治疗目标设定五步法：聚焦过程导向的技巧指南

英文原文

Good therapy can seem like magic. You sit in your therapist’s office and talk and things in your life start to get better. You don’t get as upset during conversations with your partner and don’t get as stressed out at work. You finally start dealing with that bad habit that’s been holding you back and are feeling creative again. How can therapy do this? While there’s an art to therapy, there’s a science to it, too, and specific things you can do to increase your chances of success. In this article, we explore an often-overlooked way to improve your outcomes in therapy: setting tangible and measurable goals. It’s possible to take even the vaguest or most poetic motivations for therapy and set goals based on them that you can use to track your progress. This can prevent you from getting blocked or stuck in therapy or having no idea if it’s working or not. Read on for tips on how you can set goals for therapy. By following these steps, you can come up with a list of personally meaningful goals that can keep your work in therapy focused and productive. 1. Start by identifying broad motives, hopes, and dreams. At your first therapy session, when your therapist asks, “What brings you to therapy?” the first thing that comes to mind might be a simple, heartfelt statement like, “I just want to be happy,” or “I feel stuck,” or “I’m tired of just going through the motions.” These statements express deep feelings that are important to connect to and work with in therapy. Just saying them to a therapist can kickstart a process of change, growth, and healing. But they’re too vague to make effective goals. To help transform these powerful yearnings into more specific goals, ask yourself: What does being happy look like for you? What specific struggles make you feel stuck? Taking time to reflect on these questions can be therapeutic in itself. One way to develop goals is to brainstorm and write down as many reasons for coming to therapy as you can. Whether you’re writing in paragraphs or making a mind map, the simple process of getting your ideas down on paper (or on a screen) can help you clarify them. It can help to start with a prompt. Questions to Ask Yourself to Help You Figure Out Your Therapy Goals: If you’re not sure where to start, it can help to use some prompts. Here are a few questions to get you started: What are some things in your life that you’re tired of? What are some things in your life that you love and want more of? What are some things you haven’t done yet that you still want to do? Was there a specific problem that brought you to therapy? How and when did it start? Have you been in therapy before? How did it go? What do you hope will be different or better this time? If you have a mental health condition, addressing it will probably be your most important goal. However, taking the time to come up with specific goals related to your mental health journey can help you tailor your therapy experience and make it more satisfying. As you build lists and examine your responses to these or other prompts, you may find that certain motives, hopes, or struggles stand out more than others. Explore these more deeply. What you thought your reason was for coming to therapy might not be the most important change you want to make in your life. 2. Choose a theme to focus on. You might come to therapy feeling like your life is a total disaster. Where do you even begin if you’re having serious problems at work and at home and your bad habits are affecting your health, your finances, and your relationships? How do you pick just one thing to work on if you're having trouble getting on track with anything? It’s okay to walk into your therapist’s office and say, “I’m a total wreck. Can we fix everything?” Your therapist will be sympathetic, want to help, and be ready to listen to you describe the problems you’re having. But you’ll be more successful if you ask your therapist to help you find specific issues to focus on. If you’re falling behind at work and snapping at your partner or children, for example, you might be able to connect these issues to a particular habit or behavior you want to change. It might also be related to a specific cause that you can address in therapy, such as stress, depression, or guilt. Your therapist is trained to identify root problems and can help you if you’re overwhelmed or uncertain how to proceed. 