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Thinking About Change? How Motivational Interviewing Can HelpThinking About Change? How Motivational Interviewing Can Help
If you’ve ever found yourself thinking “Part of me wants to change… but part of me’s not sure”, you’re not alone. That back-and-forth, weighing things up—“Should I? Shouldn’t I?”—is a normal part of how people process big (and small) decisions. In counselling, this is called ambivalence, and rather than seeing it as a barrier, Motivational Interviewing (MI) treats it as a starting point for meaningful conversations.
What Is Motivational Interviewing?
Motivational Interviewing is a counselling approach that helps people explore their own reasons for change, without pressure or judgment. It’s a respectful, supportive way of helping you work through the push-pull that often comes with making decisions. You’re in the driver’s seat—we’re just here to help you navigate.
You might hear MI described in different ways:
In simple terms:
“MI is a collaborative conversation style that helps strengthen your own motivation and commitment to change.”
In practice:
“MI is about helping you make sense of mixed feelings and explore what’s right for you—based on your values, your goals, and your life.”
MI isn’t about telling you what to do. It’s about listening deeply, asking thoughtful questions, and helping you make sense of where you’re at—and where you might want to go.
Why It’s Not Just a Quick Fix
While MI can be used in short sessions, the research shows it works best when there’s time to really explore your thinking. In studies where people had just one 15-minute session, the outcomes were decent. But when they had more time—say, several sessions of an hour—the results were much stronger. That’s probably because real change often takes time, reflection, and a bit of back-and-forth.
MI originally started in the health world—helping people reduce alcohol use, manage weight, or improve their health. More recently, it’s been used to address things like vaccine hesitancy. But MI isn’t just for health issues. It can also help with things like relationship struggles, career decisions, or anything where you might feel stuck or unsure.
Ambivalence Is Normal
Let’s say you’re thinking about quitting smoking, leaving a relationship, or starting something new. You might feel torn—part of you is ready, and another part isn’t. That’s ambivalence.
MI offers tools to help with this, including something called the Decisional Balance, which simply helps you look at both sides: What are the good things about staying the same? What are the reasons you might want to change?
But here’s the thing—MI isn’t about pushing you toward a particular outcome. If you’re trying to make a decision where there’s no obvious “right” answer—like whether to stay in a relationship—the counsellor stays neutral. They don’t steer you in one direction. Instead, they help you explore what matters to you.
Talking Your Way Toward Change
One of the interesting things about MI is how it pays attention to the language you use when you talk about change.
Some of the things people say when they’re starting to think about change include:
- “I probably should cut down…”
- “I’d like to feel better about this…”
- “I don’t know if I can keep doing this…”
These kinds of statements are called change talk—and they’re actually signs that something inside you is shifting. MI aims to gently encourage and grow this kind of talk, because research shows that the more someone talks about change, the more likely they are to act on it.
There’s also sustain talk, which sounds like:
- “I don’t smoke that much…”
- “I know I should, but it helps me relax.”
- “Now’s not really the right time.”
Both are normal. In MI, there’s no need to rush. Instead, the focus is on listening to both sides of you—and helping you get clearer about what you want to do next.
Getting Skilled Support
Like any professional approach, MI works best when the counsellor is trained and skilled in using it. Some practitioners have their sessions reviewed (with consent) by independent experts to make sure the spirit and skills of MI are being used well.
If you ever hear a practitioner say they “do MI”, you can ask what that looks like. The most effective use of MI goes beyond just asking open-ended questions or offering summaries—it’s about how your counsellor supports you in finding your own reasons for change.
What a Session Might Involve
Motivational Interviewing tends to follow a flexible process with four key parts:
- Engaging – Building trust and understanding
- Focusing – Exploring what matters most to you
- Evoking – Drawing out your own reasons for change
- Planning – When you’re ready, looking at possible next steps
You don’t have to go through these in a straight line. Some days you might focus on one step, then circle back to another later. It’s all guided by you—your pace, your readiness, your goals.
In Summary
If you’re feeling uncertain about making a change—or you’ve been thinking about it for a while but haven’t quite landed on what to do—Motivational Interviewing could be a really helpful way to explore things.
It’s not about being told what to do, and it’s not about “fixing” you. It’s a respectful, evidence-based approach that helps people work through their own ambivalence, connect with what matters to them, and move toward change when they’re ready.
Change doesn’t have to be instant. And it doesn’t have to be perfect. But it can start with a conversation.
