“My friend says she wants to change so and so, and I told her what she ought to do but she just doesn’t do it. I don’t know what her problem is.”
Sound familiar? Hopefully by now I have described that the process of change is a little complex. Previously I described the stages of change. Today I’m going to describe the processes that underlie a conversation about change.
We all have those conversations with others about changes either they say they wish to make or we feel like they should consider and vice versa. These conversations are sometimes fruitful and other times not. What’s up with that?
Miller & Rollnick (2013) have studied the change process extensively, particularly some of the components that go into a successful conversation about change, and have determined four fundamental processes beginning with engaging.
Engaging is the process of building rapport and trust. Having a conversation about something difficult in your life is easier with someone you trust and feel has your best interest at heart. Suppose a perfect stranger came up to me on the street and said, “Your butt is too big. You really should exercise more.” There’s truth in those statements. A whole lot of truth! However, I might turn around and tell that person, “I don’t know you from Adam. Who the heck are you to tell me what I need to do???” There is absolutely no engagement there.
Sometimes we go to others for help, such as a physician, therapist, or even a friend or family member. Even in those times when we are actively seeking counsel there is still a need to ensure a measure of trust and respect before diving into the issue at hand.
Building upon the engagement process the next stage is focus. What behavior are we talking about? For example, I want to be as healthy as possible but there are several contributing factors to my health: What I eat, how much I exercise, my sleep habits, my level of stress, etc. I could talk about any and all of these things but I might also end up talking in circles or getting off on a tangent. Conversations about behavior change need to have a clear focus and this focus should be determined by the person seeking to make the change for reasons we’ll discuss later.
So, now that we’ve established rapport/trust, and the topic has been chosen, now what? Now it is time to get down to the nitty gritty and evoke the individual’s OWN reasons and means for change…his/her own goals and desires. Why is this important? Think about it. If I’m thinking about making a change, whose ideas about making this change are the best? MINE! If you are thinking about making a change, whose ideas about making that change are the best? YOURS! The conversation needs to be tailored to the individual. It needs to reflect what is important to you, your abilities, and your challenges, as well as how you feel you can best go about making those changes. More about this later.
The final process in change conversation is planning. Think back to the beginning of this post. People often jump ahead to a change plan and can’t understand why others don’t respond positively. Perhaps because they don’t feel you have their best interest in mind (no engaging), the plan doesn’t reflect their preferred direction (wrong focus), and it doesn’t take into consideration their individuals goals and means (no personal evocation). For example, I might offer a product or service that legitimately addresses a health need I think you have, but have I taken the time to find out 1) whether this is the need you really are hoping to address first, 2) whether you are willing or able to spend money on my product or service or 3) whether you really are ready to step into the action phase of change? Pushing for action prematurely and without considering the other’s intrinsic reasons for change can shut down the conversation immediately.
To recap, the four processes are engaging, focusing, evoking, and planning. These stages build upon each other and each one must be established before moving onto the other. These stages are also recursive in that at any given point in a conversation we may need to step back down and revisit a previous stage before moving on. For instance, during the evoking phase when asking about reasons for change the conversation might get off topic. In this case there might be a need to refocus. If we move ahead too prematurely to making a plan and the other person is not ready and begins to shut down we may need to step all the way back to the engaging stage to re-establish trust and rapport.
I hope you’re beginning to see that conversations about change can be sensitive and difficult. Very few people want to be told what to do without some say in the matter, even those asking for help. My next post will cover more about tapping into intrinsic motivation. Stay tuned for DARN-CATs.
Miller, W. R., & Rollnick, S. (2013). Motivational interviewing: Helping people change. Guilford press.