Free Therapist Training›Motivational Interviewing Toolkit›Change Plan Worksheet
Last updated: November 11, 2026
A change plan worksheet is a short form on which a client writes down, in their own words, a change they have decided to make and how they will make it. This free change plan worksheet PDF and Google Doc adapt the Change Plan Worksheet from the Motivational Enhancement Therapy manual, and the post adds a completed example for a fictional client, the signs that a client is ready to plan, and how to fill in the worksheet together.
The template comes from Sentio's free motivational interviewing toolkit, and MI is one of the core therapy models taught in the Sentio MFT program. Clients who are still weighing how much the change matters often start with the importance and confidence rulers, and the plan a client writes here can carry into the goals of an MI treatment plan.
This is an optional aid from Sentio's motivational interviewing toolkit, free to adapt to your setting.
Make a copy (Google Doc)Download the PDF
The changes I want to make are:
| Write here |
The most important reasons why I want to make these changes are:
| Write here |
The steps I plan to take in changing are:
| Write here |
The ways other people can help me are:
| Person | Possible ways to help |
|---|---|
I will know that my plan is working if:
| Write here |
Some things that could interfere with my plan are:
| Write here |
What I will do if my plan stalls:
| Write here |
How confident I am in this plan (0 to 10):
| My number, and what would make it a point or two higher |
Review date:
| The date we will look at this plan together |
Clinician guide: when to use the change plan
- Use it in the planning task, once the client has decided to make a change and the talk has turned to how. Signs of readiness include more change talk and less sustain talk, mobilizing change talk (commitment, activation, steps already taken), small changes the client has already started, and talk about goals.
- Before planning, offer a summary that gathers the client's change talk, then ask a key question such as “Where does that leave you?” If the client is unsure, return to evoking and let the plan wait.
- Fill in the worksheet from the conversation, in the client's words, and give the client the original.
Adapted from the Change Plan Worksheet in the Motivational Enhancement Therapy manual (Miller et al., 1992), a public-domain publication of the National Institute on Alcohol Abuse and Alcoholism. The first six prompts are the manual's; the last three are additions.
What Does a Completed Change Plan Worksheet Look Like?
Marcus, 46, a fictional client in outpatient counseling at a community clinic, has been drinking most evenings since a layoff eight months ago; he filled in this plan with his counselor, D.O., at his fourth session, on November 24, 2026, after saying he wanted to get back in control and was not sure about quitting entirely.
| Worksheet item | What Marcus wrote |
|---|---|
| The changes I want to make are: | Get back in control of my drinking. Starting tonight: no alcohol Sunday through Thursday nights, and no more than two beers on Friday and two on Saturday. On December 8, D.O. and I will look at how it went and decide whether to keep going, change the goal or take a break from drinking. |
| The most important reasons why I want to make these changes are: | My wife is worried, and I want her to trust me again. I want to be sharp for interviews and for whatever job comes next. I sleep badly after I drink. I don't like who I've turned into since the layoff. |
| The steps I plan to take in changing are: | Stop keeping beer in the garage fridge, and buy only the four beers for the weekend, on Friday. Walk the dog with my wife after dinner, when I usually open the first beer. Log every drink on my phone and bring the log to sessions. Go to the Thursday morning job club at the library. |
| The ways other people can help me are: | My wife: walk with me after dinner, and tell me straight if she's worried instead of checking the recycling. My brother: don't push another beer on me on Saturdays, and pick up if I call on a rough night. D.O.: go over the drink log with me each week. |
| I will know that my plan is working if: | My log shows no weeknight drinks and no more than two beers on weekend nights. I'm up by 7 and job hunting. My wife says she's less worried. |
| Some things that could interfere with my plan are: | Getting turned down for a job. Saturdays at my brother's, when I end up drinking more than I planned. Long, empty afternoons. |
| What I will do if my plan stalls: | If I slip, I'll write it in the log, tell D.O. at the next session and start again the next day. Before Saturdays at my brother's, I'll tell him my two-beer limit, bring sparkling water and head home by nine if it gets hard. |
| How confident I am in this plan (0 to 10): | 6. I haven't had a drink on a weeknight since our last session, so I know I can do it. Weekends will be the hard part. Telling my wife the plan tonight would make it a 7. |
| Review date: | December 8, 2026, at my session with D.O. |
D.O. asked for Marcus's own ideas before offering any, and asked permission before mentioning that some people try a stretch without alcohol before deciding about drinking; Marcus kept his weekend limit, and the two-week trial with a review date leaves the larger decision open. When Marcus rated his confidence at 6, D.O. asked why it was not lower, which brought out the weeknights he had just managed, and what would raise it, which added telling his wife.
