A technique for evoking change talk through the exploration of extreme scenarios: the worst (if nothing changes) and the best (if the change happens). Especially useful when the client shows low desire to change or minimizes the problem. Questions about extremes help the client step outside habitual thinking and see the full range of consequences.
Step-by-step guide
- Worst scenario: "Suppose you go on living this way. What is the worst that could happen?"
- Let the client describe the worst — do not interrupt, do not soften
- Reflect what you heard
- Best scenario: "And now — if everything worked out. What would be the best result?"
- Summarize both poles, finishing on the positive scenario
When to use
- When the client minimizes the seriousness of the situation
- In low levels of desire (to change)
- When other techniques for evoking change talk are not working
- In work with addictions and risk-taking behavior
Key phrases
If you go on as now — what, in your view, is the worst that could happen?
Follow-up questions
And if it all worked out and you changed it — what would be the best possible result for you?
What do you feel when you think about these two pictures?
Alternative phrasings
In the worst case — what will happen if everything stays the same?
Warnings
- ⚠️ Do not overuse negative scenarios — they can trigger fear and avoidance
- ⚠️ Make sure you finish on the positive pole
- ⚠️ Do not turn this into fear appeal — that does not work in MI
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.