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Use decisional balance to surface ambivalence

Asking clients to weigh the good and not-so-good of both changing AND staying the same surfaces ambivalence honestly — and lets the client, not the coach, argue for change.

When to use this
Mid-sessionHandling resistanceGoal setting
  • When a client has been saying they want to change for weeks or months without action
  • When you notice yourself working harder than the client to make change happen
  • When a client is genuinely torn between two paths and can't see why
  • When previous attempts at change have failed and the client doesn't understand why
Why this matters

When a client says they want to change but isn't acting on it, the temptation is to push harder on the reasons to change. This usually backfires. Ambivalence is not the absence of motivation — it's the presence of two competing motivations. There are real reasons the client hasn't changed yet, and ignoring them doesn't make them go away.

Decisional balance is a structured way to bring both sides into the open. Rather than only asking "why do you want to change?", you also ask "what's good about how things are now?" and "what would you miss?" This sounds counterintuitive — why give airtime to the status quo? — but it works because clients feel understood rather than sold to. When the full picture is on the table, clients tend to argue themselves toward change, which sticks far better than being argued into it.

The technique fits within motivational interviewing as one tool among several. Use it when ambivalence is genuinely blocking progress, not as a routine exercise.

In practice

A client has said for months they want to leave a job that drains them, but never applies anywhere. Coach: "Let's map this out together. What's good about staying in your current role? What would you miss if you left?" Client lists: predictable income, friendships, knowing the work cold. "And what's not so good about staying?" Client: "I dread Sunday nights. I haven't learned anything new in two years." The client hears their own answers, pauses, and says: "When you put it like that, the staying side is mostly fear, isn't it?" That sentence didn't come from the coach — it came from the client seeing the balance for themselves.

What to say

Word-for-word phrases you can use in session.

  • What's good about how things are right now?
  • What's not so good about how things are right now?
  • What would be good about making this change?
  • What would be hard, or what would you miss, if you made this change?

Ask all four — skipping the "good about staying" or "hard about changing" sides is the most common mistake. Those are exactly the cells where the real ambivalence lives.

Source: Miller, W.R. & Rollnick, S. (2013). Motivational Interviewing: Helping People Change (3rd ed.). Guilford Press.

Try it today

With a client who is stuck in ambivalence, draw a 2x2 on a notepad: "good about staying / not-so-good about staying / good about changing / not-so-good about changing". Fill it in together. Resist the urge to argue for any cell — just let the client see the whole picture.

Make it a habit

Whenever you notice yourself trying to convince a client of something, stop and ask the four decisional balance questions instead. Track over time how often the client lands on change without you having to push.

Watch out for
  • Loading the question — "What's *really* good about staying stuck?" — the sarcasm signals you've already decided, and the exercise collapses.
  • Treating decisional balance as a persuasion tool. If you're using it to push the client toward your preferred answer, you're not doing MI anymore.
  • Using it routinely with clients who are already committed to change — at that point it can introduce doubt where there wasn't any. Reserve for genuine ambivalence.
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