Page 130 - Nutrition Counseling and Education Skills: A Guide for Professionals

Summarizing

Summaries by the counselor help to organize the client’s thoughts about change, such as client experiences,
suggestions, and strengths, or the practitioner may pull together something discussed. Summary reflections
should draw together and deliver back to the client any mention of changes that should help the client in
moving forward toward a commitment. One gives special weight to client “change talk” in summaries. For
example: “Here’s what I’ve heard you tell me so far.”7 Summarizing shows that you are listening and may help
clients integrate their thoughts (See Box 6-2). Thus, conversations start with open-ended questions and
reflections, affirmations, summaries, recognize change talk, and move the client toward change.11

OARS Skills Communicating
Open-ended Questions Asked Asking
Affirmations Listening
Reflective Listening Informing
Summarizing

Box 6-2 ■ Motivational Interviewing Skills: OARS Strategy.

Client Change Talk
Many people are uncertain about how they feel about a behavior change. A guiding principle of MI is that
behavior change will be more likely if clients verbalize their own arguments and reasons that favor a needed
behavior, called client “change talk.”6,7,12 Change talk may be defined as client statements that suggest the
target behavior change, such as “I’m going to cook less fried foods to help my weight.” Reasons for change, for
example, may be discontent with the current situation or seeing the advantages of change. The counselor may
ask what the client wants to change and then how he or she plans to do it. This approach requires careful
listening.

CASE ANALYSIS 5

How would you evoke “change talk” from Robin?

The client does most of the talking. The MI counselor focuses on the client’s concerns and elicits client
“change talk” to decrease resistance to change. The counselor listens for statements starting with “I want to . .
.,” “I could . . .,” “I need to . . .,” or “I intend to . . .” 7 The counselor may ask what problems concern the
person or do a benefit analysis of the possibilities for change. It is important to follow up “change talk” with
the reflective listening, reflecting back what the client said to express your interest and invite the client to
elaborate.6

The emphasis on eliciting certain phrases from the client, or “change talk,” is unique to MI. The strength
and commitment of the talk is predictive of behavior change. Since many clients are uncertain about making

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