What is Goal Directed Therapy?

The idea behind goal directed therapy is that by the first or second session, clear goals will be worked out by you and the clinical psychologist.  That way, treatment stays focused on what you want to achieve.  Without clear goals there’s a risk of getting caught up with secondary issues, or ignoring what it is you want.  It also makes it much easier to end therapy because you can see whether you’re making progress, and whether your goals have been reached.  You can always change goals down the track, but usually people pick goals that see them through the course of treatment.  Different tools and strategies from cognitive behavioural therapy are the mainstay of treatment.

The first session

When you see a clinical psychologist for the first time you’ll spend most of the session providing an overview of your issues.  Some background information will be needed as well.  The clinical psychologist will try to form a picture about your concerns, and to start planning the best approach.  Sometimes you’ll be able to establish goals of treatment by the end of the first session, though that will often only happen in the second session.  You’ll get some feedback from the psychologist, including an estimate of how many sessions are likely to be needed.  A brief description of treatment will be provided, and you’ll generally get some tasks to complete before the next session – it might be to complete a questionnaire, or to note down thoughts or emotions.  Remember that the psychologist doesn’t know you yet, so the first session is really for the psychologist to conduct an assessment rather than to provide treatment straight away.  You’ll have plenty of opportunity to ask any questions.

Session 2 and on

If you didn’t have enough time in the first session to establish goals, or if there are other questions that need to be answered, the second session should see that covered.  From session 2 is when you really start to learn.  And change.  Sessions will typically begin with a quick review of the previous week; this is to gauge where you’re at, and to see if there have been any major incidents.  A proposed agenda for the session is briefly discussed, though sessions can focus on unplanned topics if they’re worthwhile.  Towards the end of each session you’ll generally get some form of homework, possibly extending work done in the session, or putting into practice something that’s been discussed.  Every few sessions there’ll be a review of the goals to see whether you’re making progress.

While the content of sessions will depend on your own life history and personality, and the type of problems that you want help with, there are some features that you can expect.  Cognitive and behavioural approaches assume that emotional and behavioural problems are learned patterns of thinking and acting.  We form assumptions about ourselves and about the world in which we live as a way of simplifying life.  By and large these assumptions save us a lot of time because we don’t have to analyse everything from scratch.  But sometimes those assumptions are incorrect, yet we hang on to them.  When we are challenged in some way, those assumptions are activated, resulting in negative thinking and emotions to suit, whether that be anger, depression, anxiety, jealousy and so on.  Therapy teaches you to identify your negative thoughts, and strategies to be more realistic in your thinking. The underlying unhelpful assumptions are also worked on to help you avoid the same trap in the future. Behaviours that end up making matters worse are identified, and more helpful ways of responding are learned.  There’s a lot more to it than that, but that’s a broad-brush overview of what happens in the majority of sessions.  Most people are seen weekly for the bulk of psychotherapy.

Ending therapy

Treatment is usually around 8 to 10 sessions, though sometimes it’s quicker, and sometimes longer term.  Cognitive behavioural approaches teach you the skills to keep yourself mentally healthy, and to increase your confidence that you can manage on your own.  Often “booster” sessions are scheduled to make sure that you’re on track, say one month and 3 months after treatment has largely ended.  Of course help is available if things change and you need help, or you need to deal with a different problem.  Having clearly defined goals helps in knowing when it’s time to end.