Worksheet Under constructionCriterion 32 concerns helping the client decide what to do with what they have learned. The facilitator asks questions, reflects the client's thinking, and offers useful options while respecting their decisions. Motivational interviewing provides a developed approach to this conversation through engaging, focusing, evoking, and planning. The module draws on its general counseling literature and applies the relevant practices within the facilitator's training. Criteria 21 and 22 provide the goal setting and resources that can help turn a chosen direction into practical steps.
Learning Objectives
By the end of this module, the trainee will be able to:
- Explain how a client's own reasons and preferences contribute to planning a change.
- Describe motivational interviewing and the research cited for it.
- Use open ended questions and reflection to draw out the client's own solutions.
- Offer tools and frameworks in a way that supports the client's decisions.
- Anchor solutions in the client's own ceremony insights.
- Help translate insight into practical, sustainable steps that remain the client's.
- Recognize and resist the savior or rescuer dynamic, even when a path seems obvious.
- Locate goal setting and integration methods in the criteria that teach them.
Key Terms
Elicitation. Helping the client develop and express their own ideas, reasons, and possible actions.
Evocation. Drawing out the person's own motivation and reasons for change, a principle of motivational interviewing (Miller & Rollnick, 2013).
Motivational interviewing (MI). A collaborative, evidence based style of conversation for strengthening a person's own motivation and commitment to change, structured around four processes: engaging, focusing, evoking, and planning.
Autonomy support. Respecting the client's authority to make decisions and helping them consider options, consequences, and available support.
The righting reflex. The helper's urge to correct a problem or supply an answer before understanding the person's own motivation and perspective.
Savior or rescuer dynamic. A pattern in which the facilitator takes increasing responsibility for the client's decisions, limiting opportunities for the client to develop and use their own judgment.
Reflective listening. Restating or clarifying the client's meaning so they can hear, correct, and develop their own thinking.
Offering options. Presenting tools, information, or referrals in a way that allows the client to ask questions, consider alternatives, and decline a suggestion.
Core Teaching
Helping the client make decisions
A client may finish an experience with a strong sense that something needs to change and little idea how to begin. The facilitator can help them examine that uncertainty without immediately supplying a plan. Ask what they want, what they have considered, and what seems possible in their circumstances. Their reasons for making a change need to be understood before choosing the steps.
Taking over can leave the client following a recommendation they have not made sense of for themselves. It can also establish an expectation that the facilitator will resolve each new uncertainty. Supporting the client's participation gives them practice in considering options and making decisions they will have to carry into daily life. This remains compatible with providing information, discussing risks, and giving appropriate guidance within the facilitator's role.
Motivational interviewing and evocation
Miller and Rollnick (2013) describe motivational interviewing as a collaborative conversation that supports a person's motivation and commitment to change. Their third edition organizes the work through four processes: engaging, focusing, evoking, and planning. Evocation involves drawing out the person's own reasons, values, and motivation, including the uncertainty or competing concerns that can make a decision difficult.
The approach also describes the righting reflex, the helper's impulse to correct a problem by supplying an answer. A facilitator may recognize a possible solution quickly while the client is still trying to understand the concern. Reflecting the client's thinking and asking useful questions allows that understanding to develop. It also makes space for information about the client's life that the facilitator may not yet have considered.
Ambivalence often contains information about the conditions a change would require. A client who wants to stop overworking may also fear losing income or disappointing colleagues. Ask what they value about the current arrangement and what has become difficult to tolerate. Give both answers room in the conversation. If the facilitator praises only reasons for change, the client may begin defending the current behavior simply to have its purpose understood.
A reflection might be, “You want more time with your children, and you are worried that reducing your hours would put the family under financial pressure.” Allow the client to correct the account. They may explain that income is less concerning than how their manager would react. That correction directs the next question and keeps the facilitator from planning around a problem the client does not have.
Motivational interviewing has been examined across counseling and behavior change settings. Lundahl et al. (2010) found effects that varied across applications and comparisons. That evidence supports a more qualified account than saying that MI works equally well for every person or problem. The source does not establish its effectiveness for psychedelic integration specifically.
The practices described here draw on that general approach, within the facilitator's actual training. Familiarity with a few questions does not amount to competence in motivational interviewing. Use the method in proportion to your preparation and seek supervision or referral when the work requires skills beyond it, as discussed in Criterion 27.
Questions, reflection, and options
Ask questions that help the client develop their own thinking. What would they like to be different? What have they already tried? What might make a first step manageable? Reflect what you hear and give them the chance to correct it. A tentative idea may become clearer when the client hears it expressed and has time to add the parts that were missing.
