Pic 14: The screen transitions to another example conversation between client and health coach.
Client: I’d hate to force my child to exercise more. He loves his video games.
Health Coach: It might be hard for him to adjust to a change. At the same time, you feel his health is important.
Client: Yeah, this would be an easy decision if exercise weren’t important.
Notice how these examples reflect the sustain talk first and the change talk last? People are most likely to respond to the last thing they hear, so it’s best to end with change talk.
Now let’s look at some more examples of double-sided reflections
Pic 15: The screen changes to a slide titled “Identify Double-Sided Reflections.” The slide has an example statement and three response examples as well as the reminder that “Double-sided reflections highlight ambivalence, reflecting sustain talk first and change talk last.” The example statement reads “I wish Mary would eat more vegetables, but she’s only three. I just don’t want dinner to be a battle.”
- You want her to eat more vegetables, but she doesn’t like them.
- This does reflect both sides of the parent’s ambivalence. However, the statement ends with sustain talk, so she’s likely to respond to that instead of the change talk. It would be better to end with change talk.
- You don’t want to make dinner difficult, but you would like her to eat more vegetables.
- This is a good response. It accurately reflects both sides of the parent’s ambivalence. It ends on change talk, so the parent is likely to respond with more change talk.
- It’s stressful to get her to try vegetables, but there are obvious health benefits.
- This follows the format of a double-sided reflection, but it doesn’t reflect what the parent said. Instead of highlighting her ambivalence, this statement attempts to resolve it and make a decision for her. It’s more motivating for parents to come to their own conclusions.
Pic 16: The screen transitions to the next example statement and responses, with the statement being “I used to jog almost every day. It felt great and I had more energy. But now I never geta break from the kids.”
- On one hand, running has worked well for you in the past. On the other hand, it’s hard to find time.
- This does reflect both sides of the client’s ambivalence. However, it ends with sustain talk, so the client is likely to respond to that instead of the change talk. It would be better to end with change talk.
- On one hand, it’s hard to find time to exercise. On the other hand, you have to get more activity.
- This statement seems to end with unsolicited advice. Instead, a double-sided reflection should highlightthe client’s arguments both against and for change.
- On one hand, it’s hard to find time to exercise. On the other hand, running has worked well for you in the past.
- Good! That reflection captures the client’s ambivalence and ends on change talk, encouraging the client to resolve the discrepancy between their values and actions.
Pic 17: The screen transitions to the next set of examples, with the statement being “I try to cook healthy meals. It’s not my fault the kids only like chicken nuggets.”
- Your kids prefer particular foods. At the same time, they need to eat foods that are healthy, too.
- This is advice and not a reflection. It might cause the parent to disengage or give a “Yes, but…” response. Instead, a double-sided reflection should highlight the parent’s arguments both against and for change.
- You want the kids to eat well. At the same time, chicken nuggets are an easy option.
- This does sum up this parent’s ambivalence. However, it ends with sustain talk, so the parent is likely to respond to that instead of the change talk. It would be better to end with change talk.
- You want to serve food the kids like. At the same time, you want them to eat healthy food.
- Yes! This describes this parent’s dilemma, ending on change talk. People often have the ability to resolve their ambivalence and make healthier decisions, requiring little more than gentle guidance from us.
Pic 18: The screen transitions to the next set of examples with the statement being “Ever since Emily lost weight, she’s been obsessed with counting calories. Should I be worried?”
- On one hand, you’re glad Emily is thinking about what he eats. On the other, you want to make sure she’s doing it in a healthy way.
- Right! That statement reflects this parent’s ambivalence and ends by focusing on what might need to change.
- On one hand, you’re worried about eating disorders. On the other, Emily did need to lose weight.
- By ending with the speaker’s own opinion (“Emily did need to lose weight”), this reflection doesn’t help the parent resolve their own ambivalence.
- Do you think Emily has an eating disorder?
- By asking a question, the speaker pushed this parent to make a yes or no choice before they’ve finished exploring all of their feelings
Pic 19: The screen changes to a new one titled “Affirmations” with an image of a thumbs-up emoticon underneath.
Eva: Another technique is giving affirmations. Affirmations recognize and acknowledge a person’s strengths, efforts, or good intentions. Even unsuccessful attempts at change can be affirmed. Any progress, no matter how minor, is a predictor of future success.
Here are some examples.
Pic 20: The screen transitions to one titled “Examples of Affirmations” which contains two different conversations between a client and a health coach told through word bubbles.
Client: I want to eat healthier, but I don’t know if I can completely stop eating fast food.
Health Coach: You’re really taking this seriously. Healthy eating is very important to you.
Client: Well, I just want to take care of myself.
Client: I’d hate to force him to exercise more. He loves his video games.
Health Coach: This isn’t a quick or easy decision when you care so much about making the best choices for Zach.
Client: I know, maybe there’s a way I can explain it to him.
With affirmations, you’re trying to “catch them doing something right.” This serves two purposes: it shows your interest in and respect for the client, which can make them more receptive. And drawing attention to their positive accomplishments or intentions can remind them that they have the power to change.
