Exploring the plan the client would like to implement can be a very powerful experience because the client takes ownership of what they think will work best. Since the client knows themselves better than anyone else, they are in the best position to decide what plan to pursue first. This can also be a time when momentum is created as the client prepares to launch their new behavior change plan.
When the plan is decided upon by the client, this is a good time to summarize the plan together to make sure both client and clinician are on the same page moving forward. It is always helpful to verbalize and write down a change plan since speaking out loud can assist in clarifying the details and can put support pieces in place.
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 fourth task we will explore is summarizing the plan and strengthening commitment in preparation for changing behavior.
- 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.
After the clinician and client review the plan, and hopefully it is confirmed in writing as well as verbally, the clinician can look for ways to strengthen the commitment by listening for change talk. Oftentimes, the client is ready to take a small step towards making a change. The client may say something like:
“I will join the support group”
“I intend to take the medication everyday”
“I plan to exercise at least 3 times a week”
When this type of language is spoken by the client, when they have a plan, and are about ready to start, it can be so helpful for the clinician to strengthen the talk by reflecting back what the client is sharing and following up with an open-ended question about how to make the plan even more specific.
Again, once the clinician hears the change talk from the client, be sure to reinforce it and have the client speak more about the change they want. It can be powerful for the client to hear themselves speak of the change and how they intend to create it.
This step in the process makes sure the client and clinician are clear on the next steps and provides an opportunity for the clinician to strengthen the client’s plan. In next month’s blog, we will continue looking at the tasks to review with the client and troubleshoot any concerns. 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 