Scripting the Shift – Language That Moves People Between Stages
The Power of Prescriber Language
Brief clinical encounters can still ignite change when language is intentional. What we say as prescribers can nudge a patient forward—or stall them. Research on Motivational Interviewing and behavior change highlights that evoking “change talk” significantly increases follow-through (Miller & Rollnick, 2013).
Tailored Language for Each Stage
Precontemplation → Contemplation:
“Tell me if it would be okay if we talked about how this might affect your health?”
“I’m not here to push you, just to understand where you’re at.”
Contemplation → Preparation:
“Tell me what would be the first small step if you were to move forward.”
“Tell me what’s making this hard to decide.”
Preparation → Action:
“Tell me what needs to happen today to support your plan.”
“Let’s troubleshoot any barriers together.”
The Anatomy of a Shift: Evoke → Reflect → Ask
Evoke: Bring forth the person’s own reasons for change.
Reflect: Echo and reinforce what they say.
Ask: Offer a targeted, nonjudgmental question to move them forward.
Examples from Practice
“You’ve been cutting back, even if not fully stopping. Tell me what that has been like.”
“It sounds like part of you wants to change, and part of you is unsure.”
“Tell me what would tell you it’s time to take the next step.”
Tool: Scripting Cheat Sheet by Stage
Why This Matters Clinically
Subtle shifts in language can support engagement, reinforce autonomy, and increase behavior change. Even one sentence can help a patient go from resistance to readiness (Resnicow et al., 2002).
Scientific References
Miller, William R., and Stephen Rollnick. Motivational Interviewing: Helping People Change. 3rd ed., Guilford Press, 2013.
Resnicow, Ken, et al. “Motivational Interviewing in Health Promotion: It Sounds Like Something Is Changing.” Health Psychology, vol. 21, no. 5, 2002, pp. 444–451. https://doi.org/10.1037/02786133.21.5.444.