When Is a Client Ready for a Change Plan?
A client is ready for a change plan when the conversation has moved from whether to change to how. The signs are in the client's language: more change talk and less sustain talk, and especially more mobilizing change talk, the commitment, activation and steps already taken grouped as CAT (Miller, 2023; SAMHSA, 2019). Some clients have already made small changes, such as cutting down, or have begun to set goals of their own (SAMHSA, 2019).
A summary followed by a key question tests that readiness without pushing it. The clinician gathers the client's change talk into a summary, acknowledges the sustain talk briefly, and then asks a key question such as “Where does that leave you?” or TIP 35's “What's next?” (SAMHSA, 2019). An answer that holds a decision opens planning. An unsure answer sends the conversation back to evoking, and the worksheet can wait for a later session.
Planning is one of the four tasks of MI in the fourth edition of Miller and Rollnick's text, and the tasks are not fixed stages, so a client can move into planning and back to evoking within one session (Miller, 2023; Miller & Rollnick, 2023).
How Do You Fill In a Change Plan Worksheet with a Client?
Fill in the worksheet from the conversation, in the client's words. The MET manual advises against opening the planning phase by filling out the form, because its content should come out of the motivational conversation; the clinician can use the worksheet to take notes and as a checklist, and the client keeps the original (Miller et al., 1992).
- Evoke the client's own steps first. Ask what the client thinks would work before offering ideas, and offer ideas with permission. TIP 35 advises eliciting clients' own ideas about what will work for them and not jumping in too quickly with your own (SAMHSA, 2019).
- Make each step concrete. A step names what the client will do, when and where. The MET manual asks for specific first steps and for positive goals, such as starting or increasing something, as well as goals of stopping or avoiding (Miller et al., 1992).
- Plan for setbacks. Clients can predict some obstacles better than the clinician can, so ask what could get in the way and what the client would do about it, without trying to predict everything (SAMHSA, 2019). TIP 35 also states that a return to substance use is not a failure, so the plan can say in advance what the client will do after a slip.
- Check confidence. Ask how confident the client is in the plan from 0 to 10, why the number is not lower, and what would raise it a point or two. If confidence is low, make the steps smaller or easier before the session ends; TIP 35 notes that, ideally, the top goal rates higher on both importance and confidence (SAMHSA, 2019).
- Set a review date. At each later session, ask what is working and what is not, and revise the plan together (SAMHSA, 2019).
Where Does This Change Plan Worksheet PDF Come From?
The worksheet adapts the Change Plan Worksheet in the Motivational Enhancement Therapy (MET) manual by William R. Miller, Allen Zweben, Carlo C. DiClemente and Robert G. Rychtarik, published in 1992 by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) as Volume 2 of the Project MATCH Monograph Series (Miller et al., 1992). The manual is in the public domain, and the first six prompts on the Sentio worksheet are the manual's, word for word.
The manual was written for Project MATCH, which NIAAA began in 1989 to learn whether different groups of clients with alcohol problems respond differently to three treatments: Twelve-Step Facilitation Therapy, Cognitive-Behavioral Coping Skills Therapy and MET, each delivered over 12 weeks. In the trial, MET consisted of four individualized sessions, and the manual places the worksheet in its second phase, strengthening commitment to change (Miller et al., 1992).
SAMHSA's TIP 35 includes a different Change Plan Worksheet, adapted with permission from the second edition of Miller and Rollnick's text, and describes it as a way to help clients focus on the details of a plan, strengthen their commitment, enlist support and troubleshoot roadblocks (SAMHSA, 2019). The Sentio version keeps the MET manual's public-domain prompts and adds three items: what to do if the plan stalls, a 0 to 10 confidence rating and a review date.
Practice the Skill Behind This Template
The skill to rehearse next is the move into planning: a summary that gathers the client's change talk, followed by a key question about what the client wants to do, because the worksheet should record a decision the client has already made, in the client's own words. Rehearse it with the motivational interviewing practice scenarios, watch Episode 8 on Practice Time, which demonstrates eliciting change talk, the step before planning, and use the exercises in Deliberate Practice in Motivational Interviewing (Manuel et al., 2022).
