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Change Talk: Encouraging client arguments for change.

One of the things that makes Motivational Interviewing unique and different from other methods of counseling is the emphasis in MI on "change talk." Change talk is defined as client speech that favors movement in the direction of healthy behavior change. When we hear change talk, the client is arguing for change. In MI, we want to encourage change talk so we learn how to recognize and reinforce client change talk. We also learn specific techniques to elicit this kind of language because the more a client argues for change, the more likely he or she will actually make a healthy change in behavior.

There are several types of change talk identifiable in client speech. There are statements of desire, ability, need, reasons and commitment. The first four of these types are preliminary or preparatory types of change talk. A person might say that he wants to change, can change, or give you good reasons to change or tell you why he needs to change. All these statements should be recognized and reinforced. The likelihood of change increases, though, when clients give us commitment talk, when they say they “will” take some action toward change. Statement of commitment are the golden nuggets that MI counselors are seeking because commitment language actually predicts change.

Two simple ways to elicit change talk, if you are not hearing your client spontaneously giving it to you, are the use of scaling questions and the use of a decisional balance worksheet. (For more information on scaling questions, listen to my podcast on my web page: www.motivationalinterviewingonline.com)

The decisional balance worksheet is simply a sophisticated pros and cons list. In the decisional balance worksheet, though, instead of just asking about the pros and cons of a behavior change one is asked about the good things and not so good things about both changing behavior and maintaining the status quo. Asking about the good things for maintaining the status quo can be a very powerful technique in itself for eliciting what is rewarding about a particular, unhealthy behavior. When you hear answers to questions about the good things about changing and the not so good things about the status quo, though, you are eliciting change talk from your client.

There are at least 8 additional techniques taught in MI for eliciting change talk from our clients. These can all be learned readily and are usually taught in an introductory workshop. The real learning, however, takes place when you use the techniques with your clients and hear them arguing for change.

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