Guided Goal Setting in Therapy

Table of Contents

• Why is it Necessary?

• No Goal, No Problem!

• Reading Between the Thoughts & Emotions

• Values-Focused

• The Miracle Question

• Now What?

• Scaling

• References

• Free 20 Minute Consultation with FP Counselling

Why is it Necessary?

Therapy often starts with the end, i.e., trying to figure out how clients will know they have achieved what they wanted from therapy and when it should end. To get the most out of counselling, your therapist will help you set a goal by the end of the first or the second session. Your therapist may ask questions such as:

• What has to happen today for you to think later that coming in was worth it?

• How can I be most helpful to you?

• What would you like to accomplish because of coming here so that one day you can

• look back and say, 'That wasn't a terrible waste of time?

• How will you know that coming here was helpful for your child or family?

Your therapist will often refer to the goal to keep the session on track. Different concerns or items will naturally come up. A flexible therapist will try to make space for new concerns and information while asking what is most important to focus on in today's session. You may contract to tackle another concern or agree to target both simultaneously. Although it may be necessary to discuss new items, sometimes, without asking "what is more important to talk about today," therapists and clients don't know how best to utilize their hour-long session. Therapy is a collaborative process, and discussing concerns about goals at the forefront and as soon as they arise is helpful. 

See also:

• Individual counselling

• Couples counselling

No Goal, No Problem!

Sometimes we come to therapy because our parents, caregivers, teachers, or other healthcare professionals have recommended it. In this case, the goals may reflect symptom change but not why these goals should be pursued and how to begin effecting real change by targeting the root of the issue. Furthermore, it can be challenging to know what we want and need, and sometimes feelings and thoughts only hint that something is not right, that something is amiss, or discontentment to the point of not wanting to do anything.

Reading Between the Thoughts & Emotions

If we stop and listen, emotions provide vital information. Anxiety tells us we're facing a threat or challenge, guilt pops in when we've acted against our values and depression when something is missing from our lives. 

A common misconception of Cognitive Behavioural Therapy (CBT) and its treatment of depression and depressive symptoms is that it treats moods before helping clients lead the lives they've been putting off. When what we do is the opposite, help you lead a life according to your values to increase mood. We will work together to determine what you really care about. What does get you out of bed in the mornings? What if not now previously brought joy or pleasure? 

Values-Focused 

Therapy may often begin or include a reflection of values, what's important in life, and what activities make up those values. We will explore the following areas:

• work/career

• self-education/learning

• volunteering

• intimacy/romantic relationships

• friendships

• family

• philosophy/spirituality/religion

• leisure/recreation/entertainment

• health/fitness

Then, we move into what's getting in the way of participating in these activities and how we can strengthen your skills to get you there. We start scheduling activities slowly, at a pace that feels right for you and use CBT to tackle thoughts that might get in the way.

Your therapist might also ask specific questions such as:

1. How would your life look different if you felt less anxious?

2. What would you do differently today, this week, this month, or this year if anxiety weren't a problem in your life?

The Miracle Question

Another strategy that allows clients struggling with goal setting to know when therapy is over and provides helpful information to build goals is the Miracle Question from Solution-Focused Therapy. 

Now, I want to ask you a strange question. Suppose that while you are sleeping tonight and the entire house is quiet, a miracle happens. The miracle is that the problem which brought you here is solved. However, because you're sleeping, you don't know that the miracle has happened. So, when you wake up tomorrow morning, what will be different that will tell you a miracle has happened and the problem which bought you here is solved? (DeJong and Berg, 1998, pp. 77–78, cited in Pichot, 2009, p. 27).

Now What?

We now convert these larger goals into clear, concrete, specific, measurable, and manageable small behavioural steps, framing them as a solution rather than the absence of a problem and allowing therapy to move from focusing solely on symptoms, disorders, diagnoses, and problems to building personhood and achievement.

Scaling

Setting goals in therapy is important for multiple reasons, as noted above, including monitoring therapy progress. Following goal setting, your therapist may ask you a scaling question (0-10 or 1-10) for where things were when the initial appointment was arranged, where things are now, and where they will be when therapy is successful.

References

Besenhofer, R. Utilizing solutions – Focused brief practice as assessment for intervention. https://www.able-differently.org/wp-content/uploads/2012/01/UtiliIizingSolutions1.pdf

De Shazer, S., Dolan, Y., Korman, H., Trepper, T., McCollum, E., & Berg, I.K. (2021). More than miracles: The state of the art of solution-Focused brief therapy (2nd Edition). Routledge. https://doi.org/10.4324/9781003125600

Grossman, H. (2021, June 8). Goal setting to engage adolescents. Beck Institute. https://beckinstitute.org/blog/goal-setting-to-engage-adolescents/

Hindman, R. (2021, June 8). Value-focused treatment in CBT for depression. Beck Institute. https://beckinstitute.org/blog/value-focused-treatment-in-cbt-for-depression/ 
Pichot, T., & Smock, S. A. (2011). Solution-focused substance abuse treatment. Routledge.