Now that the list of options has been created by the client and clinician, it is time to talk about where the best place will be to start. This provides a great opportunity for the clinician to trust that the client knows themselves better than anyone else and the best plan forward for them. By asking the client what plan they would like to try first, it empowers the client to come up with their own ideas for success.
This approach of asking the client which strategy they would like to try first also reminds the client that there could be some challenges along the way. The client is provided a “heads up” that there may need to be some tweaking or changes to the original plan. However it unfolds, allowing the client to follow their hunches/preferences encourages autonomy and allows the clinician to support and facilitate this process.
Below are the tasks provided by Miller and Rollnick of the territory to cover with a client who has several ways to move forward. The third task we will explore is evaluating the list of options by asking the client about their hunches/preferences of which plan they think will work best.
- Confirm the goal, and as appropriate, subgoals along the way.
- Itemize the options that are available or have been discussed.
- Elicit the client’s hunches/preferences as to the best way forward.
- Summarize the plan and strengthen commitment.
- Troubleshoot-raise any concerns you have.
There could be several questions the clinician could ask the client about what plan they think would work best. The thought of making sure to ask the client for their initial thoughts and preferences is so that they take ownership of their plan and to create a plan that will be successful and sustainable over time.
A few starter questions suggested by Miller and Rollnick include:
“Here are some different routes that we could take. Which one appeals more to you?”
“What are the good things and not-so-good things about each option?”
“What would be the best route to try first?”
These questions can help facilitate the process of the client coming up with their own ideas for how best to initiate their change plan. By giving them the opportunity to talk about their hunches and preferences, it can often lead to motivation on behalf of the client to begin making some changes in their life.
Again, this step in the process keeps the client in the lead of making choices that they think will work best for them. In next month’s blog, we will continue looking at the tasks to review with the client and summarize their plan. 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 or related services, contact Steve Bradley-Bull, LCMHC, by phone, (919) 812-9203, or by email, steve_bradley-bull@med.unc.edu
UNC CFAR Motivational Interviewing 