Biopsychosocial factors influencing drug use in the LGBTQIA+ CommunityBiopsychosocial factors influencing drug use in the LGBTQIA+ Community
Psychological factors influencing drug use in Sydney’s gay community often stem from unique social and emotional challenges. Research highlights that stigma, discrimination, self-stigma, and internalised homophobia can lead to feelings of isolation, shame, and mental distress, which may increase vulnerability to substance use.
Additionally, the normalisation of partying in certain social settings, such as bars and clubs, has historically been a way for subcultural populations of LGBTQ+ individuals to connect and find community. However, this environment can also contribute to higher rates of drug use. Emotional coping mechanisms, such as using substances to manage stress or trauma, are also significant factors.
The biopsychosocial model provides a comprehensive framework for understanding alcohol and other drug dependency in the LGBTIA+ community. Here’s a breakdown of the factors:
- Biological Factors:
- Genetic predisposition plays a role, with some individuals being more vulnerable to chemical dependency due to inherited traits.
- Neurobiological changes caused by substance use can alter brain function, making it very challenging to reduce or stop using substances despite the negative consequences occurring in the individual’s life.
- Psychological Factors:
- Trauma, such as adverse childhood experiences, peer bullying, neglect, authoritarian child rearing, seemingly innocuous societal messages, and/or discrimination, can lead to emotional distress and substance use as a coping mechanism.
- Internalised stigma, homophobia, or transphobia can exacerbate mental health issues like anxiety and depression, increasing the risk of substance use and potential physical and psychological dependency.
- Social Factors:
- Experiences of ostracism, violence, or lack of acceptance and belonging can lead to isolation and substance use.
- Social norms in certain LGBTQ+ spaces, such as bars or clubs, may normalise or encourage substance use.
This model underscores the importance of addressing all these interconnected factors in prevention and treatment efforts.
The Flux Study, also known as “Following Lives Undergoing Change,” is a longitudinal research project focusing on the lives of gay and bisexual men in Australia. Conducted by the Kirby Institute at UNSW Sydney, it examines various aspects of health, behaviour, and social factors, including drug use, sexual health, and the adoption of HIV prevention strategies like PrEP.
Key findings from the study include:
- Recreational drug use is common among gay and bisexual men, with substances like marijuana, amyl nitrite (“poppers”), and party drugs being frequently used. However, dependency rates are relatively low.
- Drug use is often linked to enhancing pleasurable experiences, including sexual enjoyment.
- The study has provided insights into how men mitigate risks, such as using biomedical HIV prevention methods alongside drug use.
The Flux Study is a collaborative effort involving organisations like the National Drug and Alcohol Research Centre, ACON, and the Victorian AIDS Council. It aims to inform health interventions and support services tailored to the needs of this community.
The Flux Study has provided valuable insights into the health and behaviours of gay and bisexual men in Australia. Here are some key findings:
- Drug Use: While recreational drug use is common, most participants reported infrequent use. Harm reduction strategies, such as not sharing injecting equipment, were widely practiced.
- HIV Prevention: There was a significant increase in the uptake of HIV pre-exposure prophylaxis (PrEP), with usage rising from less than 1% in 2014 to about one-third of participants by 2017.
- COVID-19 Impact: During the pandemic, participants reduced sexual contacts and adapted strategies to minimize risks in sexual contexts. Many also paused PrEP usage due to reduced sexual activity.
- Mental Health: A notable proportion of participants reported mental health challenges, highlighting the need for targeted support services.
There are several support services available for addressing mental health challenges, particularly for the LGBTIA+ community in Australia. Here are some key options:
- QLife: A free, anonymous peer support and referral service for LGBTQ+ individuals. It operates via phone and webchat from 3 PM to midnight, 7 days a week. Phone: 1800 184 527. Their website provides a webchat service: QLife – Support and Referrals
- Beyond Blue: Offers 24/7 mental health support, including phone and online counselling. They also provide resources tailored to the LGBTQ+ community. Phone: 1300 22 4636. Click the following link to Beyond Blue’s Wellbeing Action Tool: beyond-blue-wellbeing-action-tool_dec_2024_updated.pdf
- Lifeline: A leading crisis support service available 24/7 for anyone in distress. They offer phone, text, and online counselling. Phone: 13 11 14
- Head to Health: Connects individuals to mental health resources, including helplines, apps, and digital programs. Medicare Mental Health is a free service that connects you with the mental health support that is right for you. Phone: 1800 595 212 or visit their website: Home | Medicare Mental Health
- WayAhead Directory: An online database to find local mental health services and resources. Phone: 1300 794 991
- NSW Mental Health Line: A 24/7 telephone service providing advice and recommendations for appropriate care. Phone: 1800 011 511
These services are designed to provide immediate support and guide individuals toward long-term mental health care.
