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More Powerful, Positive Techniques for Change in Motivational Interviewing

In my last post, I discussed a technique used in Motivational Interviewing called “importance scaling”.  The follow up questions are called “confidence scaling” and work in a similar fashion.

Here’s how it works.

Clinician: Thinking about ________________ change we’ve been discussing, how would you rate your confidence that you could make this change? Use a scale from 0-10, in which 0 is that you are not at all confident you could do it, and 10 is the most confident you could be.  What number would you give yourself?

Client: I’m not too confident right now.  I’ve tried this before and wasn’t able to do it then.  I’d say I’m at a 5.

Clinician: Why did you say “5” and not “0”?  Sounds like you do have some confidence about doing this.

What would have to happen to make you feel more confident? What can I do to help you increase that number from 5 to 7? 

The answers to these questions are change talk, which is the client talking about change and not you.  In MI we consider change talk to be “gold”, precious.  Your job as an MI clinician is to reinforce change talk in the direction of positive change.

The confidence scaling questions, combined with the importance scaling questions provide both you and your client with a wealth of information on their actual readiness to change.  If this change is very important to your client, but they are not at all confident they can do it, the focus is on helping build confidence.  If the client is very confident, but it’s not important, maybe this is not the time to make this change.

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