Motivational Interviewing (MI) Transition: Balancing Change and Ambivalence

Angela-Wood
Southeastern Louisiana University

Key Points

  1. Therapeutic planning can proceed despite unresolved ambivalence, focusing on eliciting and reflecting the patient’s change talk.
  2. In cases like Macy’s, where ambivalence persisted, the therapist used double-sided reflections to summarize both change and sustain talk, emphasizing the positive change talk last.
  3. Double-sided reflections are a strategic tool in motivational interviewing to heighten patients’ awareness of their ambivalence, thereby facilitating a conscious choice towards change or maintaining the status quo.
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Moving Beyond Ambivalence

In therapeutic sessions, resolving ambivalence is not a prerequisite for progressing to the planning phase. The therapist's focus is on evoking the patient's perceptions of their desire, ability, reasons for change, and any sense of urgency. This involves eliciting change talk to gauge the patient's readiness for planning.

The “Key Question”, as proposed by Miller and Rollnick, is integral to this process. It involves asking, "So where does that leave us?" to understand the patient's position and readiness for change.

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