You ask: On a scale of 1 – 10 with 1 being not at all important and 10 being extremely important, how important is it for you to cut down on your drinking?
Client says: Well, I'm about a 4.Readiness Ruler
The readiness ruler is a tool and conversational method where you ask the patient/client to rate on a scale from 1 to 10, their:
- Importance of making a change
- Willingness to change
- Commitment for taking action
- Confidence to change/take action
- Readiness to change
The readiness ruler is a window into your patient/client's perceptions of how they feel about change. It not only elicits change talk, it's an excellent, quick method whereby your clients feel you are listening.
TAP on the following examples to see how to use the ruler.
Example 1: Importance
You respond: Tell me why a 4 and not a 2?
(You are evoking positive reasons for change; if you ask why a 4 and not a 5, your client will likely be on the defensive.)Based on the client's answer you can focus on his/her strengths, which will help in the motivation process. The examples below follow this philosophy.
Example 2: Willingness
You ask: On a scale of 1 – 10 with 1 being not at all willing and 10 being extremely will, how willing are you to consider cutting down on your drinking?
Client says: I'm a 3.You respond: Tell me why a 3 and not a 2?
(Again, this evokes positive reasons for change.)
Example 3: Commitment
You ask: On a scale of 1 – 10, how committed do you feel to making this change?
Client says: About a 5.You respond: Tell me why a 5 and not a 3.
Example 4: Confidence
You ask: On a scale of 1 – 10, how confidant are you that you can cut back on your drinking?
Client says: I'm at a 7.You respond: Tell me why you selected 7 and not 5.
Example 5: Readiness
You ask: On a scale of 1 – 10, with 1 being not at all ready and 10 being extremely ready, how ready are you to cut down on your drinking?
Client says: I'm about a 6 on the scale.You respond: Why did you choose a 6 and not a 4?
It's important to remember not to put your client on the defensive by asking them what would it take to get you to a higher number. MI works by evoking change recognized by your client/patient. By asking why your client/patient has selected a number higher than another, they focus on their strengths and abilities to change.