Tip 3: Encourage change talk
When making decisions, we hold a set of scales in our mind –the good and bad things about changing, and the good and bad things of staying the same.
It may be about moving, buying a car, or changing a habit. The internal conflict can be so gentle that it’s hardly noticeable, or so stressful that we are paralysed and put it to the back of our minds and pretend it’s not there.
This ambivalence is a normal state of affairs – and is at the heart of the problem when we have habits which harm our health, and have difficulty changing them.
So what can we as clinicians do to help our patients? (and maybe even ourselves?)
Motivational interviewing is a type of conversation that helps people resolve ambivalence and make better decisions. It was developed by Bill Miller and Steve Rollnick from their work in addiction medicine. Motivational interviewing, at its core, is a type of conversation where the clinician works collaboratively with the patient, honouring their autonomy and encouraging ‘change talk’.
What is ‘change talk’? Any comment the person makes which has to do with changing a behaviour in direction of their own best interests.
“I know I could stop smoking. If I really put my mind to it.”
“If I exercise, I will be able to keep up with my grandchildren.”
“Something needs to change.”
When we hear ‘change talk’, it helps to give the patient the ‘good lines’, the positive side of the ambivalence. And we do this by asking those open questions,
“How would you do that?...”
“Tell me more about that…”
“In what way?...”
(Hint: I used to have a post-it note with the questions on my desk to remind me when I started….)