Elicit and Reinforce Client’s Readiness To Change

When the client expresses motivation to change, the counselor acknowledges these expressions, seeks elaboration, and offers reinforcement:

C: You said that your smoking has caused problems including feeling that you have lower energy. Could you tell me about that?

Miguel (M): I find I mean to do things, but they never get done. It seems that I’m tired all the time. I can’t help but think it’s related to my smoking.

C: Related to your smoking?

M: I don’t think it affected me when I was young. But now, well, I’m not getting any younger!

C: You think smoking is affecting you more as you get older. You feel less productive.

M: I think that’s related to the lower energy. I don’t finish my work at my job, and I’m not as creative. I feel that I’m drowning in backed-up work at home, at my job, everywhere.

C: And you think that if you quit smoking, you will increase your productivity.

M: Yeah.

C: That’s important to you. You’d like to regain your creativity and productivity.

M: I really would like that.

Assist Client in Preparing for Change

The counselor assists the client in preparing to stop using marijuana by discussing several key issues. If the client has not stopped already, he or she needs to select a day to stop. The counselor helps the client consider several alternative stop dates.

Topics to consider include what the client will do with his or her marijuana supply and paraphernalia, how the client will disclose the plan to stop to family and friends (both supporters and those who might sabotage the client’s efforts), and how the client will address possible problems in maintaining abstinence (e.g., sleep difficulties, boredom, anxiety, restlessness) in the first week.