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
What is it? A caregiver's statements that argue for or support change.
- 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
What is it? A caregiver's statements that make a case or give a reason NOT to change.
DARN FOR SUSTAIN TALK
- 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