3. Narrow your theme into one or more specific goals. Sometimes, it’s easy to identify specific goals for therapy. Sometimes it takes a little more work. Often, it’s a matter of finding the right term. “I want to figure out if I’m depressed” is easier to turn into an effective goal than “Something just seems to be wrong.” Either one is a fine place to start, but it’s easier to identify symptoms of depression than to identify a needle in the emotional haystack of “Something is wrong.” Therapy Goals: A Few Examples: If you’re not sure what a therapy goal might look like, these example goals may give you some ideas: “I want to heal from depression and get my hope and energy back.” “I want to stop having the same fight with my partner over and over again.” “I want to stop overeating when I’m stressed out and find healthier ways to cope.” “I want to be creative like I used to be when I was younger. I want to paint, sing, or write again.” Keep in mind that these are just examples and that the range of valid therapeutic goals is wide and varied. One of the most common reasons people seek therapy is that they want to be happy but aren’t. Of course, it’s not your job to figure out exactly why you’re unhappy—therapists wouldn’t have much work to do if everyone could figure that out so easily for themselves. But you can start the process by trusting your instincts and saying what you think the problem might be. You can share suspicions with your therapist that you’ve been afraid to share with anyone else. When you confess fears like “I think I might be unhappy because I’m in the wrong line of work,” or “I’m not sure I want to be with my partner,” your relationship with your therapist and your work with each other will deepen. Even being able to say, “I don’t know what I want” can help. 4. Make your goals concrete, measurable, and SMART. The idea of SMART goals comes from the corporate world, but it’s a good frame of reference for any process of goal formation. It helps you avoid the trap of making goals that are too fuzzy to measure. Of course, it’s okay to have fuzzy therapy goals, especially in the beginning. In fact, your goals are likely to change over the course of therapy, as therapy is a process of gaining self-knowledge. However, having only vague goals can make therapy frustrating, especially if you’re not planning on being in therapy for a long time. Think of it as “both/and,” not “either/or.” You can come to therapy to explore deep questions that aren’t concrete or measurable, and enjoy the slow process of getting to know yourself as you change and grow, while also having some specific, concrete things you’re working on. What's a SMART Goal? A SMART goal is: Specific, Measurable, Achievable, Relevant, Time-bound. These aspects make it easier to know whether you’ve achieved your goal, and they also make it easier to track your progress. For a goal to be measurable, it has to be specific. Goals that are both measurable and specific are concrete. You can visualize concrete goals and mark exactly when you’ve met them. For example, “I want to get up every morning by 7:00 AM” is much more concrete than “I want to stop sleeping late.” Saying, “I want to stop binging on Little Debbie and start going to the gym at least twice a week” is more concrete than “I want to be healthier.” Time is an important factor in any goal-setting process. If you’re not sure how long it should take to achieve a major therapeutic goal, break it up into smaller goals. For example, instead of saying, “I want to cure my social anxiety completely in one year,” you can say, “I want to go to at least two social events in the next month” or “I want to get out of the house at least once a day for the next week.” It’s okay if you don’t achieve your goals right away; part of the process of growth is learning what didn’t work and trying again when you don’t succeed the first time. 5. Create an action plan to track and achieve your goals. Once you’ve identified one or more important goals you want to achieve in therapy, you can work together with your therapist to come up with an action plan. In fact, many therapists are required to do this as part of the treatment planning process for their agencies. In general, a treatment plan includes major goals, smaller objectives you can use to track your progress toward these goals, and the methods you’ll use to facilitate change. There are many ways to track progress in therapy, but it helps if you take the time to identify your therapeutic goals first. It’s even better if you share your goals with your therapist and use them to develop a formal therapy plan. Your therapist may have already written up a treatment plan for you based on what you told them you wanted to achieve in therapy. You can ask them to see it, or you can just ask to go through and discuss the goals they’ve written down to see if those are the goals you want to track at home, too. If you haven’t found a therapist yet, you can use the search feature on OpenCounseling to find affordable therapy in your area or sign up for affordable online therapy with BetterHelp (a sponsor). If you can figure out your goals before you even start therapy, you’re sure to hit the ground running!

