MCC 670 – Setting Outcome Goals

In the last post, I discuss the problem definition process that occurs during the 1st session of therapy…

“The development of a list of problem titles involves two separate processes…'(Ingram, 2012, p41).  Ingram, (2012), defines a problem as “difficulties, dysfunctions, complaints, and impairments that are identified by the client’ (p. 41)….Additionally, they should be defined as a ‘solvable target (Ingram, 2012, p. 45).  In other words.  what is the desire outcome for this specific problem?  

This post focuses on the process of defining outcome goals when we begin developing our treatment plan.

“Every problem title is paired with an outcome goal, a description of the desired state at the end of therapy – how you will know the problem is solved” (Ingram, 2012, p. 61).   Achievement of outcome goals is the definition of effectiveness.  Therapists gather evidence and progress with outcome goals in mind.  If no progress is made, it may be necessary to reconsider your original case formulation.

Tips for Creating Good Outcome Goals…

Ingram (2012), suggests that outcome goals be specific and measurable in order to guide treatment planning.   Cognitive flexibility and critical thinking are important to help a therapist move from varied levels of abstraction.  Concrete goals can and measurable so success can be recognized.  However, this can limit one’s options at times if goals are too rigid and highly specified.   Other considerations listed in my Ingram (2012), are listed below:

  1. “Be aware of cultural biases and avoid becoming an agent of social conformity” (Ingram, 2012, p. 62).
  2. “Be sure to examine the values related to a stated goal” (Ingram, 2012, p. 62).
  3. “Question whether the client is accepting others’ definitions of happiness” (Ingram, 2012, p. 62)
  4. “How & when are not part of outcome goals….This is in the plan”  (Ingram, 2012, p. 62).

Benefits of Clearly Defined Future Goals…

  1. It can halve a positive effect on the client’s motivation.
  2. Creating a plan with the client can help instill.
  3. Clearly defined goals can help the client progress along the stages of change.
  4. Can help the client clearly define what they want (i.e. choice therapy).

Helping Clients Define Their Goals.

“Client’s usually put forth their problems without difficulty but they often need prodding and a good amount of creativity to put things in terms of a desired future” (Ingram, 2012, p. 63).  What follows are more tips from my textbook:

  1. SMART – Specific, Measurable, Attainable/Achievable, Realistic/Relevant & Time Specific
  2. PUERE – Standards for creating good goals…
    1. Use Positive Terms.  State what you do wan’t not what you don’t want.
    2. Outcome Goals must be Under your Own Control.
    3. Goals must be Evidence-Based, measurable, and operationalized.
    4. Goals must be Realistic and achievable.
    5. They must be ecological and holistic in nature.

Standards for Outcome Goals…

  1. “STANDARD ONE (LOGICAL CONNECTION) – Outcome goals are directly related to the problem title and endorsed by the client” (Ingram, 2012, p. 67)
    1. Should be evaluated for progress regularly
    2. Should ensure align with client’s goals
  2. “STANDARD TWO (THEORETICALLY NEUTRAL) – Do not contain the therapist’s connection” (Ingram, 2o12, p. 69)
  3. “STANDARD THREE: Outcome goals are realistic, attainable, and testable with evidence of real-world functioning.” (Ingram, 2012, p, 70).
    1. Not based on assumption of normal life difficulties.
    2. Not based on client’s agenda to change somebody else
    3. Not based on Utopian Beliefs or Perfectionist Standards.
  4. “STANDARD FOUR: Outcome goals do not contain the how of the treatment plan. People stifle ambitions based on perception of achievability of goals they set” (Ingram, 2012, p. 70).

References

Ingram, B.L. (2012). Clinical Case Formulations: Matching the Integrative Treatment
​Plan to the Client. (2nd ed.). Hoboken, NJ: Wiley.

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