How to set goals in cognitive therapy

One of the most important elements of the first session with my clients is setting some clear goals for their therapy. This is a key strategy in cognitive therapy, for a few reasons. First, although I see some clients for years, most people come for between 10 and 20 sessions, some less, some more, but that’s the number I always have in mind for straightforward problems like a fear of public speaking or single episode of depression. So we need to be clear about what we are trying to achieve, which of the client’s many problems we are hoping to tackle and, crucially, how we will both know when we have managed that.

When I ask about people’s goals, they often say something quite vague, like ‘I want to be less depressed’ or ‘I don’t want to worry so much about my health’. Now of course I want to help them achieve both of these end results, but it’s important that we get really specific about what exactly would be different if they were not depressed or health-anxious. Here’s how to set yourself specific goals: 

Start with a ‘problem list’. 
You, like me and every other person on the planet, probably have all sorts of problems in your life. You may be dissatisfied with your job, or unhappy in your marriage. Your kids might be hard to manage, or having difficulties at school. You might drink a bit too much or have money worries. Clearly, a relatively brief course of therapy is not going to help you solve all those problems! So be succinct and specific.

Turn the problems into goals 
Your goals should be the positive opposite of your problems. So if your biggest problem is being unable to stop worrying, your goal should be Worrying less. Ask yourself a series of questions to make this concrete:

Imagine you finish therapy and it helps you feel less worried – if I were talking to the less-worried you, how would I know? How would you be thinking, feeling and behaving differently?

What would you have space to think about if the worry didn’t take up so much of your mental energy? Enjoyable things to do with your partner, kids, or friends, maybe. Domestic tasks you have put off for ages that would give you a real sense of achievement to get done. Aspects of your life you would like to improve, but haven’t had the energy or mental space to attend to.

What positive feelings might you have more of that you don’t have right now? If you want to be less anxious, perhaps that would help you feel more calm, secure, strong, confident, peaceful or rested.

How would you behave differently if you were less worried? You may be less likely to fret about things you cannot control, for example. Or allow your teenage daughter to go to a party without it ruining your evening, as you sit at home worrying about every little bad thing that might happen to her. You might feel more able to attend social events, or just to switch off and relax – taking a long, hot bath, or listening to some beautiful music – without always being keyed up and full of restless energy.

Remember to use moderated language like ‘feeling less anxious’, or ‘being more confident at work’, ‘thinking more positively and compassionately about myself’. Your goals should be achievable, otherwise you will get disappointed and discouraged when you don’t reach them, so watch out for goals like ‘Having no anxiety at all’ or ‘Being the best public speaker in my company’, as these might be a tad hard to achieve.

Now write your goals – three or four of a paragraph each – and remember to keep referring back to them as you go through therapy.

If you would like some help with setting goals and want to arrange a session, email dan@danroberts.com

Warm wishes,