Basic Steps toward Self Motivation

1. Elicit agreement with the patient that it is acceptable to talk about behavior change for any issue.

2. Ask what the patient sees as positive aspects of his or her current behavior, then ask about the negative aspects.

3. Use the motivational RULE to assess how important it is now for the patient to make a change in the target behavior."

4. Ask how confident the patient is about making a change.

5. Resolve ambivalence. Revise the degree of anticipated change in the target behavior until the patient's confidence level is 7 or higher. If this is not possible, explicitly acknowledge that this may not be a good time to undertake change in this area.

6. Close the encounter with encouragement toward the patient's stated goal or an offer to be of assistance whenever the patient is ready.

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