Tools and information can be offered when they are useful. Ask whether the client would like a suggestion, explain it plainly, and invite their response. Journaling, a meditation practice, or a referral may fit one person and be impractical or unwelcome for another. If the client declines, explore their reasons as relevant to the plan. Agreement reached through pressure is a poor basis for an activity the client will later be expected to sustain.
Offering information can be a short exchange. Ask what the client already knows, request permission to add something relevant, then ask how it fits their situation. For example: “Would it help to look at a few ways people begin a difficult conversation?” After describing an option, return the decision to the client: “How would that go with your brother?” Their answer may reveal history that makes the suggestion unsuitable. The facilitator can then revise the option without making the client responsible for defending their refusal.
Questions should leave enough space for an answer to develop. Several questions in a row can feel like an interview, especially when the person is uncertain or tired. Reflect a phrase they used, allow a pause, and ask whether you have understood. If the client says they do not know, offer to stay with the uncertainty or return to a concrete event. The session can still be useful when it ends with a clearer question and no immediate decision.
Working from the client's experience
The client's account of the psychedelic experience may provide a starting point for the decision. They may describe wanting to reconnect with someone, practice forgiveness, or make a change they have postponed. Ask what that theme means to them now and whether it still feels relevant as they return to daily life. An insight can be examined before the client decides to act on it.
If they want to proceed, help translate the intention into something manageable. A wish to reconnect may begin with a short message. A commitment to compassion may involve a particular response the client wants to practice tomorrow. The facilitator can help clarify the step, consider resources and risks, and plan a review. Criteria 21 and 22 describe the goal setting and support arrangements in more detail.
Some clients want the facilitator to confirm that an experience has given them instructions. A person might say, “I was told I have to leave my job.” Ask what they experienced, what the instruction means to them now, and how it relates to concerns they had before the session. Then consider the consequences of acting, waiting, or gathering more information. The client can hold the experience as meaningful while deciding how much authority to give it in ordinary life.
Gorman et al. (2021) describe integration within a harm reduction approach that engages with the client's own goals. An application here is to explore the person's current choices without requiring a favorable account of the psychedelic experience. If they want to avoid further use, support that decision. If they remain interested, discuss the relevant concerns within your role and direct clinical questions to a qualified professional. Access to support should remain available when the client changes their view.
Being True To You presents preparation and integration as part of an ongoing coaching service (Being True To You, n.d.). That service description can prompt a useful question for any program: what support is available when the client returns to everyday decisions? A workbook exercise might ask the client to bring one actual decision to the next meeting, describe the options they considered, and identify what helped them choose. This gives the facilitator something concrete to discuss without prescribing the direction of the client's life.
Recognizing the urge to take over
It can be difficult to watch a client remain uncertain when a possible answer seems obvious. Notice when your wish to help becomes a wish to decide for them. Ask whether you have understood their reasons, whether information is missing, and whether the urgency belongs to the situation or to your own discomfort. A suggestion may be useful, but it should remain open to discussion.
Repeatedly resolving decisions for the client can encourage dependence on the facilitator's judgment. Give them time to think, tolerate a pace that may be slower than your own, and use supervision when the urge to rescue becomes persistent. This applies to collaborative decisions about the client's goals. It does not cancel duties to respond to an emergency or to provide clear information about a known risk.
Notice how praise affects the conversation. Calling a choice courageous or spiritually advanced can make it harder for the client to reconsider it. Acknowledge the work they did in reaching the decision and ask whether it still fits. If they return with doubts, examine those doubts with the same interest given to the original plan. They need to know that changing direction will not cost them the facilitator's approval.
At the end of the meeting, invite the client to state the decision in their own words, including any uncertainty that remains. Ask what they want to try, what would lead them to pause, and when they would like to review it. If they have chosen no action, record that accurately and clarify whether further information or support is needed. A note that says the client agreed when they merely stopped objecting can distort the next session and create pressure they did not consent to.
Checking the circumstances around a decision
A client may leave a session with renewed energy and several things they want to change. Ask how they have been sleeping and whether the urgency feels usual for them. Explore recent spending, commitments, irritability, and the ability to pause and consider consequences. A marked reduction in sleep alongside escalating activity or impaired judgment calls for qualified assessment before the facilitator helps expand the plan. Interest and enthusiasm alone do not establish a mood disorder.
Morton et al. (2023) surveyed people who reported bipolar disorder and psilocybin use. Respondents described new or increased symptoms that included manic symptoms, sleep difficulties, and anxiety. The survey was observational and self selected; it cannot establish risk for every person using psychedelics. It gives a reason to take changes in sleep and mood seriously, especially when there is a relevant history. A facilitator should describe what they observe and arrange assessment within the existing care plan, without diagnosing from a coaching conversation.
