Ask permission and understand priorities #
Ask whether the person would like to discuss the behaviour and how it fits with their goals. Use open questions to understand what they value about it and what concerns them. Reflect their meaning before offering information.
Explore both sides #
Invite the person to explain the advantages and costs of continuing, and the possible benefits and difficulties of change. Summarize ambivalence accurately. Avoid turning disagreement into a contest or labelling reluctance as lack of motivation.
Support the person’s own reasons #
Ask what might make change worthwhile and what has helped previously. Elicit their own ideas and confidence rather than supplying a scripted conclusion. Offer choices appropriate to the clinical situation.
Agree a feasible next step #
Clarify what the person wants to try, what support they need and when to review it. If they do not want change now, preserve engagement and offer an opportunity to revisit. Alcohol dependence requires separate withdrawal assessment before an abrupt reduction; this conversation does not determine a detoxification regimen.
Use in practice
References · 1
- Semple and Smyth, Oxford Handbook of Psychiatry, 4th edition, 2019 · Supplied PDF page 518. PDF locators; not a claim of original print pagination.