Facilitating Change: The Planning Process in Motivational Interviewing

Angela-Wood
Southeastern Louisiana University

Key Points

  1. Therapists reinforce clients’ commitment to change by agreeing on specific goals and using evocation techniques to encourage actionable steps.
  2. When clients respond vaguely or with uncertainty, strategic questioning, and pauses can prompt deeper reflection and concrete planning.
  3. The therapist’s role is to empower clients to discover their solutions while ensuring they feel in control of their change journey, emphasizing the importance of client permission in making suggestions.
Earn 1.25 CE Credits

Focusing on the Change Goal

After posing the key question, the focus shifts to reinforcing the client’s commitment to a specific change goal. This step involves revisiting and agreeing upon the focus for change. Using evocation—a technique that still encompasses change talk—promotes more actionable steps the client can take toward the agreed-upon goal. This approach illustrates how tasks in therapy are intertwined and complementary.

Evoking Client Response and Redirecting Focus

Managing Uncertainty and Resistance

Clients may initially express uncertainty when asked about their next steps, such as responding with “I don’t know.” In these instances, a strategic pause can encourage further reflection and response. For example, if a client discusses external frustrations, like criticism from a family member, a complex reflection can be used to redirect the conversation toward personal change.

Redirecting to Self-Improvement

In cases where external parties, such as a family member, are involved in the client’s situation, it’s crucial to steer the client back to focusing on their journey of change. For instance, by using envisioning strategies, therapists can encourage clients to contemplate reciprocal changes that would improve their relationships. This approach shifts the focus from broader, more abstract concepts to practical, achievable terms.

Establishing a Plan for Change

Setting Specific Goals

Once the client identifies a change goal—like reducing verbal aggression—the next step involves outlining a plan. This plan should be composed of specific steps the client is willing to take to achieve their goal. The therapist’s role is to evoke from the client their ideas on implementing these changes.

Addressing Vague Responses

Clients, particularly teenagers, might give vague responses, such as a general intention to “try not to do it.” In such cases, therapists should encourage clients to think more concretely about their plans. Re-asking questions in an empowering manner prompts clients to reflect on their strengths and potential solutions.

Empowering Through Self-Discovery

Encouraging clients to recall instances where they successfully managed their behavior can be a powerful tool. By asking open-ended questions, therapists empower clients to discover their own solutions. This method fosters autonomy and builds confidence in their ability to enact change.

Seeking Client Permission for Suggestions

Reinforcing Client Autonomy

Therapists may introduce new topics or suggestions for the client’s consideration when necessary. However, it’s essential to seek the client’s permission first. This approach respects the client’s autonomy, making them feel in control of their change journey. Asking permission also reduces psychological reactance, making clients more receptive to suggestions.

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Facilitating Change: The Planning Process in Motivational Interviewing