Suicidality: Talking About Suicide and SupportSuicidality: Talking About Suicide and Support
Supporting someone who’s having thoughts of suicide is one of the most important, and at times most challenging, parts of a support persons role. People who experience suicidality can vary from passing ideas to serious planning and often come from a place of deep emotional pain. We all have a duty to respond with care, compassion, and an attempt to understand the experience in a way that keeps safety at the heart of every conversation.
Firstly, if you or someone you know is having thoughts of suicide, please know that you’re not broken or beyond help. These thoughts often come when emotional pain feels unbearable and we can’t see a way out. But things can shift, and help is available. We may spend much of our time alone, and we can feel alone even in a crowded room, but you are not alone in this. Suicidality is not uncommon.
The Numbers Today
According to the latest figures (ABS, 2023):
Suicide is the leading cause of death for Australians aged 15 to 44.
In 2022, over 3,100 people died by suicide—about 8.6 deaths each day.
Men account for 75% of those deaths, though women attempt suicide more often (but less often fatally).
According to the Black Dog Institute, roughly 65,000 Australians attempt suicide each year, while around 3,200 die by suicide annually.
Rates among Aboriginal and Torres Strait Islander peoples are more than double the national average.
People living in rural and remote areas face higher suicide risks due to isolation, limited services, and other pressures.
Why Does the Mind Think About Suicide?
From a humanistic psychology point of view, suicidal thoughts are not signs of illness or failure, they are a deep emotional signal that something in your life or environment needs care, change, or healing.
Each person and living creature on the planet are inherently worthy, with an innate drive to survive, grow, connect, and for humans, find meaning. When life feels full of suffering, such as grief, isolation, trauma, shame, or hopelessness, the mind may start to believe that death is the only way to stop the pain.
In this view, suicidal thoughts are often not about wanting to die—but about wanting the pain to stop.
They arise when:
You feel disconnected from others or from yourself.
You feel stuck in circumstances that seem unchangeable.
You believe your worth or purpose has been lost.
You’re exhausted from holding on or pretending you’re okay.
But the humanistic perspective also holds this powerful truth: you are more than your pain, and within you is a capacity for healing, choice, and change, even if it doesn’t feel like it right now.
Treat Yourself with Compassion, Not Criticism
It’s easy to get caught in a spiral of self-blame. But you are not weak or selfish. You are a human being who is hurting—and just like you wouldn’t shame someone for being in physical pain, you deserve the same care when your pain is emotional.
Ask yourself:
If someone I loved felt this way, what would I want them to know?
Then try to offer yourself the same kindness.
Reach Out – Connection Saves Lives
Talking to someone can ease the intensity of what you’re feeling. You don’t have to explain everything. Just saying, “I’m not okay right now,” is enough to start.
Lifeline 13 11 14
Beyond Blue 1300 22 4636
Suicide Call Back Service: 1300 659 467
Beyond Blue: 1300 22 4636
13YARN (Support for Aboriginal and Torres Strait Islander Peoples): 13 92 76
QLife – National LGBTQIA+ Peer Support and Referral Service: 1800 184 527
Hours: 3pm – Midnight (local time), every day
What they offer: Confidential, non-judgemental, and inclusive support from trained LGBTQIA+ peer workers. They are not a crisis line like Lifeline, but they can support people in distress and connect you with further help if you’re at risk.
How Counselling Can Help: Evidence-Based Approaches
Counsellors and Psychologists don’t rely on guesswork when helping someone who’s feeling suicidal. They use researched strategies to support recovery. Here are a few key approaches:
Collaborative Assessment and Management of Suicidality (CAMS): This method focuses on working together with the person in distress, rather than telling them what to do. It aims reduce suicidal thoughts more effectively than traditional therapy.
Cognitive Behavioural Therapy for Suicide Prevention (CBT-SP): This version of CBT focuses specifically on managing suicidal thoughts by teaching problem-solving and positive thinking strategies.