The client’s freedom to choose also depends on what happens outside the appointment. If they seem unable to decline a partner’s proposal, ask privately whether disagreement is safe and whether anyone is pressuring them. Do not frame compliance with another person’s demand as the client’s own motivation. Criterion 28 covers assessment before involving partners or family. Where a person needs immediate help with violence, housing, or another urgent threat, support access to the appropriate service; a general preference for delaying major decisions must not obstruct necessary protection.
Clinical and Decision Tools
Tool 1. Language that supports choice
Compare the responses and consider how each affects the client's opportunity to explain their view and participate in the decision.
Topic | A question that invites the client's thinking |
|---|---|
Physical activity | “You said walking lifted your mood. Would you like to make more room for it?” |
Work | “What options have you considered, and what concerns you about each?” |
Journaling | “Would writing about this be useful to you? We can consider other ways to reflect as well.” |
Forgiveness | “You brought up forgiveness. What does it mean to you in this situation?” |
Tool 2. The four MI processes, applied here
The four processes described by Miller and Rollnick (2013) help organize the conversation. This criterion gives particular attention to evoking the client's reasons and ideas.
Process | In this work |
|---|---|
Engaging | Establish the relationship and safety (see the relational criteria) |
Focusing | Clarify what the client wants to work toward |
Evoking | Draw out the client's own motivation and solutions (this criterion) |
Planning | Shape the elicited solution into steps (see Criteria 21 and 22) |
Tool 3. Catching the righting reflex
Notice the impulse to supply an answer and consider what question, reflection, or information would help the client think it through.
What you notice in yourself | How to respond |
|---|---|
An urge to tell the client what to do | Ask what they have considered and what information would help |
A possible solution comes to mind | Explore the client's ideas; ask permission before offering another possibility |
A desire to take over | Review your role and how to support the client's decision making |
Discomfort with silence | Allow time, then check whether the client wants a question or further information |
Tool 4. Elicitation checklist
Review how the client's ideas developed, what options were discussed, and who made the decisions.
Check | Done? |
|---|---|
Open questions used to develop the client's ideas | Yes / No |
Reflections checked for accuracy and corrected when needed | Yes / No |
Tools discussed as choices with room for feedback | Yes / No |
Relevant insights explored in the client's own terms | Yes / No |
Client chose a manageable action | Yes / No |
Urge to supply the answer noticed and considered | Yes / No |
Facilitator's involvement supported the client's decision making | Yes / No |
Worked Example: Developing the Client's Next Step
This fictional example follows a conversation about reconnecting with a family member and choosing a manageable action.
Context: In integration, a client says their experience showed them how disconnected they have become from their brother, and then looks to the facilitator and asks what they should do.
Opening the decision: The facilitator reflects the client's wish to reconnect and asks what he has considered. They leave time for him to explain both the wish and his hesitation.
Reflective listening: The client says he wants to reach out but fears being rebuffed. The facilitator reflects both concerns and asks whether they have understood him. He adds that he would like to begin with a short message.
Returning to the experience: The client recalls feeling how much he still cares about his brother. The facilitator asks whether that feeling changes what he would like to do now.
Considering an option: With permission, the facilitator suggests that a brief message could be one way to begin. They ask whether that would fit the client's relationship with his brother and invite other ideas.
Choosing a step: The client decides to send a text about a shared memory. He chooses the wording and timing, and they discuss what support he may need if the response is disappointing.
Case Vignettes
For each vignette, identify the concern, consider the client’s needs, and describe how you would respond. Use the companion worksheet when available, or record your responses separately.
Vignette A
A client is stuck, and the facilitator, seeing what looks like an obvious solution, tells the client directly what they should do. The client complies half heartedly, does not follow through, and the change does not hold.
Guided questions: What did the facilitator learn about the client's own reasons for change? What might explain the lack of follow through? How could the conversation have supported the client's decision?
Vignette B
A facilitator, wanting to be helpful, responds to every uncertainty the client voices with advice, frameworks, and recommendations. The client grows increasingly passive, waiting for the facilitator to supply the next answer, and leaves more dependent than they arrived.
Guided questions: What dynamic did the constant advising create? What is the righting reflex? How could the facilitator have supported the client's own thinking instead?
Vignette C
A facilitator sees a client heading toward a decision the facilitator believes is a mistake, and, unable to tolerate it, takes over and steers the client firmly toward the choice the facilitator prefers. The client defers, and later feels the decision was never truly theirs.
Guided questions: What is the savior dynamic, and how did it show up? When a facilitator sees a clear path, what is their actual role? What did overriding the client cost?
Vignette D
A facilitator elicits a client's solution well, but the solution stays a grand abstraction, to live with more compassion, with no translation into anything the client can actually do. Nothing changes in the client's daily life.
Guided questions: What step was missing? How can a facilitator help translate a large insight into a sustainable action while keeping it the client's? Why does the abstraction alone fail?
