As well as working privately, I work within an NHS IAPT Service providing psychological therapy for depression and anxiety disorders and when a client comes into therapy, one of the first things we discuss is goals for treatment.
What is it the client is hoping to change by the end of treatment? Is there anything that the client is not able do now, because of their difficulties, that they would like to be doing in the next couple of months?
Goals help to focus the therapy. It’s quite common that the client will say they would like to increase their confidence or to improve their self esteem, to be less anxious or to be happy. These are very broad goals, would be difficult to measure and don’t tell us what the client would actually be doing differently if they were to be confident, have better self esteem, be less anxious or be happier. So we work together to work out what this might look like.
One way to help determine goals for change is to think of our values. When considering values we need to think about what is really important to us, what gives our life meaning and purpose. Values are what we care about and are different for everybody. They can change over time depending on where we are in our life. Meaningful activity is value driven. Values are fluid and don’t have an end point, they are how we want to live our lives, they help us to be the person we want to be.
We hold values in different areas of our life: intimate relationships / marriage / being a couple; family relations; friendships & social relationships; parenting; career / employment; physical wellbeing / healthy living; connecting with the community; spirituality; education / training / personal growth; mental wellbeing.
It can be useful to consider what values you hold in each of these areas and rate how important each domain is to you and where you are in achieving that domain. For example what kind of values do you hold in physical wellbeing? How do you want to look after yourself physically? Is it to take regular exercise, eat healthily, get enough sleep and rest? Are you achieving this as much as you would like to be? What sort of friend do you want to be and how would you like to act towards your friends? For example, loyal, trustworthy, to spend time with friends, to share, to listen, to have fun together. What kind of values might you want to model as a parent? For example, to be curios, have courage, be adventurous, have determination, gratitude kindness and have fun (to name but a few). Values can be described as compass directions in which we live our life.
If you feel that you are not where you would like to be within a particular domain, how can you bring this value further into your life? This is where goal setting comes in. Values are a direction we want to progress in. Goals can be set to help us achieve that direction. For example, if we place value upon exercise and physical health we might have the goal of going for a swim twice a week or we might have a goal of completing a qualification, which sits within the value of education and personal growth. Goals can be achieved and have an end point. You maybe familiar with the acronym SMART goals. This means goals are specific, measurable, achievable, realistic and time limited. So if we wanted to make the goal of ‘going for a swim twice a week’ into a really SMART goal we could add a set time period, i.e. ‘going for a swim twice a week for half an hour’. By setting SMART goals we break down the areas of change into manageable chunks.
Change is difficult and if we are feeling low or stressed and anxious we can often feel overwhelmed. It is likely that areas of our life that are important to us have become affected and we don’t know where to start to change this.
Setting ourselves small goals for change in line with our values is a useful starting place. It’s important to remember that there is no such thing as a failed goal. If we don’t achieve our goal it still give us useful information. Perhaps we set ourselves an unrealistic goal, in which case we might consider how we can break this down further into smaller, more manageable chunks. We can explore the process along the way whilst trying to achieve our goals and moving towards our values. In this way change takes place and has a positive impact on our mental wellbeing.
Rebecca Mead is an accredited, registered and experienced Psychotherapist offering Cognitive Behavioural Therapy (CBT) and Interpersonal Psychotherapy (IPT) to individuals adults. Rebecca is available at our Brighton and Hove Practice.
Further reading by Rebecca Mead –