appendix d: motivational interviewing - National Drug and Alcohol ...

Appendices
• “What would you like to be doing in two years time?”
• “What do you think will happen if you keep using? How do you feel about that?”
• “If you decided to make a change, what are your hopes for the future?”
• “How would you like things to turn out for you?”
• “I can see that you’re feeling really frustrated right now … How would you like
things to be different?”
• “What are your options at the moment?”
• “What would be the best results you could imagine, if you make a change?”
NOTE: In clients with symptoms of a co-occurring depressive condition, this strategy should be
avoided or used with caution 330 .
Exploring goals and values
It can be useful to ask clients about their goals and what is most important to them and compare
this to the current situation. Explore the ways in which the problem behaviour is inconsistent
with, or undermines important values and goals for them. When the highest or most central
values and goals have been defined, you can ask how the problem you are discussing (e.g.,
drinking/using) fits into this picture. For example:
• “Where do you think your using fits in?”
• “What effect is your current behaviour likely to have on these goals and values?”
Strengthening commitment
After a client commits to the idea of change (to whatever degree), the next phase in MI is to
consolidate all the issues raised by the client in the first phase, and build on his/her motivation
to change while also negotiating a plan for change. Ambivalence will still possibly be present,
and if encountered continue the use of the strategies and microskills outlined above. It can be
useful to encourage the client to confront the idea and process of change. For example:
• “Where do we go from here?”
• “What does everything we’ve discussed mean for your alcohol/drug use?”
• “How would your life be different if …?”
• “What can you think of that might go wrong with your plans?”
Although abstinence is one possible goal, some people may not be ready to stop completely and
may opt for reduced or controlled use. In MI, the client has the ultimate responsibility for
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