Page 134 - Nutrition Counseling and Education Skills: A Guide for Professionals

Useful Questions to Explore Importance

What would have to happen for it to become more important for you to change?
What would have to happen before you seriously considered changing?
How important is this change on a scale of 1 to 10, with 10 the highest?
What would need to happen for your importance score to move up from . . . to . . .?
What stops you moving up from . . . to . . .?
What are the motivators to retain your (current behavior)?
What are some of the concerns you have (or things you dislike) about . . . (current behavior)?
If you were to change, what would it be like?
Where does this leave you now? (When you want to ask about change in a neural way).

Useful Questions to Build Confidence

What would make you more confident about making these changes?
How confident are you about accomplishing this change?
How could you move up higher, so that your score goes from . . . to . . .?
How can I help you succeed?
What have you found helpful in any previous attempts to change?
What have you learned from the last time you tried this type of change?
If you were to decide to change, what might your options be? Are there any ways you know about that

have worked for other people?
What are some of the practical issues you would need to address in order to achieve this goal? Do any of

them sound achievable?
Is there anything you can think of that would help you feel more confident?

Box 6-3 ■ Assessing Importance and Confidence of the Patient/Client.

Source: Adapted from Rollnick S, Mason P, Butler C. Health Behavior Change—A Guide for Practitioners. New York, NY: Churchill Livingston;
1999.

Finally, the counselor can assess the importance, such as on a 10-point scale, as well as assess the client’s
confidence in the change. For example: “On a scale of 1 to 10 with 10 highest, how important is it to change
your food intake and lose 10 lb?” Secondly, one may ask how the client selected a number, such as 5, thus
eliciting more “change talk.” An alternative is to ask what would have to happen to make the number larger,
such as 7 or 8 instead of 5.

Then the counselor may assess the client’s confidence. “On a scale of 1 to 10 with 10 highest, how
confident are you that you can make the changes you discussed with me?” If the client replies 5, another
change or goal should be explored. Or ask what would have to happen to move it up to a 7 or 8. A client
whose rating is high in importance, but lower on confidence may need helpful ideas.

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