What are you HEARING? The 3 types of Talk in MI

IMG_3397Did you know that what comes out of your client’s mouth is highly influenced by what you are saying?

If statements from your client start with the word YOU it can mean they have perceived the conversation as potentially judgmental. In Motivational Interviewing we call this discord. Discord reflects the dissonance in your working relationship, and often conceals feelings of embarrassment, shame, guilt, or loss.

An example of discord might be “you don’t know what it’s like to live in my shoes” or “you’re lucky to have a job you like.”

The second type of talk in MI is sustain talk, which is speech that favors the status quo rather than movement towards change. Sustain talk is about the ambivalence regarding behavior change and usually starts with the word “I.”

An example might be “I don’t have the energy to consider this program and care for my family.” Ambivalence is normal and it’s important to expect it and remain non-judgmental.

In MI we are always pulling for change talk, which is speech that identifies behavior change.

Examples might be “I have to make this change for my family,” or “losing weight is important to my health.”

Many times we miss opportunities to reflect, reinforce and underline change talk.

If you hear discord, attending to the smoke in your working relationship is essential to moving forward.

If you hear sustain talk, you might try reflecting the change that your client is working towards. For example “although losing weight has been challenging, you realize it’s essential to your health.” This double-sided reflection reflects the ambivalence and the dream on the second part of the reflection. Since the brain usually hooks onto the last thing that was said the conversation can move towards change.

If you truly listen to what comes out of your client’s mouth, it will teach you MI.

If you hear discord or more sustain talk, you may be saying things your client does not like, or potentially reinforcing the ambivalence. When you hear change talk you know you are using MI to evoke the change and move your conversation towards change.