Decisional balance sheet

A decisional balance sheet or decision balance sheet is a tabular method for representing the pros and cons of different choices and for helping someone decide what to do in a certain circumstance. It is often used in working with ambivalence in people who are engaged in behaviours that are harmful to their health (for example, problematic substance use or excessive eating), as part of psychological approaches such as those based on the transtheoretical model of change, and in certain circumstances in motivational interviewing. The decisional balance sheet records the advantages and disadvantages of different options. It can be used both for individual and organisational decisions. The balance sheet recognises that both gains and losses can be consequences of a single decision. It might, for example, be introduced in a session with someone who is experiencing problems with their alcohol consumption with a question such as: "Could you tell me what you get out of your drinking and what you perhaps find less good about it?" Therapists are generally advised to use this sort of phrasing rather than a blunter injunction to think about the negative aspects of problematic behaviour, as the latter could increase psychological resistance. An early use of a decisional balance sheet was by Benjamin Franklin. In a 1772 letter to Joseph Priestley, Franklin described his own use of the method, which is now often called the Ben Franklin method. It involves making a list of pros and cons, estimating the importance of each one, eliminating items from the pros and cons lists of roughly equal importance (or groups of items that can cancel each other out) until one column (pro or con) is dominant. Experts on decision support systems for practical reasoning have warned that the Ben Franklin method is only appropriate for very informal decision making: "A weakness in applying this rough-and-ready approach is a poverty of imagination and lack of background knowledge required to generate a full enough range and detail of competing considerations.