中文翻译

好的治疗可能看起来像魔法。你坐在治疗师的办公室里交谈，生活中的事情开始变得更好。你在与伴侣的对话中不再那么容易生气，在工作中也不再那么压力山大。你终于开始处理那个一直阻碍你的坏习惯，并再次感受到创造力。治疗如何做到这一点？虽然治疗是一门艺术，但它也是一门科学，你可以做一些具体的事情来增加成功的机会。在本文中，我们探讨了一种常被忽视的提高治疗效果的方法：设定具体且可衡量的目标。即使是最模糊或最诗意的治疗动机，也有可能基于它们设定目标，用来跟踪你的进展。这可以防止你在治疗中受阻或停滞不前，或者不知道治疗是否有效。继续阅读关于如何为治疗设定目标的技巧。通过遵循这些步骤，你可以列出一份对个人有意义的目标清单，让你的治疗工作保持专注和高效。1. 从识别广泛的动机、希望和梦想开始。在你的第一次治疗中，当治疗师问“是什么让你来治疗？”时，你首先想到的可能是一个简单而真诚的陈述，比如“我只是想快乐”，或者“我感觉被困住了”，或者“我厌倦了只是按部就班”。这些陈述表达了深刻的感受，在治疗中连接和处理这些感受很重要。仅仅向治疗师说出它们就可以启动一个改变、成长和治愈的过程。但它们太模糊，无法成为有效的目标。为了帮助将这些强烈的渴望转化为更具体的目标，问问自己：对你来说，快乐是什么样子？是什么具体的挣扎让你感到被困住？花时间反思这些问题本身就有治疗作用。设定目标的一种方法是头脑风暴，写下你能想到的来治疗的所有原因。无论你是写段落还是做思维导图，简单地把想法写在纸上（或屏幕上）的过程可以帮助你理清它们。从一个提示开始会有所帮助。问自己以帮助你找出治疗目标的问题：如果你不确定从哪里开始，使用一些提示会有所帮助。以下是一些问题可以帮助你开始：你生活中厌倦了哪些事情？你生活中喜欢并想要更多的事情是什么？你还没有做但仍然想做的事情是什么？是否有一个具体的问题让你来治疗？它是如何以及何时开始的？你以前接受过治疗吗？情况如何？你希望这次有什么不同或更好？如果你有心理健康问题，解决它可能是你最重要的目标。然而，花时间制定与你的心理健康旅程相关的具体目标可以帮助你定制治疗体验，使其更令人满意。当你列出清单并检查你对这些或其他提示的回答时，你可能会发现某些动机、希望或挣扎比其他更突出。更深入地探索这些。你原以为来治疗的原因可能不是你生活中想要的最重要的改变。2. 选择一个主题来关注。你可能来治疗时感觉自己的生活一团糟。如果你在工作中和家里都有严重问题，坏习惯正在影响你的健康、财务和人际关系，你甚至从哪里开始？如果你在各方面都难以步入正轨，如何只选择一件事来努力？走进治疗师的办公室说“我完全崩溃了。我们能解决一切吗？”是可以的。你的治疗师会同情，想要帮助，并准备好听你描述你遇到的问题。但如果你请治疗师帮助你找到具体的问题来关注，你会更成功。例如，如果你在工作中落后，对伴侣或孩子发脾气，你可能能够将这些问题与你想要改变的特定习惯或行为联系起来。它也可能与你在治疗中可以解决的特定原因有关，比如压力、抑郁或内疚。你的治疗师经过培训，能够识别根本问题，如果你不知所措或不确定如何继续，他们可以帮助你。3. 将你的主题缩小为一个或多个具体目标。有时，很容易确定治疗的具体目标。有时需要更多努力。通常，这是找到正确术语的问题。“我想弄清楚我是否抑郁”比“好像有什么不对劲”更容易转化为有效的目标。两者都是很好的起点，但识别抑郁症状比在“有什么不对劲”的情感干草堆中找针更容易。治疗目标：几个例子：如果你不确定治疗目标可能是什么样子，这些示例目标可能会给你一些想法：“我想从抑郁中康复，找回希望和精力。”“我想停止与伴侣反复争吵。”“我想在压力大时停止暴饮暴食，找到更健康的应对方式。”“我想像年轻时那样有创造力。我想再次画画、唱歌或写作。”