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The Changing Times
Motivational Interviewing for Positive Behavior Change
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!
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.
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.