Healthcare Training Institute - Quality Education since 1979
CE for Psychologist, Social Worker, Counselor, & MFT!!
In the last section, we discussed goal-setting. Have you found, like I, that it is quite common at the initial goal-setting stage for clients to start with a goal that is too vague, broad, or poorly defined? What do you do about your clients who have problems setting goals? I try to encourage my clients' exploration by asking evaluative questions and allowing enough time for them to come up with more useful goal ideas. I find it is often the case that clients need more than one session to fully structure their goals.
Language of Not Doing
the Client's Language
Then I asked Leo, "In terms of the specifics about yourself, when you think about this goal, can you talk about what you need to do at this point?" When Leo answered, "I just need to be another person, that's all," I asked him what he would be doing differently if he were this other person. I have found, probably like you have found, that it is helpful to use the client's language, when I ask a follow-up question, so that he is encouraged to evaluate what he has just said.
♦ Directive Questioning
So I continued directive questioning by asking him, "What kinds of things would you do to put that smile on your face?" Leo eventually began to respond with some action words. For instance, Leo said, "Well, I like to get out into the woods by myself. And I like to fish." I urged him to come up with similar actions that he did not already do on a regular basis. Leo finally stated, "I guess I'd like to be around good people that actually do something with their lives."
When I asked him how he might begin to be around these people, he stated, "Well, I'm going to move out of the county. I know too many people here, and I'll get closer to Southern California to be closer to my oldest daughter. I haven't seen my second grandson yet." Then, Leo came up with the action-based goal of making more frequent contact with his daughter and taking steps toward moving into a house closer to her apartment.
♦ Goal Stuck
Zach, 37, was in a relationship with his girlfriend, Catherine, that he described as "really good" but was court-ordered to the group because of an altercation in which he pulled his ex-wife, Deborah, out of his home by her hair. Zach was particularly goal stuck. He could not seem to create a workable goal. He stated, "I feel fine, and everything is okay." With Zach, I tried to remain very persistent in asking questions that would assist him in his search. I not only asked Zach directive questions like the ones I had used with Leo. I also found it useful to use strength-based questions such as "What have you done that you are proud of?"
I try to see myself as a partner to court-ordered clients like Zach working in a race against the clock because these clients must develop a goal within the agreed-upon time limits. I find that an advantage of taking on the role of partner is externalizing the time limit. When we are working as partners, the time constraint is a natural law rather than a limit I have imposed on the client. It is true, after all, that the time limit is imposed on both the client and the facilitating team.
Zach often became frustrated with my persistent efforts. He stated emphatically, "I'm fine! Everything's FINE!" What do you do about your clients like Zach who are the most frustrated with goal-setting? On rare occasions, when a client like Zach remains stuck regardless of efforts to develop a goal, I break my own rules. I offer to make a goal suggestion. I gave Zach the option of getting ideas from the group, from me, or from all of us. Zach stated, "Sure. I'll tell you if I can do them or not." Zach, like many clients, decided he would like ideas both from the group and from me.
As you can imagine, most of my ideas and the ideas from the group were instantly rejected. I found the process of sharing goal suggestions was still useful. Zach was able to develop a goal more confidently after seeing that the group and I had failed to find a solution for him. Zach set a goal to take some time driving by himself, because that is how he had found in the past that he could think the most clearly. In a later session, Zach stated, "I want to start spending more time with my son and help him with his homework more."
This way, Zach hoped to have less conflict with his ex-wife concerning his worth as a father. Most of the time, I try to work on goal development without using the group-brainstorming process because it can be time consuming. Sometimes though, with clients like Zach, I find it is necessary. Are you currently treating a client who is struggling with goal-setting who might benefit from a group-brainstorming session?
If the goal-stuck client requests that I write a positive recommendation letter to the court regarding his efforts, I inform him that I will only note his attendance and my willingness to have him come back to the next series of groups. I have found that the few clients who have not been able to develop goals are later able to develop goals when they come back and successfully complete the anger management program. I believe this lack of a positive recommendation to the court until they develop a goal to be a very effective strategy. Thus, the client is recycled through the first three sessions until they develop a goal statement. How do you use your court recommendation as a lever?
In this section, we discussed ways to help clients who are "goal stuck." In the next section, we will discuss how to get out of therapeutic ruts with clients who you feel are deadlocked.