_thumbnail":false,"featured_image_alt":false,"category_details":[{"name":"Conversations About Change: Developing Discrepancy","link":"https:\/\/www.med.unc.edu\/cfar\/category\/motivational-interviewing-blog\/mi-core-skills\/conversations-about-change-developing-discrepancy\/"},{"name":"MI Core Skills","link":"https:\/\/www.med.unc.edu\/cfar\/category\/motivational-interviewing-blog\/mi-core-skills\/"},{"name":"Motivational Interviewing Blog","link":"https:\/\/www.med.unc.edu\/cfar\/category\/motivational-interviewing-blog\/"}],"tag_details":[],"_links_to":[],"_links_to_target":[],"_links":{"self":[{"href":"https:\/\/www.med.unc.edu\/cfar\/wp-json\/wp\/v2\/posts\/17898","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.med.unc.edu\/cfar\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.med.unc.edu\/cfar\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.med.unc.edu\/cfar\/wp-json\/wp\/v2\/users\/103351"}],"replies":[{"embeddable":true,"href":"https:\/\/www.med.unc.edu\/cfar\/wp-json\/wp\/v2\/comments?post=17898"}],"version-history":[{"count":5,"href":"https:\/\/www.med.unc.edu\/cfar\/wp-json\/wp\/v2\/posts\/17898\/revisions"}],"predecessor-version":[{"id":19985,"href":"https:\/\/www.med.unc.edu\/cfar\/wp-json\/wp\/v2\/posts\/17898\/revisions\/19985"}],"wp:attachment":[{"href":"https:\/\/www.med.unc.edu\/cfar\/wp-json\/wp\/v2\/media?parent=17898"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.med.unc.edu\/cfar\/wp-json\/wp\/v2\/categories?post=17898"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.med.unc.edu\/cfar\/wp-json\/wp\/v2\/tags?post=17898"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}