Decisional Balance Worksheet
Weigh both sides honestly: the upsides and downsides of keeping things the same, and of changing. No pressure, just a clear, fair picture.
About this tool
A decisional balance worksheet is a core tool from motivational interviewing, the approach developed by William Miller and Stephen Rollnick. It rests on a respectful idea: people are usually ambivalent about changing a behavior, holding genuine reasons on both sides at once. Pretending the substance has no upsides does not help. It just makes the worksheet feel dishonest and easy to dismiss.
So this tool asks you to map four things: what you get from using or staying the same, what it costs you, what changing would cost, and what changing would give you. Naming the real benefits of the substance is not a step backward. It helps you understand what need it is meeting, so you can find other ways to meet that need rather than fighting an urge you do not understand.
When the picture is complete, the balance often tips on its own. You may notice the costs of staying the same have quietly grown, or that the reasons to change have become more personal. There is no scoring and no right answer here. The aim is simply to see the whole board clearly, so that whatever you decide, you decide it with your eyes open.
- Miller WR, Rollnick S. Motivational Interviewing: Helping People Change. 3rd ed. Guilford Press; 2013.
- Janis IL, Mann L. Decision Making: A Psychological Analysis of Conflict, Choice, and Commitment. Free Press; 1977.
- Prochaska JO, DiClemente CC. The Transtheoretical Approach: Crossing Traditional Boundaries of Therapy. Dow Jones-Irwin; 1984.
Decisional Balance Worksheet FAQ
What is a decisional balance worksheet?
A four-box tool from motivational interviewing that maps the pros and cons of staying the same versus changing. Seeing all four together gives you a fair, honest picture to decide from.
Why list the good things about using?
Because they are real, and naming them is honest. Understanding what the substance does for you helps you meet that need in other ways, which is far more effective than ignoring it.
Will this tell me what to do?
No. There is no scoring and no right answer. The aim is clarity, so that whatever you decide, you decide it with the whole picture in front of you.
Is my information saved?
No. Everything stays in your browser and nothing is uploaded. The PDF is created on your own device.