Motivational Interviewing is powerful in enhancing motivation to change. This happens when the counselor listens for and brings out preparatory change talk (desire, ability, reasons, and need). When enough of these have been said, the client may naturally move into mobilizing change talk, such as activation and commitment. The more change talk in a session, the more likely the person is to make the change. In previous Tips, we’ve explored the various types of change talk, how to elicit more of it, and how to best respond to it (Tips #69, 110, and 121). Here we focus in on the change talk that tells us a commitment is being made.
Do or do not. There is no try.
Reduce your plan to writing.
The moment you complete this,
you will have definitely given concrete form
to the intangible desire.
Research shows the pattern of change talk during a session that will most likely result in actual change. Miller and Rollnick (in Motivational Interviewing: Helping People Change, Third Edition) speak of the “ambivalence hill.” In the initial parts of a session, we are on the uphill side. We are exploring and evoking preparatory change talk, and it can feel like a tough climb. The more carefully and thoroughly we traverse this section, the easier the mobilization, or downhill side, will be.
It is not always as simple as first using only preparatory change talk and then switching to only mobilizing talk. The types of change talk will be sprinkled throughout. This simple idea of the hill helps us determine the type of change talk we are hearing so we can envision where we are in the change process.
When you hear a good amount of preparatory change talk and it has been fleshed out, you may begin to hear some commitment talk. These are all statements about doing something. This will sound like:
- I am going to…
- I plan to…
- I will…
If you don’t hear commitment language, you can gently evoke it. You could summarize the preparatory change talk you have heard and then ask, “What’s your next step?” or “What do you see yourself doing this week?”
Sometimes we hear vague commitment statements. We can encourage them. For example, if you hear, “You know, they do have a gym at work,” you could ask for more in that direction: “How might you make use of that resource?” If you hear, “I like that idea of slowing down to ask myself if I am hungry,” you could respond, “Tell me how you might do that” or “How would that look this week?”
There are potential downsides of too much evoking of commitment talk.
- People vary in how much clear commitment talk they will naturally voice. MI research has shown that it is a good sign to hear commitment language in a session, but that it is not necessary for change to happen. If we push for a commitment when the client is not ready, we may evoke resistance. Carefully monitor how your client responds to your invitations to explore commitment, and back off if you sense resistance. You can go back to the language the client was using just before the resistance
- One way to avoid this premature focus on commitment is to attend to the client’s preparatory change talk. If you are trying to evoke commitment before you have heard much, if any, preparatory talk, this is a clue that commitment is premature.
- Another possible misstep in working with commitment is to suggest a plan to the client. “How about you begin by recording your food this week?” or “Let’s make changes to your portions first.” These are your ideas for a plan of action, not the client’s. You may get silence or “I guess I could try that.” This is not a commitment statement; it’s resistance. To avoid this, if you have an idea about a way forward for this person, use the MI-consistent way of offering advice (Tips #59 &147).
- The client may voice commitment when there is little motivation behind it. This sometimes happens when a part of a person thinks he should do it (or should say he will do it) but other important parts of him are not at all on board. We can sometimes sense this is happening. To check this out, you could ask a scaling question about confidence (Tip #76). For example, “So your plan is to cook all your meals at home during the week. When you think of the next couple weeks, what is your confidence that this will happen every weeknight — on a scale of one to ten, where one is you know it won’t happen, and ten is you are completely sure it will?”