It’s time to change…

What does change talk look like?

Problem Recognition Concern about the problem Awareness of the problem Potential benefits of change Costs of not changing

D – Desire to change (want, like, wish…)A – Ability to change (can, could…)R – Reasons to change (if, then…)N – Need to change (got to, have to, need to…)

Preparatory change talk & Implementing Change Talk

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C – Commitment (intention, decision, readiness…)A – Activation (ready, prepared, willing…)T – Taking steps

DesireAbilityReasonNeed+Commitment

I know I can quit if everyone just gets off my back.I’ve got to have my GED to get the apprenticeship.I don’t want my kids getting in the same trouble I did.This time, I am going straight to the halfway house from here.My mom’s not going to let me back in the house if I don’t quit.It ain’t worth it to be landing up in here again (jail).This time I’m going to stay clean.

Missed opportunities during change talk

• Not listening• Expert focus/trap

gathering informationHot on a trail (Going to “why”)

• Not “recognizing” what change talk is• Not directive enough (wondering focus)• Not knowing how to respond to change

talk

How Motivational Interviewing is directive (TOWARD evoking change talk):

E: Eliciting, ElaborationA: AffirmingR: ReflectionS: Summarizing

E.A.R.S!

Responding to change talk: EARS!Elaborating: In what way? Tell me more… What else?

Affirming: That took a lot of courage. You’re a person who can make changes when you need to.

Reflecting: That’s really important to you. You realize it’s become a problem.

Summarizing: There are a number of things I’m hearing about your situation. First, you’re

concerned about… Also, you feel… and you are thinking…