# Step 3: Enhance Motivation
# Key objectives:
- Assess the client’s readiness to change their behaviour.
- Help the client recognize discrepancies between their goals/values and their present behaviour.
- Bolster the client’s confidence by eliciting change talk.
| Objectives | Actions / Examples |
|---|---|
Check-in with Client | Ask client how they are feeling right now and about their screening results |
Discuss Pros and Cons | “Help me understand your perspective. What do you enjoy about gambling? What about some of the not-so-good things?” Summarize |
Develop Discrepancies
| Listen carefully for discrepancies between the client’s gambling and their values or goals |
Assess Readiness to Change
| Show readiness ruler (see 'Discussing Pros and Cons' below) Importance Readiness Confidence |
TIP
# Discussing Pros and Cons
Motivational interviewing skills can help move the conversation forward when discussing the pros and cons of change.
# Asking Open-Ended Questions
When you ask open-ended questions, it helps you learn about the client’s thoughts and feelings without suggesting an answer. For example:
- It can be useful to use a decisional balance (see below) to gain insight into the client’s views about gambling, which can then be tied in when discussing change. For example,
- “When someone is thinking about change, it can be helpful to consider the ways that gambling helps versus harms. Tell me first about some ways that gambling has benefitted you. Now, tell me about the ways that gambling has cost you.”
- “What would be the pros of limiting your gambling spending? What about the cons? What are the pros and cons of not putting those kinds of limits in place and continuing gambling as you have been?
| Pros | Cons | |
|---|---|---|
|
Making a change | ||
|
Not making a change |
# Using Reflections
When you use reflections, it shows you are listening to the client and allows you to confirm that you have understood them correctly instead of making assumptions. This can help elicit change talk from the client.
# Providing a Summary
Providing a summary allows you to pull together the conversation and highlight certain aspects. For example, “Thank you for sharing this information with me. Just to make sure I understand correctly, on the one hand gambling has benefitted you [summary] but it has also cost you [summary]. It seems like gambling has done more harm than good, but also it seems like you’ve taken some important steps to reduce the amount you play.”
# Listening for Readiness to Change
The readiness ruler can help guide conversations about goals and change.
The questions can help the person hear their desires for change in their own words. It can also help to tease apart how important a change is versus how confident they are that they can make those changes.
The example below shows you how to use the ruler to assess a client’s readiness for change as well as how to increase their confidence level.
| Readiness Ruler |
|---|
Not At All Extremely |
1 2 3 4 5 6 7 8 9 10 |
Example:
# 1. Assessing Importance
“On a scale of one to ten, how important is it to you to change your gambling patterns?”
“Why did you chose [X] instead of [Y (higher number)]?”
[If problem is not important, take some time to provide education and help make connections between behaviour and consequences]
# 2. Assessing Confidence
“On a scale of one to ten, how confident are you right now that you can make that change?”
“What would it take for you to go from [X] to a higher number, such as [Y]?”
[If confidence is low, take some time to bolster the client’s confidence by highlighting past successes, breaking down goals into smaller steps, giving suggestions to overcome any barriers, etc.]