The way that clients talk about the potential for a particular change is of special interest to people who facilitate MI conversations. When clients are forming and speaking thoughts that are pulling them closer to a decision or plan to change, their speech will contain “Change Talk” (words that suggest desire, ability, reasons, and need for change).
There is a flip side to the Change Talk coin however! If client speech doesn’t contain words that suggest a pro-change argument, their language will often reflect a point of view that suggests “no – I’m ok to just leave things the way they are, at least for now”. When clients favour the point of view that sustaining things the way they are (rather than changing them) is preferable, the MI approach views such speech as “Sustain Talk”.
In the chart below, the middle column lists five major categories of motivational language (desire, ability, reason, need and commitment to change). In the left column, change talk examples are provided that related to each of the five types of motivational language listed in column B. In the far right-hand column, examples of “sustain talk”, or speech that argues for leaving this “as is” are provided). You’ll note that sustain talk is more or less the “flip side” of the motivation in change talk.
| SUSTAIN TALK EXAMPLE | MOTIVATIONAL LANGUAGE | CHANGE TALK EXAMPLE |
|---|---|---|
| I don’t want to quit smoking. I enjoy it. | DESIRE to pursue the change | I want to quit smoking. I like it. |
| There’s nothing much I can do about my weight. I’m sure as heck not going to join a gym. | ABILITY to pursue the change | I guess I could start walking more. That would help me lose weight I think. |
| My insulin is a bit high alright, but it’s not as big a deal as my doctor thinks. It doesn’t really matter if I get all fired up about it at this point. | REASON to pursue the change | Well, if I did manage to lower my blood sugar, the doctor says I could avoid having to take insulin. That would be good because I hate the thought of using needles. |
| Maybe someday I’ll take this more seriously, but for now it’s not the end of the world if I don’t change things. It’s not really a matter that I have to do it. | NEED to pursue the change | I’ve got to get on this now. If I don’t do this now, it’s just going to get harder and harder the older I get. |
| I’m not going to get involved in coming up with fancy plans to try to change this right now. I’m not willing to make this into a major effort – at least not right now. | COMMITMENT to pursue the change | Well, what I’m going to do here is register for that self-help group that runs on Wednesday nights. I’m going to see if having group support will help. |
Developing skills in working effectively with sustain talk and with change is essential to effective MI practice. We introduce various change talk practices in our “Foundations” workshop. Then, in our intermediate and advanced-level courses, we focus on strengthening change talk skills and on helping people become more strategic in the way they manage change talk and sustain talk. Change talk work is so vital to effective MI practice that we offer an intensive two day training session on this single aspect of MI for any learner who has completed our Foundations workshop.
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