How to Coach Yourself and Others Empowering Coaching And Crisis Interventions | Page 53

This book is in B&W, not color - Print page in Grayscale for Correct view!  “What would it take to move a bit higher on the scale?” Clients with lower readiness to change (e.g., answers decreased from a “5” 6 months ago to a “2” now)  “So, it sounds like you went from being ambivalent about changing your [insert risky/problem behavior] to no longer thinking you need to change your [insert risky/problem behavior]. How did you go from a ‘5’ to a ‘2’?”  “What one thing do you think would have to happen to get you to back to where you were 6 months ago?” AFFIRMATIONS Rationale: Affirmations are statements made by therapists in response to what clients have said, and are used to recognize clients’ strengths, successes, and efforts to change. Affirmative responses or supportive statements by therapists verify and acknowledge clients’ behavior changes and attempts to change. When providing an affirmation, therapists should avoid statements that sound overly ingratiating (e.g., “Wow, that’s incredible!” or “That’s great, I knew you could do it!”). While affirmations help to increase clients’ confidence in their ability to change, they also need to sound genuine. Example of Affirmative Statements  “Your commitment really shows by [insert a reflection about what the client is doing].”  “You showed a lot of [insert what best describes the client’s behavior—strength, courage, determination] by doing that.”  “It’s clear that you’re really trying to change your [insert risky/problem behavior].”  “By the way you handled that situation, you showed a lot of [insert what best describes the client’s’ behavio r—strength, courage, determination].”  “With all the obstacles you have right now, it’s [insert what best describes the client’s behavior— impressive, amazing] that you’ve been able to refrain from engaging in [insert risky/problem behavior].”  “In spite of what happened last week, your coming back today reflects that you’re concerned about changing your [insert risky/problem behavior].” ADVICE/FEEDBACK Rationale: A frequently used MI strategy is providing advice or feedback to clients. This is a valuable technique because clients often have either little information or have misinformation about their behaviors. Traditionally, therapists and other health care practitioners have encouraged clients to quit or change behaviors using simple advice [e.g., “If you continue using you are going to have (insert health consequence).”]. Research has shown that by and large the effectiveness of simple advice is very limited (e.g., 5% to 10% of smokers are likely to quit when simply told to quit because smoking is bad for their health). The reason simple advice does not work well is because most people do not like being “told what to do.” Rather, most individuals prefer being given choices in making decisions, particularly changing behaviors. What we have learned from MI is that how information is presented can affect how it is received. When relevant, new information should be presented in a neutral, nonjudgmental, and sensitive manner that empowers clients to make more informed decisions about quitting or changing a risky/problem behavior. One way to do this is to provide feedback that allows clients to compare their behavior to that of others so they know how their For [email protected] Property of Bookemon, do NOT distribute 53