What are some of the advanced skills or strategies that you use to enhance Motivational Interviewing?

1 Elicit change talk

Change talk is any self-expressed language that indicates a person's desire, ability, reason, need, or commitment to change. It is a key indicator of readiness and motivation for change and can be influenced by the way questions are asked, statements are reflected, and strengths are affirmed. To elicit more change talk, open-ended questions can be used to explore the pros and cons of change, reflective listening can be employed to mirror back the person's change talk, and affirmations can be provided to acknowledge the person's efforts, values, and strengths. For example, an open-ended question might be "What are some of the benefits of quitting smoking for you?", while reflective listening could be "It sounds like you are worried about your health and want to take better care of yourself.", and a positive affirmation could be "You have shown a lot of courage and resilience in dealing with your challenges."

2 Use evocative questions

Evocative questions can help you gain a deeper understanding of a person's perspective, values, goals, and emotions. To use them effectively, you should avoid questions that can be answered with a simple yes or no, or that imply a judgment or suggestion. Try to ask questions that start with "how", "what", or "why" as they tend to encourage more elaboration and exploration. Additionally, make sure your questions are specific, concrete, and relevant to the person's situation and stage of change. Examples of evocative questions include “How do you cope with stress without smoking?” “What are some of the barriers that prevent you from eating healthier?” and “What are some of the steps that you have taken to reduce your gambling?”

3 Use decisional balance

Decisional balance is an effective technique for helping someone weigh the pros and cons of changing or not changing a behavior. It can help them clarify their ambivalence, identify their priorities, and resolve their discrepancies. To use it effectively, you should ask the person to list the advantages and disadvantages of changing or not changing the behavior, whether it's through a table, a chart, or simply a conversation. Summarize and reflect back the responses, emphasizing any discrepancies between current behavior and desired outcomes. Additionally, have them rate the importance of each advantage and disadvantage on a scale from 0 to 10. Afterwards, compare the ratings to see if there is a pattern or preference for change or no change. Finally, ask the person to share their thoughts and feelings about the decisional balance process and their readiness for change.

6 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?