Motivational Interviewing: Conversations about Change: Values and Goals

When we think about values and goals, particularly related to a therapeutic setting, we are often attempting to gain some insight or understanding into the client’s internal perspectives. These perspectives can often be the motivation for making decisions in their lives. And these decisions could be short term or long term but the key is really listening to what the client wants or how the client may want their life to look in 5 or 10 years down the road. Sometimes, it can be challenging for some clients to think about the future, but it may be an opportunity for the client to focus less on the day-to–day and more on long term goals. This may allow the client to determine whether there may be some changes they want to make in their lives, and if so, how they would go about making these changes.

There are many ways to discuss values and goals and one of the easiest ways is to begin a conversation with the client. Below are a few example questions offered by Miller and Rollnick to find out more about a client’s goals, priorities, and values:

“Tell me what you care most about in life. What matters to you most?”

“How do you hope your life will be different a few years from now?”

“What would you say are the rules you live by? What do you try to live up to?”

“Suppose I asked you to describe the goals that guide your life, the values you try to live by. What would you say are your five most important values, maybe just one word for each to begin with. What would they be?”

“If you were to write a “mission statement” for your life, describing your goals or purpose in life, what would you write?”

“If I were to ask your closest friends to tell me what you live for, what matters most to you, what do you think they would say?”

These questions are just examples, and you likely know your clients best, so you would likely be able to come up with questions that would be most appropriate. Again, the goal is to perhaps think about the future, with a larger perspective, and about how the client would like their life to look. And when this discussion is occurring, the clinician encourages the client to continue sharing by using reflective listening statements. Miller and Rollnick offer a good example of using reflections as values and goals are discussed:

Client: Well, one thing I want to be is loving.

Interviewer: To care for other people (Reflection).

Client: I don’t mean just having warm feelings. I mean being a loving person.

Interviewer: To love in a way that makes a difference (Reflection).

Client: Yes. I want to make a difference.

Interviewer: For the people you care for, who are close to you. (Reflection).

Client: Not just for them, although I certainly try to be loving to my family and friends, too.

Interviewer: But you mean something beyond your circle of friends. (Reflection).

Client: Yes, to act in a loving way to people I don’t even know; the check-out clerk at the market, children, a beggar in the street.

Interviewer: You want to be kind to them, too, to strangers. (Reflection)

Client: Kind-yes, that’s a good word.

Hearing from the client about their values and goals allows the clinician to learn more about their internal perspectives, which may lead to the motivation needed for behavior change. And an easy way for the clinician to explore values and goals with the client is to begin with asking the client open-ended questions related to what is most important. Once there is a clear understanding of these values and goals, the clinician can discuss with the client how aligned their current behaviors are with their values and goals. This process of “exploring discrepancy” is what we will focus on next month. I hope you all have a great month and have opportunities to use and practice Motivational Interviewing!

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For more information about Motivational Interviewing or related services, contact Steve Bradley-Bull, LPC, by phone, (919) 812-9203, or by email, unc.cfar.mi@gmail.com.

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