What are your goals for therapy?
When clients come to therapy for the first time and they're asked what their goals are, the most common answer in my experience is, "I want to feel better". Of course, this is a valid answer, however, as a client we need to understand that counselling is an active process and we have our role to play in it, to be ‘actively engaged’.
What is active engagement in therapy?
Surely this means turning up, staying to the end of the session, listening dutifully and paying the appropriate fee? Many think so, but therapy involves work outside of the counselling environment; whether it be via mutually agreed set tasks, reflection, implementing better practices for living, psychoeducation... and perhaps the starting point begins with thinking about what we want to achieve from attending counselling sessions.
Therapy is not something that is done to us – our counsellor cannot fix us, only we can do this. Life sometimes feels very unfair and indeed sometimes, things are done to us and we are left to deal with the aftermath. It makes sense, therefore, that we might learn that things are done to us and this will be the case with therapy as well. However, despite whatever our previous experiences may be, our thoughts and feelings are our responsibility and ours alone.
Therapy will only affect change by clients regaining their own sense of self-agency, their understanding that they are responsible for their lives.
A counsellor cannot affect healing by rescuing clients from their feelings, no matter how much a client may want them to.
A counsellor needs to respect a client’s free will, autonomy and responsibility for their own life. If they take on that responsibility either by wresting it from the client or accepting it as a consequence of the client’s abdication, there can be no progress.
The importance of goals in the therapeutic relationship
Imagine visiting your GP who asks how they can help and you say, "I don’t know." Well in my experience, that is often the case with clients attending therapy sessions. As a patient, of course, we are not expected to be able to diagnose ourselves but we do know the GP cannot determine what the end goal might be by our saying, "I don’t feel well".
Instead, we help them by saying "I want help with….." and then describing our symptoms and experiences more fully, thereby helping the GP form a picture of what the issue might be and what the goal for treatment is.
There would be little point in letting the GP just guess and coming away with a treatment plan for migraines when actually we wanted help with a painful knee – it’s no different with therapy. By sharing with your counsellor what you want to gain from counselling, they can ensure you are getting the support you need.
Without having some direction, we run the risk of concluding therapy by saying something along the lines of "Well they were nice to talk to but I’m not sure what I actually got from it" or "It didn’t really help me with x". Counselling is a big investment, not just financially but also of your time and energy and identifying therapeutic goals are helpful to ensure you are getting a good return on your investment.
What do goals for therapy look like?
A goal is unique to each of us and can be whatever you feel will help you. Examples might include:
- Psychoeducation – for example anxiety. You might want to learn about the fight/flight/freeze response to better understand how it works so you can manage your own anxiety.
- Gaining mastery – do you want to learn to say ‘no’ and develop your assertiveness skills?
- Stabilisation/coping techniques – maybe you would like to learn some relaxation techniques or perhaps some strategies to manage recurring nightmares.
- To feel heard – often counselling is the first opportunity for us to tell our story and say how it really is without fear of judgement or reprisal, or maybe you have always coped by bottling things up and would like to express your feelings.
- Improve self-esteem – are you always feeling lesser than others and as though you are 'not good enough’ and want to change this moving forward?
- Stop overthinking – maybe you want to be able to move forward without constantly worrying about what others might think.
How to identify your goals
For some, a goal is clear and obvious but if things just feel so overwhelming, it can be really difficult to know where to begin, which often leads to us giving it back to the counsellor with phrases such as "I don’t know".
Another way to understand what you might like to focus on is to imagine what differences you would notice in your daily life if counselling had been successful and to work backwards.
Imagine that, while you’re sleeping, all of your problems are solved. When you wake up, what changes do you notice?
I would be able to say no in a polite but assertive manner and not feel bad about it. I would not be taking on everybody else’s stuff but handing the responsibility back to them. I would not feel taken for granted. I would be able to concentrate more on the things I want to do rather than what others expect me to do. Therefore the goal would be to learn to say no.
I would feel heard, understood and validated. Therefore the goal might be ‘to tell my story freely without judgement or reprisal from those who are listening.'
To get a good night's sleep without waking up sweating and scared. Therefore the goal might be ‘to manage my recurring nightmares and improve my sleep routine overall’.
Once you have established your goals, you can then discuss with your therapist how you might get to your desired end result, considering what support you might need from them and others along the way. In essence, you will discuss what the work might look like.
Using the example above of learning to say no:
- Explore the various communication styles and identify what your current style is.
- Understand your fears about saying no and where this derives from.
- Learning about the six key ways we can say no.
- Practise by role-playing with your counsellor.
- Practise with your support network.
- Practise in daily life when required.
Having a goal means that, along with your counsellor and in your own time, you can review progress at each step, perhaps noting areas of resistance from yourself and what help you need to overcome this; revisiting previous steps if appropriate, reflecting on what might be most difficult and how you are feeling compared to when you started.
So, if you are thinking of engaging with a counsellor, rather than expecting/hoping them to fix things, just take a moment to consider your role in the relationship and ask yourself:
- What specifically do I need help with?
- What do I want to achieve from sessions?
- What difference(s) will I notice in daily life at the end of therapy?
Please feel free to reach out to me to arrange an initial call.