In
the last track 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.
  The
Language of Not Doing
Leo, age 53, came to the group with a vague desire
to be different. However, he was without a goal that was specific enough to meet
the requirements stated on the previous track that I had outlined during our first
session for him. Leo stated, "I quit drinking for over a year and started
back again. That's been one of my goals, quitting drinking. Tomorrow, I'm going
to see the doctor and get peace and quiet. I'm just working on a lot of new things.
I'm becoming a vegetarian, like I used to be."
Using
the Client's Language
I found it useful to focus my language on doing,
since Leo seemed more focused on not doing. I mentioned to Leo that if he stopped
drinking, he could use the time he usually spent drinking to do other activities.
I then asked him what those alternate activities might be, and whether they might
lead to a goal. Leo continued to resist the goal-setting process with language
of "not doing." He stated, "I just want to make myself stronger,
because what happened to me, being arrested, is never going to happen again."
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
As
you know, success is most often far from immediate. For instance, after some directive
questioning, Leo still gave answers that avoided physical, goal-reaching actions.
He stated, "All I know is I won't be drinking, and that's going to give me
a lot more time. I want to work. I want to get my body and mind to work together."
To focus on actions, I asked Leo, "How we would know when your body and mind
are actually working together?" Leo stated, "I'll know when I start
feeling good about myself and I have a smile on my face."
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.
Complex,
Undefined Goals
I find that many of my clients are like Leo in that they
begin with a complex, undefined goal that needs to be simplified. I find that
clients benefit from thoughtful questions that help move from general ideas to
more concrete and visible tasks. Simplifying a goal implies that the goal will
not only be easier for clients to define, but also easier for them to perform
and remember. As you know, keeping the goal simple in the beginning allows for
early success and room to expand it later on in the process. Think for a moment
about a client you are currently treating. Would your client, like Leo, benefit
from directive questions and action-focused language?
Goal Stuck
Even
though the client has been court-ordered into anger management, I find that some
clients in denial feel that life is going so well for them that there is nothing
they can think to change or work on. The idea of goal-setting is a completely
foreign concept. Still others put off the goal task, as if it will go away if
they wait long enough. In my mind, I describe all of these clients as being stuck
or unsure about what they want to do. How do you deal with clients who are "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 track, we discussed ways to help clients who are "goal stuck."
In the next track, we will discuss how to get out of therapeutic ruts with clients
who you feel are deadlocked.
Online Continuing Education QUESTION
11
What are two types of questions that are effective in facilitating
clients who are goal-stuck? To select and enter your answer go to .
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