Reasons for Change and Ambivalence — Clinician dialogue

Invite and obtain permission

Offer: "Would it be useful to explore reasons for change and ambivalence using an ordinary or fictional example? We can adapt it, observe, or stop." Ask what the person wants from the conversation.

Elicit before teaching

Ask: "How does this show up, if at all, in your own words?" Offer this idea tentatively: Mixed feelings can be explored without demanding readiness. Ask what fits and what does not.

Guide the task

Place reasons to change, reasons to hesitate, and needed supports in separate columns. Ask for permission before giving an example. Use this fictional illustration if useful: Jordan wants fewer consequences and worries about losing a familiar coping strategy.

Reflect and check accuracy

Reflect only what was offered: "I heard you describe ___. What did I miss?" Ask: What deserves understanding before a next step is chosen? Avoid assigning motives or interpreting silence as agreement.

Respond to a mismatch

If the person rejects the frame, say: "Thank you for correcting it. What would be more useful?" Return to their language or choose a different approach.

Close with agency

Ask which observation, question, or support request the person wants to keep. Confirm a manageable ending and appropriate follow-up; do not turn a tentative possibility into a homework obligation.

Prompts for this resource

1. Readiness, permission, cultural context, and access needs to check:
2. What deserves understanding before a next step is chosen?
3. What would tell me to adapt, stop, or seek supervision?