Keep reading
Readiness Ruler Worksheet, importance and confidence rulers with the follow-up questions that draw out change talk.
Motivational Interviewing Treatment Plan Example, a 12-week plan for Marcus with goals in his own words.
Motivational Interviewing Cheat Sheet, OARS, change talk and responses to sustain talk and discord in one reference.
Free Motivational Interviewing Toolkit, every template in the set, each with a completed example and a PDF.
Deliberate Practice in Motivational Interviewing, the free webinar with Robert Scholz, Tony Rousmaniere and Alexandre Vaz.
Frequently Asked Questions
What is a change plan worksheet?
A change plan worksheet is a short form on which a client writes down, in their own words, a change they have decided to make, their reasons, their steps, the people who can help, how they will know it is working and what could get in the way. Clinicians use it in the planning task of motivational interviewing, once the client is ready to talk about how to change. The Sentio version adds what to do if the plan stalls, a 0 to 10 confidence rating and a review date.
Who developed the change plan worksheet?
The Change Plan Worksheet appeared in the Motivational Enhancement Therapy manual by William R. Miller, Allen Zweben, Carlo C. DiClemente and Robert G. Rychtarik, published in 1992 by the National Institute on Alcohol Abuse and Alcoholism for Project MATCH. The manual is in the public domain, so its worksheet can be copied and adapted with credit. SAMHSA's TIP 35 includes a different change plan worksheet, adapted with permission from the second edition of Miller and Rollnick's text.
What should a change plan include?
A change plan should name a specific change, the client's own reasons, concrete first steps with times and places, the people who can help and how, signs that the plan is working, and the obstacles the client expects. Adding what to do if the plan stalls, the client's confidence in the plan and a date to review it makes the plan easier to revisit and revise.
What should I do when a client chooses a goal I would not choose?
Respect the client's choice, because the plan belongs to the client; as TIP 35 puts it, “You cannot push your hopes and plans onto the client.” Ask permission to share a concern or information, ask what the client makes of it, and consider treating the goal as a trial with a review date. Where the goal carries a risk to health or safety, safety comes first; TIP 35, for example, says that tapering off opioids, benzodiazepines or multiple substances should be done under medical supervision.
Can I use the change plan worksheet PDF in telehealth sessions?
Yes. The client can fill in a printed copy and hold it up to the camera, or the clinician can share the Google Doc on screen and type the client's words as the client says them. Either way, the words on the plan should be the client's own, and the client keeps a copy.
References
Manuel, J. K., Ernst, D., Vaz, A., & Rousmaniere, T. (2022). Deliberate practice in motivational interviewing. American Psychological Association. ISBN 978-1-4338-3618-3. https://www.apa.org/pubs/books/deliberate-practice-motivational-interviewing
Miller, W. R. (2023). The evolution of motivational interviewing. Behavioural and Cognitive Psychotherapy, 51(6), 616-632. https://doi.org/10.1017/S1352465822000431
Miller, W. R., & Rollnick, S. (2023). Motivational interviewing: Helping people change and grow (4th ed.). Guilford Press. ISBN 978-1-4625-5279-5. https://www.guilford.com/books/Motivational-Interviewing/Miller-Rollnick/9781462552795
Miller, W. R., Zweben, A., DiClemente, C. C., & Rychtarik, R. G. (1992). Motivational enhancement therapy manual: A clinical research guide for therapists treating individuals with alcohol abuse and dependence (Project MATCH Monograph Series, Vol. 2; DHHS Publication No. (ADM) 92-1894). National Institute on Alcohol Abuse and Alcoholism. ISBN 0-16-038187-8. Reprinted 1999 as NIH Publication No. 94-3723. https://casaa.unm.edu/tools/met.pdf
Substance Abuse and Mental Health Services Administration. (2019). Enhancing motivation for change in substance use disorder treatment (Treatment Improvement Protocol (TIP) Series No. 35, SAMHSA Publication No. PEP19-02-01-003). https://library.samhsa.gov/product/tip-35-enhancing-motivation-change-substance-use-disorder-treatment/pep19-02-01-003