Dialectical Behaviour Therapy (DBT): Originally designed for people with intense emotions or borderline personality disorder, DBT is now widely used to reduce suicide risk by teaching emotional regulation, mindfulness, and better relationship skills.
Safety Planning: This involves creating a personalised plan for what someone can do when they feel at risk, including who to call, calming strategies, and safe places to go.
Means Restriction Counselling: This involves helping someone reduce their access to anything they might use to harm themselves, like certain medications or weapons, done through sensitive, respectful conversations.
Barriers to Speaking Up
Even with growing public awareness, there’s still a strong stigma around suicide. Many people worry they’ll be judged, locked up, or shamed if they admit they’re struggling. These fears can stop people from reaching out for help, which is why creating a safe, non-judgmental space is so important in counselling.
Rural and Remote Communities
People in regional and remote parts of Australia often find it harder to access mental health support. Telehealth (online or phone sessions) has helped bridge that gap, but it’s not always easy to pick up on non-verbal cues or respond to crises from a distance.
Cultural Awareness Matters
For Aboriginal and Torres Strait Islander peoples, suicide cannot be separated from the impacts of colonisation, loss of culture, and ongoing trauma. Culturally safe, community-led solutions are essential and more effective in these contexts.
Remember That Feelings Change—Even the Darkest Ones
It may not feel like it right now, but these feelings will pass. Emotions are like waves—sometimes crashing, sometimes calm—but never permanent.
What you feel today is not a life sentence. With support and time, things can change. You deserve the chance to see what healing and hope feel like.
Safe Haven NSW Services (for suicidal distress, NOT EDs)
Please check official websites for update information re contact information, hours of operation, and status of operation i.e., still operating. The information on this website has been collected June 2025.
Safe Havens are calm, non-clinical spaces where you can talk with peer workers and mental health clinicians if you’re in emotional crisis — no appointment needed.
No police or emergency involvement unless requested or necessary.
Warm, trauma-informed and recovery-focused.
🔗Find your local Safe Haven: nsw.gov.au/mental-health-initiatives/safe-haven
Examples:
Safe Haven locations across NSW — these are welcoming, non-clinical places where anyone feeling suicidal or in deep distress can drop in and speak to peer workers or mental health clinicians. No appointment, referral, or Medicare card needed. Visit the following for operating hours and locations across NSW: Safe Haven
Regional & Metro Locations
Campbelltown / Ambarvale (SWSLHD)
Address: 80 Woodhouse Drive, Ambarvale (Campbelltown area)
Open Mon, Fri, Sat, Sun 2 – 9 pm
Phone: 0457 093 109 during hours swslhd.health.nsw.gov.au
North Ryde (Macquarie Hospital)
For youth aged 12–17 (sometimes to 18 if still at school)
Open daily 4 – 8 pm and public holidays nslhd.health.nsw.gov.au
Parramatta / Westmead
Drop-in at 26 Grand Ave, Westmead
Open Sun–Wed 3:30 – 9:30 pm
Phone: 0436 377 113
Bega Safe Haven, Bega, NSW, Australia, Supports 14 + in a calm, welcoming space.
Broken Hill Safe Haven, Broken Hill, NSW, Australia, Supports 17 + with peer and clinician support
Brookvale Safe Haven, Brookvale, NSW, Australia, High‑school aged young people support
Darlinghurst, NSW, Australia, 16 + LGBTQIA+ inclusive spot at St Vincent’s
St Vincent’s O’Brien Centre, 390 Victoria Street, Darlinghurst NSW 2010
Hours: Monday: closed, Tuesday: closed, Wednesday: 5:00pm – 8:30pm, Thursday: 5:00pm – 8:30pm, Friday: 5:00pm – 8:30pm, Saturday: 12:00pm – 4:00pm, Sunday: 12:00pm – 4:00pm.
Gosford Safe Haven, General adult Safe Haven
Corner of Ambulance Road and Holden Street, Gosford NSW 2250
Hours: Monday: 9:00am – 4:30pm, Tuesday: 9:00am – 4:30pm, Wednesday: 9:00am – 4:30pm, Thursday: 9:00am – 4:30pm, Friday: 9:00am – 4:30pm, Saturday: closed, Sunday: closed, Closed on public holidays
Phone: (02) 4394 1597
Kogarah Safe Haven, Kogarah, NSW, Australia,16 + adults,
U2/15 Kensington St, Kogarah NSW 2217
Phone: (02) 9113 2981