Effective Communication

Tips for effective motivational communication: 
  • Listen rather than talk
  • Reflect and do not just move on when the client speaks
  • Focus on change talk and not sustain talk
  • Support client self-efficacy / confidence
  • Get permission or buy in before offering information and advice

Change Talk

What is it? A caregiver's statements that argue for or support change.

Remember DARN

  • Desires: want, would like, hope to do this or make this change
  • Abilities: Can, am able, I could or believe I could do this
  • Reasons: For my child, my health, my family
  • Needs: Need to or must make this change

Commitment language: I am going to, will do it, promise to start next week

Responding to change talk: Highlight and emphasize their feelings in your reflections, affirm past success

Sustain Talk

What is it? A caregiver's statements that make a case or give a reason NOT to change.


  • NO desire: I do not want or desire to make this change
  • Not able: I do not think I can do it, I tried and failed, I cannot do it
  • Not convinced of reasons not sure change would be good, do not have a reason
  • No need to change: I do not have any need to change this

Overwhelmed or unwilling: I cannot do this at this time with everything going on

Responding to Sustain Talk

  • Strategic responding: emphasize autonomy, you are in charge, you have the choice to do this or not
  • Reflective Responding: Straight, Amplified, Double-Sided: reflect any change talk you can find, show you are listening to concerns, ambivalence, and arguments against change


As a general rule, ask for permission to offer information and share advice. Use the Elicit-Provide-Elicit framework:

Elicit: Ask them what they know and ask permission to provide additional information.

  • Example: "You seem concerned about your older child's asthma attacks and wonder if there is more you can do to prevent them. I have some information about secondhand smoke that might be useful. Would it be ok if I shared that with you?"

Provide: Offer clear and important information. Support caregiver autonomy rather than telling them what to do.

  • Example: "Children who are around cigarette smoke are more likely to have an asthma attack. The smoke acts as an irritant and trigger for asthma attacks."

Elicit: Ask what caregiver makes of the information provided.

  • Example: "What do you think about this information?"


Here is an example of Elicit-Provide-Elicit