1.25 CE Credits Available
Resolving Ambivalence in Motivational Interviewing
by Cathy Cole
Learn Motivational Interviewing's tools and techniques for helping clients fully explore their ambivalence as a critical part of the change process.
Ambivalence is often at the heart of our struggles to embark upon change. Motivational Interviewing, a widely used methodology in diverse settings, employs specific tools and techniques to help clients fully explore their ambivalence as a critical part of the change process—since it is ultimately their decision whether to change or not.
In this third video in the series Motivational Interviewing Step by Step, expert MI practitioner and trainer Cathy Cole conducts three full-length demonstration sessions where the focus is on fully exploring both sides of ambivalence. Extensive commentary and pre- and post-session interviews help viewers understand the strategies and guiding principles of MI.

Jim has been offered a job promotion that would ease his family’s financial struggles but require extensive travel. In her role as an EAP counselor, Cole guides Jim’s exploration of his options and leads him into next steps, all the while maintaining her neutrality about his career decision.

Holly has mixed feelings about when to stop breastfeeding her son. As a health educator, Cole skillfully provides information in a collaborative manner that reinforces Holly’s autonomy and supports her in making a decision that’s right for her.

Kathy is reluctant to stop smoking but concerned about her health. Cole avoids the trap of trying to convince her to change, and strategically capitalizes on the subtle shift between “sustain talk” and “change talk” in order to help Kathy establish a change plan.

By watching this video, you will be able to:
  • Learn MI strategies useful with clients stuck in ambivalence.
  • Recognize the difference between sustain talk and change talk.
  • Identify specific techniques used to reinforce change talk and move toward a change plan.

What therapists are saying…

“In this video Cathy Cole deepens the understanding of motivational interviewing by demonstrating its use across a variety of settings. She offers her personal reflections on the how's, why's, and when's of MI practice and does so in an authentic and insightful manner. A must see for the new and the not-so-new MI practitioners.”

—Anya Sheftel, MS, Motivational Interviewing Trainer and Consultant, Eugene, Oregon
“I showed the smoking cessation session during the recent training I offered for medical students, and the students’ responses were uniformly positive. Although they were most struck by how good Cathy Cole is at MI, and how powerfully beneficial MI can be for patients approaching difficult behavior changes, they also discussed the ways in which the commentary before, during, and after the session helped increase their understanding of MI.”

—Julie Schumacher, PhD, Reviewed in Motivational Interviewing: Training, Research, Implementation, and Practice
In Depth
CE Test
We all know what it feels like to be ambivalent and how difficult it can be to move forward when we have mixed feelings about making a change. You want to exercise more, but you also want time to watch television and relax. You want to stop smoking, but you enjoy the feeling it gives you. When people are ambivalent about making changes, telling them what to do won’t help. What most of us need when we’re ambivalent is a space to explore both sides of our dilemma, and that is exactly what Motivational Interviewing provides.

In this video, expert MI trainer Cathy Cole addresses common concerns clinicians face when working with people who are ambivalent, such as:
  • How do I remain neutral when I have a strong opinion about what my client should do?
  • How do I decrease the likelihood that my clients will get defensive when I give them feedback about their behavior?
  • When should I be directive and when should I follow the client’s lead?
Cole sheds light on these questions and many more, teaching viewers how to facilitate clients’ exploration of their dilemmas, how to reinforce change talk, and how to respond effectively when clients express their reasons for not wanting to change. Learn core MI techniques for resolving ambivalence such as double-sided reflections, decisional balance, and envisioning. By watching Cole skillfully engage each of the three clients and listening to her voiceover commentary, you will gain a deep understanding of what MI is, how to use it with ambivalent clients, and why it is such a powerful and widely-used approach to behavior change.

For a comprehensive understanding of Motivational Interviewing, we recommend that you view the complete series, Motivational Interviewing Step by Step. Note that this is the third video in that series, and while you will learn a lot by watching only this one, you will get a much fuller understanding of the approach by viewing all of them. For a complete introduction to the fundamental principles and techniques of MI, we particularly recommend starting by watching the first video in the series, Core Concepts in Motivational Interviewing. 

Length of video: 1:42:00

English subtitles available

Individual ISBN-10 #: 1-60124-316-2

Group ISBN-10 #: 1-60124-317-0

Group ISBN-13 #: 978-1-60124-317-1

Cathy Cole, LCSW, has trained thousands of diverse professionals in MI since 1995, and is a member of the Motivational Interviewing Network of Trainers. She maintains an active clinical practice.

See all Cathy Cole videos.

CE credits: 1.25

Learning Objectives:

  • Describe MI strategies that are useful with ambivalent clients
  • Describe the difference between sustain talk and change talk
  • Apply specific MI techniques in building a therapeutic change plan

Bibliography available upon request

This course is offered for ASWB ACE credit for social workers. See complete list of CE approvals here

© 2012

Course Reviewed January 2024

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