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Asking effective questions

Talking about change leads to more successful outcomes. Rather than lecturing or telling patients the reasons why they should change, change talk centres around the patient’s responses. These responses usually contain reasons for changing that are personally important.

Below are some examples of the types of questions you can use to keep the conversation flowing, but in a way that provides you, and more importantly your client, with the information they need to change.

Questions to elicit/evoke change talk

There are many ways to ask questions that will get your client to think about their behaviour.

Here are just a few examples:

  •  “What would be the good things about changing your [problem]?”
  • “What would your life be like three years from now if you changed your [problem]?”
  • “Why do you think others are concerned about your [problem]?”

Questions to ask if your client is having difficulty changing

As we have discovered, change is hard and there are times when your patient will struggle. You need to focus on being supportive.

These types of questions may help:

  • “How can I help you get past some of the difficulties you are experiencing?”
  • “If you did decide to change, what would you have to do to make this happen?”

Questions where your client has little desire for change

There will be occasions when, despite your best efforts, you can see your client just does not 'get' that they need to change. In this situation you could then get them to describe in their own words what would be the extreme consequences of continuing on this path, and then what would be the consequences if they decided to change.

Examples of the kind of questions you could use:

  • “Suppose you don’t change, what is the worst thing that might happen?”
  • “What is the best thing you could imagine that could result from changing?”

Another technique would be to ask your client to compare their current situation and what it would be like to not have the problem in the future.

These types of questions may help:

  • “If you make changes, how would your life be different from what it is today?”
  • “How would you like things to turn out for you in two years?”

Exploring importance and confidence

Gauging how important a patient considers change and how confident they are about that change, are vital to change talk. These two ratings help us to understand how our patient's feel about the change and to what extent they feel it is possible. 

You can continually check these in your conversation with your clients (although don't overdo it) Importance and confidence ratings can be used to get patients to talk about what they would need to do to change. You can use their scores to explore their behaviour.

Examples of how you can explore importance/confidence ratings:

  • “Why did you select a score of [insert #] on the importance/confidence scale rather than [lower #]?”
  • “What would need to happen for your importance/confidence score to move up from a [insert #] to a [insert a higher #]?”
  • “How would your life be different if you moved from a [insert #] to a [higher #]?”