10 Strategies for Evoking ‘Change Talk’

1. Ask Evocative Questions

Ask evocative, open-ended questions, to which the answers are likely to be change talk:

  • “Why would you want to make this change?”
  • “What makes you willing to stop / start _____?”
  • “What are the three best reasons for you to do this?”
  • “Why is it important for you to make these changes?”
  • “So, what do you think that you will do from here?”

2. Explore the Decisional Balance

Help the person to explore the advantages and disadvantages of making changes:

  • “What are the good things about ________?”
  • “What are the not-so-good things about ________?”
  • “What are the benefits of stopping / changing ___?”

3. Ask for Elaboration

When a change talk theme emerges, ask for more detail:

  • “How has this impacted on your health/relationships/family?”
  • “In what ways?”
  • “Tell me more about …”

4. Ask for Examples

When a ‘change talk’ theme emerges, ask for specific examples:

  • “When was the last time that happened?”
  • “Can you give me an example?”
  • “What else?”

5. Look Back

Ask about a time before the current concern emerged:

  • “How were things different or better then?”

6. Look Forward

Ask:

  • “What might happen if things continue as they are?” or
  • “How would you like your life to be in five years’ time?”

Try the ‘Miracle Question’:

  • “If you were 100% successful in making the changes you want to make, what would be different?”

7. Query Extremes

  • Ask “What are the best things that might happen if you do make this change?” or
  • “What are the worst things that might happen if you do not make this change?”

8. Use Change Rulers

Ask

  • “On a scale of nought to ten, how important is it for you to make this change – where nought is not at all important and ten is extremely important?”

Follow up with:

  • “Why are you at _ and not at _ [lower number than they stated]? What might need to happen so that you could move from _ to _ [higher number]?”

Instead of:

  • “How important is …?” you could ask “How much do you want to …?” or
  • “How confident are you that you can …?” or
  • “How committed are you to …?”

Avoid asking:

  • “How ready are you to …?”

It can be confusing because it combines the competing components of:

  • Desire;
  • Ability;
  • Reason(s); and
  • Need.

9. Explore Goals and Values

Explore what a person’s guiding values are.

What do they want in life?

How does the person’s behaviour fit with their goals and values?

Does it help to achieve goals, interfere with them or is it irrelevant?

10. Come Alongside

Try explicitly siding with the negative (continuing and not changing) side of ambivalence:

  • “Perhaps smoking weed is so important to you that you will not give it up, no matter what the cost.”

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