Guided Goal Setting: How to Set Goals in Therapy

Why is it necessary?

Therapy often starts with the end — 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 second session. Your therapist may ask:

• 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. Therapy is a collaborative process, and discussing concerns about goals as they arise is helpful.

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. Sometimes feelings and thoughts only hint that something is not right, that something is amiss.

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 and its treatment of depression is that it treats moods before helping clients lead the lives they’ve been putting off. What we do is the opposite — help you lead a life according to your values to increase mood. We’ll 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 with a reflection of values, what’s important in life, and what activities make up those values. We will explore:

• 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.

Your therapist might also ask:

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 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 brought you here is solved?” (DeJong & Berg, 1998)

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 — allowing therapy to move from focusing on symptoms and diagnoses to building personhood and achievement.

Scaling

Setting goals in therapy is important for monitoring 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.

If you’re considering therapy, book a free 20-minute consult — we’ll talk through what goals might look like for you.