I often hear that one must be committed to working on a goal before engaging in therapy, however, I believe this is not necessary. In truth, a person often decides to attend therapy because he or she is ambivalent about a difficult choice. It is important to remember that a person engages in unhealthy behaviors because those behaviors work for him or her, and there is an underlying reason for the behavior. Additionally, an individual may choose not to engage in healthier behaviors because there may be a perceived cost to making a more positive decision. As a therapist, the majority of my work with clients is helping them process ambivalence. From experience, I have learned that if I push a client to action too quickly, he or she is less likely to return for a follow-up visit.
I utilize a variety of approaches to help a client work through ambivalence. One approach I utilize is a tool from motivational interviewing: a pros and cons list. People often complete pros and cons lists for a variety of reasons and I utilize this process to implement an intervention. First, I have clients list the pros and cons of maintaining their current behavior. Then I have the client consider and list the pros and cons of an alternative, healthier behavior. After both lists have been created and reviewed, I have clients identify the items they value most on each list. Finally, I help clients explore any feelings they may experience if they were to make a change, and any feelings they may experience after the outcome has been achieved. A person may be unwilling to alter a behavior to avoid immediate painful feelings, even though he or she may feel better long-term.
The above intervention is one example of how I help a client process ambivalence. This intervention may take several weeks to a few months to complete. I continuously remind myself no one is fully committed to change when they first engage in therapy. Even though making a change and modifying behavior can be hard, with good support a person can make healthier decisions that can improve overall happiness and well-being.
ABOUT JAMES OGLE
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