040- Goal Setting

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Goal Setting
Dr. Dawn-Elise Snipes PhD, LPC-MHSP, LMHC
Executive Director, AllCEUs

On Demand course can be found here: https://www.allceus.com/member/cart/index/product/id/521/c/

Why Do I Care
~    Goal setting is an integral part of treatment
~    Goal setting is something everyone does every day
~    Ineffective goals can have a negative impact on self esteem
~    Ineffective goals can make people mistakenly think they are helpless to change anything.
~    Specific
~    Measurable
~    Achievable
~    Realistic
~    Time Limited

~    Think about the last goal you set that was successful…
~    Think about the last goal you set that was unsuccessful.
~    What is the difference between the two?
~    SMART?
~    Motivation?

Goals—The Beginning
~    Goals (WHY)þ
~    Goals are the overarching reason a person begins to do something.
~    Often goals are broad and abstract. “I want to be healthier.”  “I want to be happy.”
~    Goals need to be broken down into manageable, meaningful, observable objectives.
~    Phrase goals as adding a positive instead of removing a negative.
Miracle Question
~    One way to elicit goals is through the miracle question:
~    If you woke up tomorrow and you were _____ (i.e. your problem was resolved/goal was achieved) what would be different?
~    This gives you insight into the foundations of this particular persons symptoms/definition of the problem.
~    Overall Goal for Treatment
~    What is the problem?
~    Example: Depression
~    How will you know when the problem is resolved?
~    Emotionally, I won’t feel as hopeless and helpless.  I wont dread getting out of bed.
~    Mentally, I won’t be so foggy headed and will be able to concentrate
~    Physically, I will have more energy and lose some weight
~    Socially, I will enjoy spending time with friends

~    Subgoals
~    Main Issue
~    Learn about the overall problem (Depression)
~    Learn about your symptoms/causes/triggers of the problem
~    Identify ways to address your specific symptoms/causes/triggers
~    I won’t dread getting out of bed each day
~    Reframed– I will be happy to wake up and face the day
~    Identify causes of dread for you and interventions
~    I will have more energy
~    Learn about causes of fatigue and low energy
~    Identify potential causes of your fatigue and low energy

~    Frequency   (#/time)
~    Number of times per day or week
~    i.e. Number of crying episodes
~    i.e. Number of eating episodes NOT due to hunger
~    i.e. Number of glasses of water consumed/day
~    i.e. Number of wake-ups during the night
~    Duration (How long)
~    Sleep
~    Exercise
~    Crying episodes
~    Intensity
~    Likert (1-mild; 2-moderate; 3-intense; 4-excruciating)
~    Number of calories per binge

~    Main Issue: Depression
~    Likert scale 1-can’t go on, 2-okay, 3-pretty good, 4-Awesome
~    I won’t dread getting out of bed each day –Cause of dread–Job
~    Likert scale 1-can’t go on, 2-okay, 3-pretty good, 4-Awesome
~    I will have more energy—Cause of low energy– poor sleep
~    Record hours slept; number of awakenings; quality of sleep

Activity: Observable and Measurable
~    Write each of the following “goals” on a piece of paper:
~    Lose weight
~    Get in shape
~    Feel better about myself
~    Be happier
~    Identify at least 2 ways for each goal that tells the person he or she has achieved that goal.  “How will you know when you are/have _____”
~    How would you measure each of those?
Achievable, Realistic, Time-Limited
~    Rome was not built in a day
~    Built on prior strengths and individualized
~    Something the client is motivated to change
~    Weekly goals;  Daily goals (IOP); Hourly goals (crisis)

The Hook, A.K.A. The 5 Ws
~    Who is responsible for doing What, When, Where, Why and How
~    This is your client's action plan or map
~    Who (your client)þ
~    What are they responsible for doing, when and where
~    Why are they doing it
~    How is it helping them meet their ultimate goal

~    Main Issue (8/1/2016-9/5/2016)
~    Sally will learn about the overall problem (Depression) by reading one chapter of XYZ Book and the handouts provided by Dr. Snipes each week for 5 weeks.
~    Sally will learn about her symptoms/causes/triggers of the problem by taking notes on what sounds like her as she reads the book and handouts about depression.  She will process those notes in counseling with Dr. Snipes each week.
~    Sally will identify ways to address her specific symptoms/causes/triggers by completing the My Symptoms and My Triggers worksheets provided by Dr. Snipes
~    Each morning and evening, Sally will rate, on a scale from 1-4 her happiness and explain her response.  These logs will be discussed with Dr. Snipes each session.

