Think Again

BEYOND THE CLINIC

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Years ago I got a call asking for help from a biotechnology startup. The
CEO, Jeff, was a scientist by training; he liked to have all the necessary data
before making a decision. After more than a year and a half at the helm, he
still hadn’t rolled out a vision for the company, and it was in danger of
failing. A trio of consultants tried to convince him to offer some direction,
and he fired them all. Before the head of HR threw in the towel, she threw a
Hail Mary pass and contacted an academic. It was the perfect time for a
motivational interview: Jeff seemed reluctant to change, and I had no idea
why. When we met, I decided to see if I could help him find his motivation
to change. Here are the pivotal moments from our conversation:
Me: I really enjoy being the guy who gets hired after three
consultants get fired. I’d love to hear how they screwed up.
Jeff: The first consultant gave me answers instead of asking
questions. That was arrogant: how could he solve a problem
before he’d even taken the time to understand it? The next two did
a better job learning from me, but they still ended up trying to tell
me how to do my job.
Me: So why did you bother to bring in another outsider?
Jeff: I’m looking for some fresh ideas on leadership.
Me: It’s not my place to tell you how to lead. What does
leadership mean to you?
Jeff: Making systemic decisions, having a well-thought-out
strategy.
Me: Are there any leaders you admire for those qualities?
Jeff: Abraham Lincoln, Martin Luther King Jr., Steve Jobs.
That was a turning point. In motivational interviewing, there’s a
distinction between sustain talk and change talk. Sustain talk is commentary
about maintaining the status quo. Change talk is referencing a desire,
ability, need, or commitment to make adjustments. When contemplating a

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change, many people are ambivalent—they have some reasons to consider
it but also some reasons to stay the course. Miller and Rollnick suggest
asking about and listening for change talk, and then posing some questions
about why and how they might change.
Say you have a friend who mentions a desire to stop smoking. You
might respond by asking why she’s considering quitting. If she says a
doctor recommended it, you might follow up by inquiring about her own
motivations: what does she think of the idea? If she offers a reason why
she’s determined to stop, you might ask what her first step toward quitting
could be. “Change talk is a golden thread,” clinical psychologist Theresa
Moyers says. “What you need to do is you need to pick that thread up and
pull it.” So that’s what I did with Jeff.