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Motivational Interviewing: Sustain Talk

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Lauren Carroll

on 6 June 2015

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Transcript of Motivational Interviewing: Sustain Talk

Motivational Interviewing: Sustain Talk

By: Amber, Lauren, Mac, and Melissa
What is sustain talk?
A reason not to make a change or stay with the status quo
Sustain talk counters change talk, but it is not student resistance
Sustain talk is a part of the conversation about change
Sustain talk helps move the client forward to talking about change
Sustain talk can create discord; however this is part of the therapeutic relationship
Sustain talk is talking about the change, but mainly talking about why they can't do it
The counselor's role
Normalize sustain talk using MI skills
Evoke the client’s reasons for concern and arguments for change or not changing
Accept and reflect perceived disadvantages of change or sustain talk
Reflect both sides (double-sided reflection)
Recognize ambivalence as an addition to clarity where the client has not been ready to move forward or reach a decision
Continue to listen and evoke the client's own arguments for change and assists the client to keep moving in the direction of change
Eliciting change talk
The objective is to facilitate high levels of change talk and low levels of sustain talk
The decision balance: identifying pros and cons within four quadrants:
A. What is good about continuing the behavior
B. What is not good about changing the behavior
C. What is not good about continuing the behavior
D. What is good about changing the behavior
Weight of the behavior: this as compared to that
Examples of sustain talk
"I do not want to"
"It did not work last time"
"I think I will be okay"
"I can manage without help"
"I really do love ___ and how it makes me feel"
"I have to ___"
"I just need to accept this is how I am"
"If I change I will just relapse"
"I do not have time"
"I can accept the consequences"
"I am not going to change"
"I am not ready"

Change talk is not sustain talk!
It can be easily confused...

LETS PRACTICE!: Activity #1
Discord is not sustain talk
"Discord refers to client statements about the intervention process or relationship to the counselor, particularly the direction in which the client perceives things are going" (Miller & Rollnick, 2013)
Discord is a normal human response to feeling pressured or challenged to do something (ambivalence)
It often comes in the form of a "yes, but" statement
Discord is an interpersonal process, and natural response to counter a MI or a directive stance
Counselors should respond with different types of reflections, emphasizing choice and control, and/or shift the focus
Both discord and sustain talk are part of ambivalence, but should not be confused...

Miller, W., & Rollnick, S. (2013). Motivational interviewing: Helping people change (3rd ed.). New York, NY: Guilford Press.

• http://www.motivationalinterview.net/miglossary.pdf
• http://www.dhs.state.mn.us/main/idcplg IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=dhs16_162865
• https://books.google.com/books?id=8Pr5RflKYmYC&pg=PA60&lpg=PA60&dq=normalize+sustain+talk+MI&source=bl&ots=NAIx9WrzrJ&sig=iinG2mUS4brjotPQ0xf9g91Rhp8&hl=en&sa=X&ei=PvlYVcuxDs6lyASCsYDwAQ&ved=0CEsQ6AEwBw#v=onepage&q=normalize%20sustain%20talk%20MI&f=false
• https://www.porticonetwork.ca/treatments/treatment-methods/motivational-interviewing/mi-sustain-talk-and-discor
• http://www.addictionz.com/addictions.htm

Rosengren, D. (2009). Building motivational interviewing skills: A practitioner workbook. New York: Guilford Press.
Want to try it?: Activity #2

Miller, W., & Rollnick, S. (2013). Motivational interviewing: Helping people change (3rd ed.). New York, NY: Guilford Press.

Rosengren, D. (2009). Building motivational interviewing skills: A practitioner workbook. New York: Guilford Press.
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