Change Talk in Motivational Interviewing

Change talk in Motivational Interviewing is the person’s own language that favours movement towards change. Learning to recognise and respond skilfully to change talk is central to the Evoking task of MI.

Why listen for change talk?

When practitioners become worried about someone, it is easy to supply reasons for change ourselves. MI takes a different approach. We become interested in the reasons, desires, abilities and needs for change that come from the person.

Instead of asking, “What can I say that will convince this person?”, MI invites us to ask, “What might help this person hear themselves thinking about change?”

What does change talk sound like in Motivational Interviewing?

“I want things to be different.”

“I could probably start by walking a couple of evenings a week.”

“I need to get this sorted before it affects the children.”

“I know I can do it because I managed for six months before.”

“I’m going to ring them tomorrow.”

Preparatory and mobilising change talk: DARN-CATs

MI distinguishes between two broad forms of change talk. Preparatory change talk suggests movement towards change without yet committing to action. It is remembered as DARN: Desire, Ability, Reasons and Need.

Desire: “I want to feel healthier.”

Ability: “I could probably manage that.”

Reasons: “I’d have more energy for the children.”

Need: “I really need to do something about this.”

Mobilising change talk signals movement closer to action. It is remembered as CATs: Commitment, Activation and Taking Steps.

Commitment: “I will ring them tomorrow.”

Activation: “I’m ready to start making some changes.”

Taking Steps: “I’ve already stopped buying cigarettes for the house.”

The distinction matters. Need is preparatory change talk; commitment is mobilising change talk. Someone can strongly need or want change without yet committing to it. Practitioners do not need to turn the conversation into a hunt for particular words. The broader skill is recognising the direction and strength of the person’s language and cultivating change talk without getting ahead of their readiness.

These are sometimes remembered using the shorthand DARN-CAT. Practitioners do not need to turn the conversation into a hunt for particular words. The broader skill is hearing when the person is moving towards change and deciding whether to invite further exploration.

How to respond to change talk in Motivational Interviewing

Responses can include reflections, open questions, affirmations and summaries.

Person: “I don’t want my daughter thinking this is normal.”

Reflection: “Being the kind of parent you want to be really matters here.”

Open question: “What would you like her to see instead?”

Notice that neither response introduces the practitioner’s reasons for change. They help the person elaborate what they have already expressed. In Motivational Interviewing, practitioners selectively attend to change talk and invite the person to elaborate, strengthening their own arguments and motivations for change.

Change talk and sustain talk can coexist

Ambivalence often means hearing both sides, sometimes in the same sentence.

“I know I need to cut down, but drinking is the only thing that helps me relax.”

The first part favours change. The second favours maintaining the status quo. MI practitioners learn to hear both without turning the conversation into a contest.

Avoid overreacting to change talk

Change talk does not always mean the person is ready for a plan. Moving immediately into advice or action can sometimes get ahead of them. A reflection or invitation to elaborate may be more useful. The practitioner listens for whether the person is exploring why change matters or beginning to express readiness and commitment to act.

Person: “Maybe I do need to do something.”

Rather than immediately asking, “So what are you going to do?”, we might respond, “Something about this is beginning to feel more important.”

Developing skills for responding to change talk

One useful practice is simply to listen to a conversation and identify change talk without trying to respond to it. Once recognition becomes easier, practise several possible responses. This separates the skill of hearing change language from the pressure of immediately finding the perfect response.