Why Goal-Setting Sucks

Me (as a young, frustrated youth worker): "Hey, guys, I know that setting treatment goals and doing your case plans really sucks. Let's spend the next hour talking about all the ways that it sucks."

Group of confused youth: "....... seriously?"

Me: "Yes, seriously. What sucks about being forced to come up with SMART goals all the time?"

What followed was a memorable outpouring of all the pent up frustration that clients seeking treatment for addiction and mental health feel with our traditional goal-setting and case-planning processes.

Here are a few of the themes that stood out from that conversation (and many that were to follow over the years);

1. Goals are often extrinsically imposed on clients. They're not the client's goals, they're the goals of (insert authority figure). They lack meaning.
2. Being forced to set goals on a regular basis is a constant reminder that something (you) is "broken" and requires fixing. That you are incomplete as you are.
3. Goals become one more opportunity to fail at achieving something, and can then be used as leverage by (insert authority figure) to re-affirm the problems in the first place.

Case planning, or the setting and evaluation of treatment goals, is widely recognized by clients and helping professionals as one of the most challenging and often least rewarding aspects of treatment. The reasons for this revolve around a simple fact: people seek the services of helping professionals because of the problems in their lives. This is an inherently vulnerable position to be in, because no one wants to be scrutinized in the most painful areas of their lives. 

No one wants to be seen as a ‘problem’.

Chatting about this phenomenon with my good friend and colleague Kelly (a psychologist and family therapist), he had this to chime in:

"Goal setting is particularly challenging whenever there's an external mandate on the client to access services. When people are subjected to external mandates, it can often seem as though personal needs, preferences and hopes become secondary to the goals that others have for them. Under such circumstances, even the most positive, strengths-focused, solution-oriented activity carries with it an implicit assumption - you are unacceptable as you are, and you must meet our expectations.

At some point, people might have heard so much about their problems that they come to identify with these problems. When the story of "problems" is told often enough, for long enough, clients can become dislocated from the larger story of self. And when problems become identities, then even something as positive as ‘goals’ serve as reminders of personal failure.

When circumstances such as the above endure for long enough, motivation tends to become extrinsic - driven by the ‘sticks and carrots’ of punishment and reward. At worst, clients can become altogether de-motivated, drained of personal investment in the services offered them, or completely resistant. This is one of the ways that treatment sometimes unintentionally replicates common dynamics in clients’ lives. The experiences of judgment and failure are familiar to those who have been named as the problem."

When seen in this light, common client experiences of overwhelm, defensiveness, irritation, boredom, disengagement and anger become understandable human responses to the goal-setting or treatment planning process.

Funny enough, treatment planning and goal setting gets a lot easier when you acknowledge the challenges associated with it, and then take steps to address those issues with your clients.

It's possible to rehabilitate the goal-setting process in your program, moving from case planning as necessary (and painful) administrative burden to meaningful therapeutic intervention and opportunity to relocate the client to the centre of our practice.

Your clients might even thank you after they experience a meaningful goal-setting process (that doesn't suck).