请记住，这些只是例子，有效的治疗目标范围广泛多样。人们寻求治疗的最常见原因之一是他们想要快乐但不快乐。当然，弄清楚你为什么不快乐并不是你的工作——如果每个人都能如此轻易地为自己弄清楚，治疗师就没有太多工作可做了。但你可以通过信任你的直觉并说出你认为问题可能是什么来开始这个过程。你可以与治疗师分享你一直害怕与他人分享的怀疑。当你坦白恐惧，比如“我想我可能不快乐是因为我入错了行”，或者“我不确定是否想和伴侣在一起”，你与治疗师的关系以及你们之间的工作将会加深。甚至能够说“我不知道我想要什么”也会有帮助。4. 使你的目标具体、可衡量和SMART。SMART目标的概念来自企业界，但对于任何目标形成过程来说，它都是一个很好的参考框架。它帮助你避免设定过于模糊而无法衡量的目标。当然，有模糊的治疗目标是可以的，尤其是在开始时。事实上，你的目标可能会在治疗过程中改变，因为治疗是一个获得自我认识的过程。然而，只有模糊的目标可能会让治疗令人沮丧，特别是如果你不打算长期接受治疗。把它看作是“两者兼有”，而不是“非此即彼”。你可以来治疗探索不具体或不可衡量的深层问题，享受在改变和成长中慢慢了解自己的过程，同时也有一些具体、具体的事情在努力。什么是SMART目标？SMART目标是：具体的、可衡量的、可实现的、相关的、有时限的。这些方面让你更容易知道是否实现了目标，也更容易跟踪进展。要使目标可衡量，它必须是具体的。既可衡量又具体的目标是具体的。你可以想象具体的目标，并准确标记何时实现了它们。例如，“我想每天早上7:00起床”比“我想停止晚睡”具体得多。说“我想停止暴食小黛比，并开始每周至少去健身房两次”比“我想更健康”更具体。时间是任何目标设定过程中的重要因素。如果你不确定实现一个主要治疗目标需要多长时间，将其分解为更小的目标。例如，与其说“我想在一年内完全治愈社交焦虑”，你可以说“我想在下个月至少参加两次社交活动”或“我想在下周每天至少出门一次”。如果你没有立即实现目标也没关系；成长过程的一部分是学习什么没有奏效，并在第一次不成功时再次尝试。5. 制定行动计划来跟踪和实现你的目标。一旦你确定了一个或多个想要在治疗中实现的重要目标，你可以与治疗师合作制定行动计划。事实上，许多治疗师被要求这样做，作为其机构治疗计划过程的一部分。一般来说，治疗计划包括主要目标、可以用来跟踪进展的较小目标，以及你将用来促进改变的方法。有许多方法可以跟踪治疗进展，但如果你花时间首先确定治疗目标会有所帮助。如果你与治疗师分享你的目标并用它们制定正式的治疗计划，那就更好了。你的治疗师可能已经根据你告诉他们想要在治疗中实现的目标为你写了一份治疗计划。你可以要求看它，或者你可以要求通读并讨论他们写下的目标，看看这些是否也是你想在家里跟踪的目标。如果你还没有找到治疗师，你可以使用OpenCounseling上的搜索功能在你所在地区找到负担得起的治疗，或者注册BetterHelp（赞助商）的负担得起的在线治疗。如果你甚至在开始治疗之前就能弄清楚你的目标，你肯定会迅速开始！

文章概要

本文以“治疗中设定过程导向目标的技巧”为核心，提供了一份五步指南。第一步从识别广泛动机开始，鼓励通过自我提问将模糊愿望转化为具体目标；第二步建议选择一个焦点主题，即使生活一团糟，也能在治疗师帮助下找到核心问题；第三步将主题细化为具体目标，例如从抑郁中康复或改善关系；第四步引入SMART原则，使目标具体、可衡量、可实现、相关且有时限；第五步强调制定行动计划并与治疗师合作跟踪进展。文章强调目标设定能提高治疗效率，防止停滞，并提供了实用示例和提示问题，帮助读者个性化治疗体验。

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