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How do you transition from building motivation to planning for change in motivational interviewing?

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Motivational interviewing is a collaborative and client-centered approach to help people overcome ambivalence and make positive changes in their behavior. It involves four core processes: engaging, focusing, evoking, and planning. In this article, you will learn how to transition from building motivation to planning for change in motivational interviewing, using empathy and affirmation to elicit change talk.

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Susie Napier, MS MAMFT

Encourager - Passionate About Continuous Improvement for People and Organizations

1 Engaging and focusing

The first step in motivational interviewing is to establish a trusting and respectful relationship with your client, and to understand their goals and values. You can use open-ended questions, reflective listening, and summaries to show interest and empathy, and to clarify what matters to them. You also need to focus the conversation on a specific behavior change that is relevant and important for your client, and that they are willing to explore. You can use agenda setting, collaborative goal setting, or scaling questions to help your client choose a focus area.

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Susie Napier, MS MAMFT

Encourager - Passionate About Continuous Improvement for People and Organizations
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In my experience scaling questions help the client truly identify their desire for change, in addition the therapist has a better idea of which stage of change the client is really in.

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2 Evoking change talk

The next step is to elicit change talk, which is any statement that expresses a desire, ability, reason, need, or commitment to change. Change talk indicates that your client is motivated and ready to move forward. You can use empathy and affirmation to elicit change talk, by reflecting back what your client says, validating their feelings and strengths, and reinforcing their positive intentions. You can also use strategic questions, such as asking about the pros and cons of changing or staying the same, the discrepancy between their current behavior and their goals, or the importance and confidence they have in changing.

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William Clabaugh

SUD counselor @ Amity Foundation
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As a professional we need to help the client identify the qualities and gifts they possess. We can see qualities in them they may not see I’m themselves due to traumatic experiences. We need to teach them how to identify the strengths and abilities that lay dormant within them. Teach the client to use positive self-talk and positive affirmations to generate positivity in their lives and relationships.

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3 Planning for change

The final step is to transition from building motivation to planning for change, which is the process of developing a concrete and realistic action plan with your client. You can use the readiness ruler, a scale from 1 to 10, to assess how ready your client is to take the next step. If they are not ready, you can continue to evoke change talk and explore their ambivalence. If they are ready, you can ask for permission to move to planning, and use the SMART framework (Specific, Measurable, Achievable, Relevant, and Time-bound) to help your client set a goal and identify the steps, resources, and potential barriers to achieve it. You can also use elicit-provide-elicit, a technique that involves asking your client what they already know or want to know, providing information or advice in a neutral way, and asking for their feedback or reaction.

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Cindy Paras, OTD, MOT, OTR/L, ECHM

Occupational Therapist, Home Healthcare, Aging-in-Place, Education, Adult Rehabilitation, Health & Wellness, Mentorship
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The four processes of MI are dynamic and overlapping; not independent of each other. Building motivation occurs through engaging the client, building rapport, and developing a partnership to address ambivalence for health behavior change. Using MI communication skills of asking, listening, and informing to develop "change talk" and quiet "sustain talk" is at the center of the evoking process. Empowering the client to identify solutions that work best for them supports movement through the stages of change. As confidence and autonomy over health decisions increases, and solutions are identified, asking "what" and "how" questions are used in the MI conversations to elicit an action plan.

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4 Here’s what else to consider

This is a space to share examples, stories, or insights that don’t fit into any of the previous sections. What else would you like to add?

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How do you transition from building motivation to planning for change in motivational interviewing?

1

2

3

4

1 Engaging and focusing

2 Evoking change talk

3 Planning for change

4 Here’s what else to consider

Motivational Interviewing

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How do you transition from building motivation to planning for change in motivational interviewing?

1

2

3

4

1 Engaging and focusing

2 Evoking change talk

3 Planning for change

4 Here’s what else to consider

Motivational Interviewing

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