Reading A

Often, counsellors (or sometimes clients will complain, “The session didn’t go anywhere” or “I felt like we were talking in circles.” As part of the assessment process, it is important to translate general client concerns into specific desired goals. Goals give direction to the therapeutic process and help both the counselor and the client to move in a focused direction with a specific route in mind. They represent the results or outcomes the client wants to achieve at the end of counseling. Without goals, it is all too easy to get sidetracked or lost. Goals help both the counselor and client to specify exactly what can and cannot be accomplished through counseling. In this respect, goal setting is an important extension of the assessment process in counseling. Recall that during assessment, clients focus on specific concerns and issues that are difficult, problematic, or not going very well for them. In goal setting, clients identify, with the counselor's help, specific ways in which they want to resolve these issues and specific courses of action they can take for problem resolution.

Goals serve four important functions in the counseling process. First, goals can have a motivational effect. When clients are encouraged to specify desirable changes in their lives, they are more likely to work toward accomplishing those outcomes. This is particularly true when clients actively participate in the goal-setting process.

Goals also have an educational function in counseling. Over and over again, helpers realize that clients have not been successful in managing their lives because they do not know how to set positive, achievable goals. Such goals can help clients acquire new life responses. By going through a goal-setting process, clients learn not only how to structure their lives but also what changes in behavior or thinking may be involved in the new vista. Dixon and Glover (1984) explain the benefits in this way:

Once a goal is formulated and selected by a problem solver, it is likely to be rehearsed in the working memory and stored in long-term memory. A goal encoded in this way, then, becomes a major heuristic for the problem solver as he or she interacts with the environment. (pp. 128-129)

This is quite evident in the performance of highly successful performers and athletes who set goals for themselves and then use the goals to rehearse their performance over and over again in their heads. Concert pianists, for example, cognitively rehearse the way they want a particular passage to sound; champion divers visualize themselves performing a particular dive in a desired fashion both before the competition and on the platform.

Goals provide an evaluative function in counseling. The type of outcomes or change represented by the client's goals helps the counselor to select and evaluate various counseling interventions that are likely to be successful for a particular client pursuing a specific goal or set of outcomes. Goals also contribute to the evaluative function in counseling because a goal represents a desired outcome, a point at which counseling would be deemed successful. Thus, when outcome goals are established, both the counselor and the client can evaluate client progress toward the goals in order to determine when they are being attained and when the goals or the counseling intervention may need revision. But goals need to be defined so that clients can measure their progress. This means that goals must be observable and measurable rather than global and nonmeasurable. When goals are observable and measurable, clients can recognize when efforts are succeeding or when efforts need to be revised because they are not succeeding.

Finally, goals serve a treatment assessment function in counseling. As the impact of managed care on counseling practice continues to grow, peer review of the effectiveness of treatment becomes increasingly important. In this context, goal setting by the counselor becomes part of the formal treatment plan. (See Chapter 7 for a more extensive discussion of treatment plans.) Typically, these goals are derived from the goals that have been identified in the counselor-client discussion. Others will be developed by the counselor after reviewing and interpreting data from the assessment phase of counseling.

The counseling process involves two types of goals: process goals and outcome goals. Process goals are related to the establishment of therapeutic conditions necessary for client change. These are general goals, such as establishing rapport, providing a nonthreatening setting, and possessing and communicating accurate empathy and positive regard. They can be generalized to all client relationships and can be considered universal goals. Process goals are the counselor's primary responsibility; you cannot expect your clients to share the responsibility for these goals. Most of what was discussed in Chapters 4 and 5 are process goals.

Unlike process goals, outcome goals are different for each client. They are the goals directly related to the life changes your clients hope to accomplish through counseling. As you help each client understand his or her concerns, you will want to help each client understand how counseling can be useful in responding to those concerns. The two of you will begin to formulate tentative outcome goals together. As counseling continues, the original goals may be modified through better understanding of the problems and through the development of new attitudes and behaviors that will eliminate or reduce problems. Goal setting should be viewed as a flexible process, always subject to modification and refinement. Most important, outcome goals are shared goals—goals that both you and your client agree to work toward achieving.

