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How to create better goals for your patient in CBT

Updated the 19th of March 2023

A central part of Cognitive Behavioral Therapy (CBT) is the case formulation. The purpose of the case formulation is for the patient and psychologist to develop a joint model for the patient's problem, and how the treatment should be adapted for the specific patient. The last step is to set treatment goals. Setting good goals is important for the patient to be motivated to complete their treatment.

What are treatment goals in CBT?

The purpose of treatment goals is to create concrete yardsticks for what counts as a successful outcome in treatment. Treatment goals should be set collaboratively, and adapted to the patient's life situation. The theoretical analysis of the therapist is woven in and put in context to the patient-specific wishes. The goals are measurable and specific, and can be evaluated at the end of therapy, to reevaluate the case conceptualization.

Easy tips for goal setting in CBT

1. Create goals with different time horizons

At the beginning of therapy, a central aim is to convey hope that the patient can change his/her situation. A good way to get the patient to experience that this change is possible is to set near-term goals that the patient can achieve relatively quickly. These goals should be achievable within the first few sessions of therapy. At the same time, goals should be set for the end of treatment, and after a longer period of time after the end of treatment. Early goals may be about symptom reduction and returning to regular activities, while longer goals may focus on relapse prevention and personal development.

2. Formulate goals with the SMART methodology

A SMART goal is:

  • Specific. It describes an outcome that can be defined.

  • Measurable. It is possible to verify for a third party that the goal has been met. It is possible to observe and measure the degree of compliance.

  • Achievable. The goal is realistic based on the patient's situation.

  • Relevant. The goal is associated with the patient's problems and personal hopes about the treatment.

  • Time bound. The goal is limited to a specific time period.

The advantage of setting specific, measurable and time-bound goals is that they can be easily evaluated, both in the long and short term. This makes the patient's progression easier to visualize. It also makes it easier to implement measures if the treatment does not bring the patient closer to his/her goals.

3. Create both negative and positive goals

During the case conceptualization, the patient's problems and symptoms should be listed concretely. It is natural that the reduction of these problems is seen as a goal in itself. However, it is not always possible or preferred that all symptoms should disappear, as the main treatment goal. It may be just as important to formulate positive treatment goals that deal with what the patient wants to add in terms of behavior to their life, in the absence of their symptoms.

Do you want help in guiding your patient through treatment in a motivating way? Book a demonstration of our tool Zeeds, and we can show you how we can help you.

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