Readiness is not just about want. It’s also about personal motivation. It’s possible to see what’s important, identify that as a personal goal and also not be ready to do it. 

In motivational interviewing, a big part of our job is to ask the questions that will help our patients get closer to the why of their goal. The hope is that the better connected someone is to how it will impact their life, the closer it will get them to feeling prepared to make a change towards that goal.

When we use open-ended questions along with active and reflective listening, we’ll start to hear where attempts at achieving these goals fall short. 

What might be seen on the surface as a form of carelessness, suddenly begins to sound a lot more like something else. Maybe your patient’s lack of readiness is a fear of failure, a lack of home support or even just good old-fashioned “I don’t want to”. 

Though you might not agree with the reasoning behind it, being able to accept your patient’s level of readiness using empathy and non-judgmental language is key to providing the support your patient is ready to receive.

The Readiness For Change scale is a great reference for these moments. It can help us get a clearer understanding of what our patients are both willing and prepared to do – and what they’re not.

As you’re asking questions, listen for clients who are experiencing:

• High amounts of ambivalence (mixed feelings about change overall)
• Low confidence levels (doubting their ability to make a change)
• Low levels of desire (unclear if they want to change)
• Low amounts of importance (unclear on the benefits/disadvantages of making a change)

These are some of the indicators that your patient just isn’t ready to move forward with change that’s big, new or different. And that’s ok. 

It’s not our job to force our patients into change they’re not ready for. Our job is to gently and without judgement allow our patients to create change objectives at their own pace.