Outcome goals that are visible or observable are more useful because it is easier to determine when they have been achieved. But not all outcome goals are stated as visible goals. For example, consider these two outcome goals:

1. To help your client develop his or her self-esteem
2. To increase the number of positive self-statements at home and at work by 50% over the next six weeks

Both of these could be considered outcome goals. They might even be so closely related as to be the same goal in terms of outcomes. (That is, the person who is saying more positive things about him- or herself may be well on the way to developing positive self-esteem.) Your client may be more attracted to less explicit goals (e.g., better self-esteem) because most people are inexperienced in making specific, measurable goals.

You may want to view the development of self-esteem as a composite of many smaller and more specific changes. To state it a little differently, self-esteem is a quality that is reflected in many behaviors. It is inferred through those observed behaviors. Using enhanced self-esteem as your goal, you have no way of knowing the types of activity that your client will enter into while proceeding toward the goal. As a result, you and your client may spend a lot of time talking about self-esteem and how much he or she has or doesn't have, but things that can be done to enhance self-esteem are not addressed. Consequently, the first goal (number in the list above) does not provide as much information about how counseling should proceed as does the second goal.

When outcome goals are stated precisely, both you and your client have a better under-standing of what is to be accomplished. This better understanding permits you to target your client's problems or concerns more directly and reduces tangential efforts. Equally important are the benefits you are able to realize in working toward specific behavioral goals. You are able to enlist the client's cooperation more directly because your client is more likely to understand what is to be done. In addition, you are in a better position to select appropriate interventions and strategies when your client has specific objectives. Finally, both you and your client is in a better position to recognize progress when it happens—a rewarding experience in its own right.

Perhaps you have noticed from our previous examples that outcome goals are different from process goals in several respects. A well-stated outcome goal includes the behavior to be changed, the conditions under which the changed behavior will occur, and the level or amount of change. One client may want to modify eating patterns; another may wish to reduce negative self-appraisals; a third may wish to increase assertive requests or refusals.

The second element of an outcome goal indicates the conditions under which the desired behavior(s)—clients might say desired outcomes—will occur. It is important to weigh carefully the situations or settings in which a client will attempt a new behavior. You wouldn't want to set your client up to fail by identifying settings in which there is little hope for success. The client might agree to modify eating habits at home during the evening but not to attempt to modify those eating habits at the company picnic on Saturday.

The third element of outcome goals involves the choice of a suitable and realistic level or amount of change. That is, how much of the new behavior will a client attempt? Some clients begin diets with the expectation that they will reduce their consumption from 3,000 calories per day to 900 calories per day. A more realistic and attainable goal might be 1.800 to 2,000 calories. This brings up another thought about goals. As you modify goals, you come closer to the ultimate goals of the client. Each time you set a goal, it is a closer approximation of the client's ultimate objective. Successive approximations are very important. They allow a client to set more attainable goals, experience success more frequently, and make what might be dramatic changes in his or her lifestyle.

As noted earlier, most clients are unaccustomed to thinking in terms of specific, concrete goals. Instead of saying, "I want to be able to talk to teachers without getting nervous," the client is likely to say, "I am shy." In other words, a personal characteristic has been described rather than the ways in which the characteristic is expressed. It then becomes the counselor's job to help the client describe the ways in which the characteristic is expressed and, consequently, could be expressed differently. Taking nonspecific concerns and translating them into specific goal statements is no easy task for the counselor, who must understand the nature of the client's problem and the conditions under which it occurs before the translation can begin.

What can you expect of yourself and your clients in terms of setting specific goals? First, the goals that are set can never be more specific than your understanding, and a client's under-standing, of the problem. This means that, at the outset of counseling, goals are likely to be non-specific and nonbehavioral. But nonspecific goals are better than no goals at all.

Clients tend to move from nonspecific to intermediate goal setting and then from intermediate to specific goal setting as they move through the process. In other words, a client will not jump from "I want to be happy" (nonspecific) to "I want to have more friends" (specific). Rather, the client will probably move to the intermediate level of goal setting, as in "I want to have a social life."

As you and your client explore the nature of a particular problem, the type of goal(s) appropriate to the problem should become increasingly apparent. This clarification will permit both of you to move in the direction of identifying specific behaviors that, if changed, would alter the problem in a positive way. These specific behaviors can then be formulated into goal statements; as you discuss the client's problems in more detail, you can gradually add the circumstances in which the client will perform the behaviors and how much or how often the target behaviors might be altered.

