Easy as 1, 2, 3

'''Abstract''': Participants practice offering reflections, affirmations, and asking for elaboration in response to change talk.

'''Overview''': This exercise was developed specifically to help people practice MI-consistent ways of responding to change talk when it occurs.

'''Guidelines''': In order to generate change talk statements as stimuli for this exercise, have all participants think of a change that they are considering making within the next six months, and then have them write down at least four change talk statements about this change. Seven possible categories of change talk statements to consider are:
• D: Why do you want to make this change?
• A: How might you be able to do it?
• R: What is one good reason for making the change?
• N: How important is it, and why? (0-10)
• C: What do you intend to do?
• A: What are you ready or willing to do?
• T: What have you already done?

Then assemble participants in a group of 5 or 6, one of whom may be an observer. They sit in a circle. One person begins by reading a change talk statement to the person on the right. Then the task of that person (on the right) is to reply once with any of three responses, summarized by the acronym EAR:
• E: ask for Elaboration or an Example (in what ways? how? etc.)
• A: offer an Affirmation (agree, encourage, praise, support)
• R: Reflect what the person has said (preferably complex reflection)

The speaker then replies once to this response in whatever way feels nature. After this, the person on the speaker’s right becomes the new speaker. Proceed around the circle until everyone has been the speaker at least twice.

If you are using an observer, have him or her track each 1-2-3- sequence. Was the speaker’s statement (1) change talk? [If you want an additional challenge, what kind of change talk might it be: DARN-CAT.] Then how did the listener respond (2): with E, A, R, or something else? Finally, was how the speaker replied (3) change talk or not [and what kind]?

'''ERA Variation''': After the first round, when everyone has been the speaker once, you can change the listeners’ task. The speaker still offers one change talk statement, but this time the person on the speaker’s right offers an E (elaboration or example) response, to which the speaker replies. Then the speaker repeats the same original change talk statement, and this time the next (second) person to the right offers a complex Reflection, to which the speaker replies. Finally, the speaker repeats the original change talk statement a third time, and the next (third) person to the speaker’s right offers an Affirmation, to which the speaker replies in whatever way feels natural. After this is done, the person to the speaker’s right becomes the next speaker. Continue around the circle until everyone has been the speaker once.

'''Notes''': This is a complex exercise that should be demonstrated first. To begin, the trainer can respond with any EAR response to change talk statements tossed out by trainees. Then the trainer can set up a demonstration circle to show how it works. This is particularly important when using the ERA variation. If more than one circle is practicing, circulate and coach.

Contributed by: Bill Miller and Terri Moyers