~    Goal setting means changing a behavior
~    Change usually involves learning something
~    Part of the learning process involves improving motivation
~    Effective change means presenting the information in a form in which the person most easily learns.
~    3 parts to the learning process:
~    Cognition
~    How people acquire knowledge: Seeing, hearing or doing
~    Conceptualization
~    How people process information: Abstract, specific, memory pathways
~    Affective
~    People’s motivation, decision-making styles, values and emotional preferences: How much does this information matter

Learning Styles and Goal Setting
~    Active/Reflective
~    When you process information
~    Auditory/hearing, visual/seeing, or kinesthetic/doing
~    Methods for receiving information
~    Factual or Emotional
~    How you conceptualize information
~    Sensing vs. Intuitive
~    What you pay attention to
~    Global vs. Specific
~    Parts to whole or vice versa
Problem Selection: Motivation
~    Changeable
~    Variable
~    Components
~    Emotional– I want to
~    Cognitive/Intellectual– I need to
~    Social
~    Physical
~    Situational
Motivational Exercise
~    Decisional Balance

~    Completed on each unique behavior and repeated often
~    Can be useful in addressing “resistance”

Maintaining Emotional Motivation
~    List 10 reasons you want to ________ and review them daily.
~    Create a collage of all the reasons you want to __________.
~    Keep a journal of how things change positively for you as you ___________.
~    Make a list of disputes for your most frequent cop-outs.
~    Tell three people about your goal.

Maintaining Intellectual Motivation
~    List 10 reasons you need to _______________.
~    Keep written information available that highlights the benefits of the program.
~    Have clients research how this change can benefit them
~    List 10 reasons you know you can _________.
~    Set an end date for each objective.

Maintaining Social Motivation
~    Identify 3 social supports that understand (or are willing to learn about) addiction and co-occurring disorders recovery
~    Buddy-Up– Encourage people with similar goals to support each other in and out of group/class.
~    Plan weekly fun social activities with friends, children, pets

Maintaining Environmental Motivation
~    Create a positive environment
~    The way things look on the outside often reflect how you feel on the inside
~    Eliminate sensory (visual, auditory, olfactory) stimuli –i.e. Bob Marley has to go.

Maintaining Physical Motivation
~    Keep a daily check-in sheet of how you feel physically (pain, lethargy, fatigue, irritability)
~    Use money you would have spent on your addiction to take care of yourself
~    Fitness center membership
~    Massage
~    Hot-tub
~    Spa day
Maintaining Motivation–General
~    Identify 5 obstacles to accomplishing your goal, what motivations they are related to, and 3 solutions for each

~    Identify 5 reasons for prior relapses, motivations for each and alternative behaviours
~    Failing to consider why you currently do (or do not) engage in certain behaviors.
~     Setting goals that are too big
~     Setting goals that are too hard
~     Setting too many goals
~     Setting goals without sufficient rewards
~     Setting goals that are too specific

~    Identify 3 treatment plan goals patients have set which failed and why.

~    Good Goals
~    Use positive language
~    Address the reasons for not changing as well as changing
~    Are meaningful to the patient
~    SMART
~    Use the KSA progression
~    Knowledge in general
~    Knowledge specific to the patient
~    Skills in general
~    Skills specific to the patient

~    Well formed goals guide effective treatment
~    Making goals SMART helps clients
~    Improve self-esteem and self-efficacy
~    See incremental improvements