Two kinds of skills are associated with goal-setting activities in counseling: the verbal skills the counselor uses to open and guide discussions about client goals, and the structuring skills that the counselor uses to help the client formulate or conceptualize life goals. The counselor should be informed during the assessment stage about the client's ability or insight into the process of goal setting. Some clients will be able to take verbal guidance in the process. Others, especially those who are more visually based, will require visual aids to help them conceptualize goals.

Verbal Goal-Setting Skills

Counselors utilize all the verbal skills presented in preceding chapters when working with clients in the goal-setting process, including verbal attentiveness, reflections, paraphrases, enhancing statements, and various types of questions. In addition to these core responses, counselors also use visualizing, confrontations, and encouraging responses to facilitate goal setting.

Visualizing

Visualizing invites clients to consider how their world might be different or how they would wish to make their world different. It is usually introduced as a targeted question, such as, "When you finish school next year. what would be the ideal job to move into?" Asking about "ideal jobs" is akin to asking about dreams, so the counselor is really asking the client to dream a bit about the future, or his or her relationships, or self-perceptions. Visualizing can be used with almost any topic and often yields information that clients might be shy about stating at first. And indeed, some clients find it almost impossible to visualize a different world, perhaps because their reality is so bleak that hope seems like a dangerous activity.

Confrontation

One of the most useful counselor responses is the confrontation. The word confrontation has acquired some excess emotional meanings. It is sometimes misconstrued to mean "lecturing," "judging," or "punishing." It is more accurate to view the confrontation as a response that enables the client to face that which is being avoided, be it a thought, a feeling, or a behavior. Avoidance is usually expressed as one part of a discrepancy present in the client's message. Thus, the confrontation helps the client to identify a contradiction, a rationalization or excuse, or a misinterpretation. The discrepancy or contradiction is usually one of the following:

1. A discrepancy between what the client is saying and how the client behaves (e.g., the client says that he is a quiet type, but in the interview he talks freely)
2. A contradiction between emotions and behaviors that the client presents (e.g.. the client says that she is comfortable, but she continues to fidget)
3. A discrepancy between two verbal messages (e.g., the client says that he wants to change his behavior, but in the next breath he places all blame for his behavior on his parents and others)

Operationally, the confrontation is a compound sentence. The statement establishes a "you said–but look" condition. In other words, the first part of the statement is the "you said" (a paraphrase or affective reflection). It repeats a message given by the client. The second part of the statement presents the contradiction or discrepancy—the "but look" of the client message. Sometimes the "you said" part can be implied rather than said, particularly if the discrepant message has just occurred. For example:

CLIENT: I just can't talk to people I don't know.
COUNSELOR: [implied] But you don't know me all that well.

The confrontation describes client messages, observes client behavior, and presents evidence. However, the confrontation is not meant to accuse, evaluate, or solve problems. Use of the confrontation serves four important purposes:

1. It assists in the client's effort to become more congruent by helping the client recognize when discrepancies exist.
2. It establishes the counselor as a role model for direct and open communication; if the counselor is comfortable acknowledging contradictions, perhaps the client can become more comfortable challenging them, too.
3. It is an action-oriented response. Unlike the reflection that mirrors the client's feelings, the confrontation mirrors the client's behavior. It is useful in initiating action plans and behavior change.
4. It is useful for exploring conflict associated with change and goal setting.

The Encouraging Response

The encouraging response is intended to say to the client, "I know you have within you the capability to do this" or "to be this." It is often introduced with such phrases as "You could," "You might," and so on. It is an important statement from the counselor and should be used discreetly; that is. it should not be used if the counselor has any doubts about the client's potential to carry out an activity. Although the encouraging response can sound like advice, it can be used effectively as a way to identify alternatives available to the client. It is misused when, in oversimplification, the counselor attempts to suggest or prescribe a solution; the effect is to negate or ignore the client's concerns.

Structuring Goal-Setting Skills

Structuring skills are particularly useful tools when clients need help in understanding the goal-setting process. It was mentioned earlier that clients often don't know how to set goals or, more precisely, how to set appropriate goals. They may literally need to be taught how to select goals that are achievable. Structuring skills often involve visual aids, such as a goal-setting map, a time line, or successive approximation.

