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Dr Ellen

ISSUE #4 - April 2012

Future Events with Dr. Ellen

Onsite Workshop

Motivational Interviewing and Health Behavior Change

May 11, 2012

Northeastern University
Boston, MA

$200.00 per person 

For student rate, email Dr. Ellen at  

Live Webinar

Motivational Interviewing and A Non-Diet Approach

May 16th, 1:30pm

$50.00 per person

All times are East coast, USA.
Webinars are 90 minutes 

Where is Dr. Ellen?

April 19: Advanced MI Workshop for Fallon Community Health Program, Worcester, MA

April 30: Advanced MI Workshop at the Intensive Tobacco Treatment Training and Conference, Portland, ME

May 4: New York State Dietetic Assoc Conference, Albany, NY

May 8: Rhode Island Dietetic Assoc., Warwick, RI

Contact Us

Training with Dr. Ellen
Waltham, MA 02451

Phone: 781.890.1618


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Newsletter Bonus  

If you missed my teleclass with Coach Jean Caton of The Profitable Woman, click the audio link below and hear How I turned Motivational Interviewing into a Business

The Business of Changing Behavior with Dr. Ellen

Teleclass Audio Link


Introduction to Motivational Interview DVD now available!

Learn the basics of Motivational Interviewing and its application to health behavior change counseling

Discover the spirit and techniques of Motivational Interviewing including:

  • The guiding, collaborative style of Motivational Interviewing 
  • Dealing with the “righting reflex” and client resistance
  • Identifying and responding to change talk
  • Using the Decisional Matrix and Importance/Confidence techniques

Email to Order or at  (DVD102)


The Changing Times

Motivational Interviewing for Positive Behavior Change

Dear Friend,

I’ve been thinking recently about change, and how difficult it is for most people.  While many of us find change exciting in some ways, most people have very mixed feelings.  Ambivalence, or holding two conflicting feelings at the same time, is an uncomfortable place to be.

            In Motivational Interviewing, we assume that people are ambivalent when faced with change.  The technique of “Decisional Balance” or “Good Not-So-Good” can be very helpful in making decisions and resolving ambivalence.  My article this month describes how this works.

            I hope you find this helpful, for your clients, patients or for yourself!

Ellen Glovsky Signature

Decisional Balance: A Powerful Technique in Motivational Interviewing

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We know that most people are ambivalent when faced with change, especially change in behavior.  The goal of most health behavior consultations is to help the client resolve ambivalence about the proposed change.  One technique that can be useful is called “Decisional Balance” or “Decisional Matrix”.  This is basically a balance sheet of the costs and benefits of both changing and staying the same. 

By carefully talking with the client about the “good and not so good” aspects of change or no change, we can use the decisional balance exercise to “tip” the balance towards change. For a diabetic considering improvements in diet, the conflict might be thus: “If I continue to eat as I have been, I will continue to enjoy the food I love [benefit of staying the same]. However, my health will continue to deteriorate [costs of staying the same]. On the other hand, if I change my eating habits, I will feel better physically and worry less [benefit of change], but I won’t be able to eat whatever I want [costs of change].”

You can use a simple table, such as that illustrated below to help your client organize their thoughts.   The decisional balance points to the complex nature of decision-making processes and the intricate interplay of forces for and against change. 


Eat Whatever

I Desire

Healthier Eating Habits


I like the tastes.

It’s cheaper.

I don’t have time.

I feel fine

At least I don’t smoke.

Stay healthy.

Fewer meds.

Control sugars

Take charge!

I don’t want to die!


My dietitian lectures

I’ve gained another 20

I can’t control my sugars

Too much $$

Hard to prepare

We don’t do veggies!!

You are welcome to use Dr. Glovsky's articles in any of your own publications provided you copy the following into the article: "Dr. Ellen Glovsky is a Registered Dietitian and Motivational Interviewing trainer. She is on the faculty of Northeastern University in Boston, MA, where she teaches courses in nutrition, public health and MI. Her website, newsletter, and blog are at Training With Dr. Ellen."

Ellen Glovsky, PhD, RD, LDN 2012. All rights reserved.

Training With Dr. Ellen
Waltham, MA 02451

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