A technique for the structured exploration of ambivalence: client and therapist together study the pros and cons of changing and not changing. The classic 2×2 matrix: good in the current behavior, bad in the current behavior, good in change, bad in change. Important: with an ambivalent client the technique can entrench ambivalence — use with care.
Step-by-step guide
- Introduce the technique: "Let's try to look at the situation from different sides."
- Explore the pros of the current behavior — start here, the client feels heard
- Explore the cons of the current behavior
- Explore the pros of change
- Explore the cons of change
- Summarize both sides — finish on change talk
When to use
- When the client themselves speaks of "two sides"
- When the client has already decided to change — for consolidation
- At the start of work, as an instrument for understanding the client's position
Key phrases
What is good for you about continuing to drink? I want to see the whole picture.
Follow-up questions
Now tell me — what troubles you about it?
Let's look at the other side — what would be better if you stopped?
Alternative phrasings
Let's write out both sides and see what comes of it.
Warnings
- ⚠️ With an ambivalent client this may entrench ambivalence — use carefully
- ⚠️ Do not dwell on the cons of change — finish on arguments in favor of change
- ⚠️ Do not turn it into a mechanical exercise
Source: Miller & Rollnick, 2013
Materials are informational and educational and summarize publicly available scientific sources. They are not medical or psychological advice, are not intended for self-diagnosis or self-treatment, and do not replace consultation with a qualified professional.