When you are trying to help someone decide to make a behavioral change, it’s more common than not to experience a back and forth process of openness and resistance to the change being considered. Change is hard and ambivalence is normal. As family members, friends, and treatment providers we can contribute to the change process moving along (and maybe even speed it up) or we can contribute to it grinding to a halt. If you know what to look for in conversations, you can help build up a person’s motivation to change.
“Change talk” refers to statements that suggest there is a window of opportunity for change to take place. They happen all the time and often spontaneously. They aren’t usually declarations of change (“that’s it, I’m done drinking forever!”), although they can be. Often they are much more subtle statements that suggest that the person you are working with or care for is contemplating making a change. How you react to statements like “ugh, I hate feeling hungover” can open or close the door to a larger discussion about the possibility of making a change in behavior.
Let’s start by looking at a typical exchange where change talk is noticed, but not necessarily encouraged.
Husband: Man, I think I overdid it last night.
Wife: Overdid it? That’s an understatement! You were a mess and embarrassed me! I’m so mad I can’t even deal with you right now!
Husband: Calm down! Why do you always have to overreact like that?
Wife: You are ridiculous and selfish.
In this situation, the wife noticed the change talk (she even repeated it!), and then went on to extend the conversation in a way that shut it down and got her husband on the defensive. Let’s look at this conversation again if the wife is responding to change talk in a different way.
Husband: Man, I think I overdid it last night.
Wife: Yeah, you drank a lot last night. How are you feeling?
Husband: Ugh, I don’t feel great this morning. I don’t really know what happened. The night kinda got away from me.
Wife: Sounds like it snuck up on you.
Husband: Yeah, I didn’t expect to drink that much.
Wife: You wanted to drink less? That’s encouraging to know! How can I help you next time?
By using reflections and open-ended questions, this wife got new information and improved her ability to be a part of helping make change, instead of shutting her husband down and ending the conversation.
There are many ways to listen to another person, some more helpful than others. A powerful therapeutic approach called Motivational Interviewing emphasizes four strategies: open-ended questioning, affirming, reflecting or active listening, and summarizing. This is an approach to listening that helps open doors to the potential for change.
Open-ended questions – These are questions that call for some elaboration, that can’t be answered with one word. “What concerns you most?” “What would you like to be different?” Open questions invite description, giving you, the listener, more to listen to and learn from. They also set a collaborative tone, as they communicate more interest in your partner’s view.
Affirmations – Listen for the positives. Communication can easily become all about what’s wrong. Noticing what’s going right and explicitly acknowledging it can change everything: it puts some balance back in the conversation and maintains a positive connection. Affirming statements also reduce defensiveness, which helps when you get to tougher issues (what’s not going so well).
Reflections – Also called active listening, reflections involve restating some or all of what you think the person has said. Your reflection can simply restate the words you heard, or it may reflect the feeling in the words. Reflections are statements, not questions (which can slow down or redirect the other person).
Summaries – With open questions, affirmations, and reflections you may end up in a long and productive conversation! Summarizing communicates that you were listening, and helps pull together the important things that were said. It can also help your partner tie his thoughts together in a way that might lead him to connect certain dots. Summaries can even guide the conversation toward a next step, without forcing an agenda.
If you are someone who is trying to help another person change, consider listening for change talk and using these strategies to promote even more of it!