Vignette E
A facilitator offers a tool, but frames it as a directive: telling the client they need to meditate every morning. The client, who does not connect with the practice, feels it as an instruction from an authority, complies briefly out of obligation, and then drops it and feels they failed.
Guided questions: What was the difference between offering an option and issuing a directive? How should the tool have been framed? Why does the framing determine whether autonomy is supported?
Role Play and Practice Scripts
Practice in pairs, then switch roles. Use open questions and reflections, offer options when useful, and notice your own urge to decide for the client.
Turning a request for advice back to the client
The partner asks, “What should I do?” Respond, “What have you considered so far? I can help you think through the options.” Explore their concerns before offering advice, and check whether they want additional information or a suggestion.
Reflecting to deepen the client's own thinking
“You want to reach out, and you're worried about how he'll respond. Have I understood that?” Give the partner time to clarify, then ask what might help them decide how to proceed.
Offering a practical option
“Would it help to consider a smaller first step, such as a short message? How would that feel to you?” Allow the partner to accept, change, or reject the idea. Discuss the reasons they give and use those details to refine the plan.
Catching the urge to rescue
The partner takes time to consider a decision. Notice your own urge to fill the silence, then give them space. If a prompt is needed, ask, “What are you weighing up?” After the exercise, discuss how your discomfort affected the timing and amount of guidance you offered.
Checking the circumstances around a decision
A client plans to spend their savings on a new project and reports sleeping only a few hours while feeling unusually energized. Practice asking about the change from their usual pattern and explaining the need for qualified assessment before developing the project plan.
Self Assessment and Reflection
Knowledge check
Explain how to support the client's participation in choosing and planning an action.
Define evocation and state how motivational interviewing grounds this criterion.
Describe the research cited for motivational interviewing and the limits of applying it to psychedelic integration.
Describe how to elicit a solution using open questions, reflection, and options.
Describe how to explore whether a proposed action relates to an insight the client wants to pursue.
Explain the righting reflex and how to catch it.
Explain the savior dynamic and why resisting it serves the client even when a path is clear.
Reflection
When a client is stuck and you see an answer, how strong is your urge to supply it? How will you hold it?
Where in your practice do you slip from offering options into issuing directives? How will you notice?
How comfortable are you tolerating a client's uncertainty and slower, self authored progress?
Summary
Criterion 32 develops the client's participation in decisions about change. Open questions, reflective listening, and discussion of options help them clarify what they want and what they are prepared to do. Motivational interviewing provides a structured account of this work through engaging, focusing, evoking, and planning (Miller & Rollnick, 2013). Its general evidence varies across applications and does not establish an integration specific effect (Lundahl et al., 2010).
The client's experience can inform a possible direction, which they can then examine in relation to daily life. The facilitator helps develop manageable steps and appropriate supports using Criteria 21 and 22. Notice the urge to take over, particularly when progress feels slow, and allow the client room to make informed choices. Clear guidance about risk and an appropriate response to emergencies remain part of professional responsibility.
References
Sources
Being True To You. (n.d.). Personal transformation & psychedelic integration. Retrieved September 18, 2026, from https://beingtruetoyou.com/
Gorman, I., Nielson, E. M., Molinar, A., Cassidy, K., & Sabbagh, J. (2021). Psychedelic harm reduction and integration: A transtheoretical model for clinical practice. Frontiers in Psychology, 12, 645246. https://doi.org/10.3389/fpsyg.2021.645246
Lundahl, B. W., Kunz, C., Brownell, C., Tollefson, D., & Burke, B. L. (2010). A meta-analysis of motivational interviewing: Twenty-five years of empirical studies. Research on Social Work Practice, 20(2), 137–160. https://doi.org/10.1177/1049731509347850
Miller, W. R., & Rollnick, S. (2013). Motivational Interviewing: Helping People Change (3rd ed.). Guilford Press.
Morton, E., Sakai, K., Ashtari, A., Pleet, M., Michalak, E. E., & Woolley, J. (2023). Risks and benefits of psilocybin use in people with bipolar disorder: An international web-based survey on experiences of ‘magic mushroom’ consumption. Journal of Psychopharmacology, 37(1), 49–60. https://doi.org/10.1177/02698811221131997
Related workbook material
Turning an idea into a behavioral goal: Criterion 21.
Integration practices and resources: Criterion 22.
Qualifications and selection of methods: Criterion 27.
The person centered therapeutic relationship: Criterion 26.
Exploration of behavior, attitudes, and feelings: Criterion 29.
Evidence and application
Miller and Rollnick describe the approach and its four processes. Lundahl et al. examine outcomes across general counseling applications, with effects that vary by population and outcome. These sources do not establish a specific effect in psychedelic integration.