“Try the Decisional Balance” has become such an important daily reminder for me. I'm naturally inquisitive and love spending time researching subjects that interest me. While this curiosity is a strength, it can sometimes interfere with my daily schedule and cause delays.
To manage this, I’ve learned to apply MI techniques to myself. I gently say, “Hey, it’s fun to learn something new, isn’t it? We can continue this fun tonight when we can fully relax and enjoy some quality time. Doesn’t that sound good to you?”
It works for me every time, and I love sharing this strategy with my clients.
I’m naturally inquisitive too and I can be in the same boat that you can find yourself in. Thank you for this helpful tip and reminder that it is not that we cannot do a deep dive later it just means for right now. Great and thank you Pei Fen! :)
Decisional Balance can seem to take on a life of its own. Living in the complexity of both sides of the coin. Which way will the sea-saw lean. This is not a liner path and being up close and personal to the clients experience can support the way forward. Timing and sensitivity to what unfolds influences the outcome.
Rethinking Decisional Balance in Motivational Interviewing
In the world of MI, decisional balance—the classic pros and cons list—is often mistaken for a core technique. In truth, Miller and Rollnick have long advised caution. While decisional balance can create space for clients to explore ambivalence, it can also unintentionally reinforce the status quo. When both sides of a dilemma have equal weight, clients may feel more stuck than supported, holding tightly to the familiar instead of moving toward change.
Still, decisional balance is not without value—particularly when approached with nuance and deep respect for client autonomy. Over the past year, under Sky’s tutelage, I’ve come to see a powerful way to work with sustain talk, especially when clients are in pre-contemplation or early contemplation. Rather than rushing to elicit change talk, I’ve learned to linger in the client’s experience of what’s working. I invite them to speak freely about the appeal of the status quo. This isn’t a technique—it’s an act of acceptance.
In a world where many clients have been judged, pressured, or “fixed,” showing genuine curiosity about what keeps them where they are can build something essential: trust. When I demonstrate that I won’t push or persuade, clients often open up. They feel safe enough to explore both sides of their ambivalence—sharing the costs of staying the same or hopes they quietly hold for change. In these moments, change talk arises not because I’ve evoked it but because the client feels safe enough to voice it.
Even when a client has moved into later stages of change, I pay close attention to any return of sustain talk. When it resurfaces, I gently return to the engaging task, making room for the client to explore what’s still unresolved. We give the status quo the attention it deserves—not to reinforce it, but to honor its role in the client’s story. From there, we return to evoking change talk, now with more clarity and trust.
At its core, MI is a method for evoking change talk and strengthening motivation. But that doesn’t mean we ignore sustain talk or avoid decisional balance. Used skillfully, they can deepen rapport, model respect, and create the safety needed for authentic exploration. I’m encouraged by this evolving understanding within the MI community. It reflects what I’ve seen in my practice: that sometimes, the way forward begins by standing still—with empathy, curiosity, and a willingness to walk alongside.
Today when a client began talking about the downside to cooking healthy foods at home ("wasting time cooking" rather than running out for fast food) I was able to ask questions about her values that are connected to each side. She was able to realize on her own that while she values her time, she's got more than enough of it right now while in between jobs, and that she also values her health and the changes she's making. She came to the conclusion that there is "actually no loss here" despite her original complaint, as she enjoys cooking, has plenty of time to do it, and loves that she's making positive changes toward a healthier lifestyle.
Such a beautiful and moving conversation today in MI Snack. I’m truly grateful for all the wisdom. The touching stories. I am definitely seeing ambivalence differently. And I have so much to take away to use in my own MI day to day as well as my future practice. ❤️. My heart has been touched.
“Try the Decisional Balance” has become such an important daily reminder for me. I'm naturally inquisitive and love spending time researching subjects that interest me. While this curiosity is a strength, it can sometimes interfere with my daily schedule and cause delays.
To manage this, I’ve learned to apply MI techniques to myself. I gently say, “Hey, it’s fun to learn something new, isn’t it? We can continue this fun tonight when we can fully relax and enjoy some quality time. Doesn’t that sound good to you?”
It works for me every time, and I love sharing this strategy with my clients.
I’m naturally inquisitive too and I can be in the same boat that you can find yourself in. Thank you for this helpful tip and reminder that it is not that we cannot do a deep dive later it just means for right now. Great and thank you Pei Fen! :)
Decisional Balance can seem to take on a life of its own. Living in the complexity of both sides of the coin. Which way will the sea-saw lean. This is not a liner path and being up close and personal to the clients experience can support the way forward. Timing and sensitivity to what unfolds influences the outcome.
Rethinking Decisional Balance in Motivational Interviewing
In the world of MI, decisional balance—the classic pros and cons list—is often mistaken for a core technique. In truth, Miller and Rollnick have long advised caution. While decisional balance can create space for clients to explore ambivalence, it can also unintentionally reinforce the status quo. When both sides of a dilemma have equal weight, clients may feel more stuck than supported, holding tightly to the familiar instead of moving toward change.
Still, decisional balance is not without value—particularly when approached with nuance and deep respect for client autonomy. Over the past year, under Sky’s tutelage, I’ve come to see a powerful way to work with sustain talk, especially when clients are in pre-contemplation or early contemplation. Rather than rushing to elicit change talk, I’ve learned to linger in the client’s experience of what’s working. I invite them to speak freely about the appeal of the status quo. This isn’t a technique—it’s an act of acceptance.
In a world where many clients have been judged, pressured, or “fixed,” showing genuine curiosity about what keeps them where they are can build something essential: trust. When I demonstrate that I won’t push or persuade, clients often open up. They feel safe enough to explore both sides of their ambivalence—sharing the costs of staying the same or hopes they quietly hold for change. In these moments, change talk arises not because I’ve evoked it but because the client feels safe enough to voice it.
Even when a client has moved into later stages of change, I pay close attention to any return of sustain talk. When it resurfaces, I gently return to the engaging task, making room for the client to explore what’s still unresolved. We give the status quo the attention it deserves—not to reinforce it, but to honor its role in the client’s story. From there, we return to evoking change talk, now with more clarity and trust.
At its core, MI is a method for evoking change talk and strengthening motivation. But that doesn’t mean we ignore sustain talk or avoid decisional balance. Used skillfully, they can deepen rapport, model respect, and create the safety needed for authentic exploration. I’m encouraged by this evolving understanding within the MI community. It reflects what I’ve seen in my practice: that sometimes, the way forward begins by standing still—with empathy, curiosity, and a willingness to walk alongside.
Today when a client began talking about the downside to cooking healthy foods at home ("wasting time cooking" rather than running out for fast food) I was able to ask questions about her values that are connected to each side. She was able to realize on her own that while she values her time, she's got more than enough of it right now while in between jobs, and that she also values her health and the changes she's making. She came to the conclusion that there is "actually no loss here" despite her original complaint, as she enjoys cooking, has plenty of time to do it, and loves that she's making positive changes toward a healthier lifestyle.
Such a beautiful and moving conversation today in MI Snack. I’m truly grateful for all the wisdom. The touching stories. I am definitely seeing ambivalence differently. And I have so much to take away to use in my own MI day to day as well as my future practice. ❤️. My heart has been touched.