Goal-Setting Map

A goal-setting map is a useful tool to help clients learn how to set goals (see Figure 6.1 on the following page). The map provides a visual representation of the goal-setting process and requires the client to focus on the steps that lead to change. The first step is to help your client establish a desired outcome (main goal). Then encourage your client to identify three (or more) changes that have to happen for this goal to be realized (subgoals). Finally, the client must identify two or three behaviors that he or she must do for each of the subgoals to happen (immediate tasks). When several subgoals are identified, they are usually arranged in a sequence or hierarchy, from easiest to attain to most difficult. Similarly, the immediate tasks related to each subgoal are arranged in a logical sequence and are accomplished in that order. The client completes one subgoal before moving on to another. By gradually completing the activities represented by the subgoals and immediate tasks in a successful manner, the client's motivation and energy to change are reinforced and maintained. Successful completion of subgoals always represents actions that move clients in the direction of the desired goal. There are several ways to ensure that counseling subgoals are effective:

• Build subgoals on existing client resources and assets.
• Base subgoals on client selection and commitment.
• Make subgoals congruent with the counselor's and client's values.
• Identify subgoals with immediate tasks the client can reasonably be expected to accomplish.

Time Line

The time line is another visual aid that helps clients gain a time perspective for their goals. Clients often can't visualize potential progress and have unrealistic expectations for what they can accomplish. The time line involves a discussion between the counselor and the client that introduces reality checks for how quickly something might happen (see Figure 6.2 on the following page).

Successive Approximation Stairs

Successive approximation is a way to define change by breaking down the process into a logical sequence of easily achievable steps. It is how humans first learned to walk, talk, read, play, socialize, work, and so on. Even though everyone has had these experiences, many adults cannot analyze goal attainment in terms of steps or stages. They may need to be taught the concept and may need help in defining the steps that are inherent in a particular goal. One way this lesson may be presented is with a visual drawing of the process (see Figure 6.3 on the following page). Using a visual like the one in Figure 6.3 often helps the client visualize the process more easily. By asking the client to help you fill in the blanks for each step in the process, the client becomes involved in the goal-setting procedure.

Step 1: Choose a main goal (long-term or short-term)

Step 2:  Write five steps you must take toward achieving this main goal. These are your subgoals.

Step 3: For each subgoal, write down two specific things you must do to achieve the subgoal. These are your immediate tasks.

FIGURE 6.1 The Goal-Setting Map

The process of setting goals can have important effects on clients. Most are positive or helpful although an occasional client may resist the goal-setting process. The advantages of establishing concrete goals are several. Clients feel clearer about themselves and their wants and needs. Goal setting helps clients sort out the important from the unimportant, the relevant from the trivial of their lives. Goal setting encourages clients to make decisions and choices that represent their most significant values and priorities. As a consequence, clients often feel more enlightened and clearer about what they really want for themselves.

Goal setting is often the first time during counseling that clients begin to take specific action in response to a problem or issue. Sometimes the problem has existed for a long time. Through goal setting, clients can feel better about themselves by overcoming a sense of inertia, by mobilizing their forces, and by starting to set in place a chain of events and behaviors that will lead to problem resolution. As a result, clients often feel a great sense of accomplishment during and after the goal-setting process.

Goal setting affords clients a different view of their problems and concerns. The process of establishing specific goals can be reactive; that is, the act of selecting and defining results can contribute to desired changes in itself. This is particularly true when clients are heavily invested in the goal-setting process.

It is generally agreed among professional counselors that clients progress more rapidly when they have been involved in the goal-setting process and have a clear understanding of how achievement of those goals would enhance their lives. When clients understand and commit to outcomes in counseling, they become co-participants in that process of growth and change.

Research into client perceptions of various aspects of the counseling relationship supports the importance of goal setting (Halstead, Brooks, Goldberg. & Fish, 1990). In the results of their research, Halstead et al. observe

that clients perceived the goal portion of the alliance as being stronger than their counselors did. A possible explanation for this finding, again, may be associated with the nature of the client's personal investment. One would expect the counselor and client to have a common understanding of the explicit goals that help to guide the counseling process. These goals, from the counselor's frame of reference. serve as a beacon by which to set a course to help the client. To the client, however, the goals of counseling, especially in early sessions. may be associated directly with a way to relieve emotional pain. The goals in counseling may represent a real sense of hope for the client. Therefore, it is likely that clients form stronger personal attachments to their goals in that goals can serve to create solutions to what may look like overwhelming situations. (p. 216)