Setting Goals — Using SMART
One strategy to help consumer’s set meaningful goals that have a high likelihood of change is to use the SMART method in the spirit of MI.
SMART: Specific Meaningful Accessible Realistic Timed
- What will be your next step?
- What will you do in the next one or two days?
- Have you ever done any of these things before to achieve this?
- Who will be helping and supporting you?
- On a scale of 1 to 10 what are the chances that you will do your next step? Or How likely is it that you will take the next step? (anything under 7 and their goal may need to be more achievable)
Brief Action Planning Video: Mr. Carlson Develops a Walking Plan
This 5-minute brief interview video demonstrates the use of an open-ended question to elicit ideas for change, Brief Action Planning in the collaborative spirit of MI, use of the confidence ruler, summarizing and scheduling a follow-up visit. It is low on open-ended questions and reflective listening — however, since the spirit of collaboration is there, the provider is able to engage the consumer in a person-centered conversation that moves him toward a SMART change plan that is specific, meaningful, accessible, realistic for this consumer, and the action steps are timed. As you watch the video make note of the different kinds of change talk the consumer expresses and the effect of the provider using the confidence ruler with regard to the consumer’s level of commitment to taking action.
Considering/Sorting Change Options
MI-consistent strategies for sorting through change options include:
- Brainstorming options.
- Eliciting the consumer’s hunches as to his/her own preferred options.
- Offering a menu of options (with the consumer’s permission) if the consumer has difficulty coming up with ideas. (Miller & Rollnick, 2013, pp. 269–284)
Arriving at a Plan
MI strategies for arriving at a plan include:
- Using OARS to elicit and respond to specific ideas and action steps the consumer expresses.
- Focus the conversation on clarifying goals and specific action steps.
- Ask questions to elaborate on the specifics steps of the change plan (start broad, then narrow the focus). (Miller & Rollnick, 2013, pp. 269–284)
MI consistent strategies to elicit and reaffirm commitment to change include:
- Respond with reflective listening that focuses on mobilizing change talk (CAT — Commitment, Activation, Taking Steps).
- Use the confidence ruler (see Exploring Confidence below) to emphasize ability change talk.
- Offer affirmations that emphasize the consumer’s motivation, commitment, perseverance, etc. Summarize the change plan.
- Ask: “Are you going to do this?” “Is that what you intend to do?”
- Write down the change plan and give a copy to the consumer/client. Writing it down solidifies commitment.
- Ask the consumer to verbally express his/her commitment to change to you and someone else in his or her life. (Miller & Rollnick, 2013, pp. 269–284)
Confidence Scaling Question
If you decided right now to [change], how confident do you feel that you will do this? If 0 was ‘not confident’ and 10 was ‘very confident’, what number would you give yourself?
Open Ended Questions to Explore Confidence
Here are some open-ended questions to help you explore a person’s confidence about change:
- What would make you more confident about making these changes?
- Why have you given yourself such a high score on confidence?
- How could you move up higher, so your score goes from x to y?
- How can I help you succeed?
- Is here anything you found helpful in any previous attempts to change?
- What have you learned from the way things when wrong last time you tried?
- If you were to decide to change, what might your options be? Are there any ways you know about that have worked for other people?
- What are some of the practical things you need to do to achieve this goal? Do any of them sound achievable?
- Is there anything you can think of that would help you feel more confident?