On the One Hand... On the Other Hand

This skill is helpful when the patient’s behavior and their stated goals are incongruent or inconsistent.  It helps the person gain clarity about what the obstacle is (or obstacles are) that stands in the way of having their contraception behavior (condom use, or adherence to a method) help them reach their goal (prevention of unwanted pregnancy or protection from an STD).

 

The goal is for the person to get clarity about what the obstacle is so that they can make choices that are consistent with what is most important to them.

Examples of Patients

That Would Benefit

  • They are repeated getting sexually transmitted infections

  • They have said it is important to them to prevent pregnancy at this time and:

    • Have had unprotected sex

    • Are not interested in any of the effective contraception options

    • Are coming in for a pregnancy test that is negative

    • Are requesting emergency contraception

Examples

  • “So it sounds like on one hand you are saying you really want to wait until…(fill in with something they have said), and yet on the other hand, part of  you would like to have a baby right now?  Do I have that right?”

  • “On the one hand you would really like to finish school before you become a parent, and on the other hand it’s hard to be consistent with your (pill use, or depo use, or condom use)…"

  • “So I hear you saying  on one hand that it’s very important to you to wait until you are ready… and it’s great hearing about all of your plans and on the other hand, you had unprotected sex last night?”

  • "On the one hand you said that you are understandably distressed about getting chlamydia again, and on the other hand asking your husband to use condoms feels really uncomfortable for you. Do I have that right?"

Los Angeles, CA
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