Setting Therapeutic Goals

Setting Therapeutic Goals

Goal setting is extremely important to the therapeutic process. It anchors the client to the purpose of therapy and provides a concrete objective to work towards. In all, it ensures that therapy is effective and that the client doesn’t just “feel” better but actually “gets” better. In fact, goal setting is a core counseling skill for any mental health practitioner.

Goal setting can be done by asking following questions :

  • What would you like to achieve by the end of this session/of therapy?
  • What and how would you like to change?

 

Goal setting should be a collaborative process, guided by the client’s intent and the therapist’s expertise. Once the goal is identified and agreed upon, the next step is to understand where the client is in relation to their goal. To prevent the client from feeling overwhelmed, it’s helpful to break the goal into smaller, manageable steps. No matter the direction therapy takes, it always begins with asking questions.

At the beginning of therapy, it’s important to assess and confirm the client’s commitment to

achieving the goal, and how the goal will be beneficial to them in the long term. It’s also helpful to discuss any obstacles that might prevent the client from completing a step and discuss strategies to overcome them. 

Characteristics of a Helpful Goal

A goal should be mutually negotiated upon so that it is SMART :-

  • Specific: Goals must be clearly defined. What does the client want to accomplish? For example: “I want to overcome my fear of heights.”
  • Measurable: Outcomes must be felt or quantified in some way by the client. How will the client know when the goal is accomplished? For example: “I want to overcome my fear of heights to the extent that I can sit in a plane.”
  • Achievable: The goal should be objectively achievable within a specific time frame. How can the client go about accomplishing the goal? For example: “I want to overcome my fear of heights to the extent that I can sit in a plane, by gradually exposing myself to increasing heights over time and challenging my extreme beliefs about heights.”
  • Realistic: The goal should be challenging and incite behavioural and emotional change. It should be tailored to the client’s specific needs. Is the goal practical and relevant to the client? For example: “I want to overcome my fear of heights to the extent that I can sit in a plane to attend my sister’s wedding, by exposing myself to gradually increasing heights over time.”
  • Time bound: The goal should be concrete in terms of a start and end point. By when does the client want to accomplish the goal? For example: “I want to overcome my fear of heights to the extent that I can sit in a plane to attend my sister’s wedding next month, by exposing myself to gradually increasing heights within the month.”

 

 

When setting goals, be mindful of unhelpful characteristics like :

  • Expecting a magical solution

  • Unclear or vague goals
  • Things that aren’t in the client’s control

  • Feeling neutral or unaffected

 

To ensure every session is effective, and that the client is engaging with the therapeutic process, frequent reassessment of the goal is vital. By doing this, the therapist checks that they are working towards a goal that is relevant to the client at that time. It’s also important to assess aspects such as inhibitions towards goals, expectations from the process, and the client’s motivation for change. This ensures every session is as effective and efficient as the overall therapeutic process.

Types of Therapeutic Goals

  • Emotional goals: The therapist helps the client deal emotionally with their adversity as effectively as possible. For example, after an incident where a friend has betrayed your trust, it is not helpful to be depressed by the adversity. Nor is it realistic to be indifferent toward a negative situation. What might be helpful is to set feeling healthily sad about the betrayal as a potential goal.

  • Behavioural goals: people have a tendency to behave in ways that relate to their current effect. Therefore along with negotiating an emotional goal, it is helpful to have an appropriate behaviour change goal. For example, Unhealthy negative emotions like anxiety about an upcoming presentation will yield unhealthy behaviours like panicking, avoidance, sleep disturbances, etc. Healthy negative emotions like concern about an upcoming deadline will correspond to healthy behaviours like appropriate preparation, confidence while delivering the presentation, etc.

  • Decision-Making Goals: These goals can help the client make a choice and take appropriate actions when faced with conflicting options. This can help them move forward and be ‘unstuck’. For example, a married woman, in an unhappy marriage is struggling with the decision to stay in it or leave. Therefore, the goal could be to assess both options, make a suitable choice and implement it.

  • Developmental Goals: these goals help people learn new skills, prepare for unforeseen challenges, improve their character and discover ambitions. For example, building communication skills like assertiveness and setting appropriate boundaries personally and professionally.

In the end

Setting therapeutic goals is a complex task. Goals may change along the path to recovery, therefore frequent reassessment of the goal is vital. A goal must be mutually agreed upon, non-harmful to the client, and realistic in all ways. Keep in mind, emotional goals are often connected to behavioural ones. And, outcomes must be, in some way, measurable to the client.

About Author – 

Hardika Zaveri – 

Hardika has completed her MSc. in Clinical Psychology from Erasmus University Rotterdam. She has been trained in REBT at the Advanced Level from the Albert Ellis Institute, New York. Hardika has previously worked with underprivileged children and cancer patients through various NGOs and also has prior experience working in a psychiatric clinic.