The development of a method for studying goal setting in psychotherapy

If you answered “yes” to the question above, please describe your understanding of the goal of the theoretic orientation or treatment approach

Do you currently receive clinical supervision?

Do you have a favorite type of client or specific issue that you prefer to work with and feel most effective in treating?

What are your favorite techniques or tools, or the ones that you use most often?

Have you ever received therapy as a client? If so, for how long? Was this a requirement of your psychology training program?

Are you aware of your therapist's theoretical orientation? If so, what was it?

Date

The Case for Analysis (the Fragment)

Client: I came here two years ago with motivation issues, and you helped me. At that time you said that you also work with people who stutter, from a psychological perspective. I would like to know more about that. What, how, and if it is helpful.

Therapist: Yes, I remember you. Tell me, please, what results would you like to achieve? What goals do you have to work toward right now?

C: Well, the highest goal is a complete elimination of my stuttering. However, there are also a lot of sub-goals. For example, to stop thinking about my speech all the time and to stop allowing it to affect my life so much. Other sub-goals are to stop associating my self-esteem with my speech impairment and, for example, stop thinking that I can't deal with the stuttering. In general, it would be enough for me to reduce the stuttering to the level where communication is possible. Then my speech wouldn't be the center of my life and a fundamental aspect of everything.

T: Those goals you described as connected to reducing your dependence on your speech quality, can be achieved through therapy. Whether the reduction of the dependence on the speech quality leads to changes in the speech -- it's difficult to make predictions.

T: I should emphasize again that I do not provide treatment of stuttering as a speech disorder. Instead, we are going to work toward managing your emotional states and thoughts related to the stuttering. Developing those skills can lead to a relief or, at least, reduce emotional distress -- I can help you with that. In regard to improved speech quality at the end of treatment, I honestly can t give you any guarantees -- it 's out of my area of competence.

T: Imagine that we are transported into the future, 2 -3 months ahead. And you ve got that state you wanted -- freedom to speak, independence from speech. That freedom would be reflected in some thoughts, right? You don't want to think every time “Can I do it or not?” What would you like to think instead?

C: Maybe it sounds weird, but nothing. At least based on my past experience at Center X, my head was absolutely empty then. The speech was just produced by itself, and my thoughts were busy with their own things.

C: I understand everything. I'm not new to stuttering.

Questions of Structured Interviews

What is the problem presented by the client? Describe in your own words.

What problem does the therapist work with? How did the therapist formulate the problem for him or herself?

What general goal did the therapist set?

What goal was set for this specific session described above?

Did the therapist do anything to reach an agreement on the goals with the client?

If yes, please underline those phrases of the therapist that served that goal.

What effect from the work does the therapist expect?

at the end of the therapy

at the end of this session

Did the therapist achieve what he planned for this specific session? Did he achieve the goal he had set? Please explain your answer.

Why do you think the therapist said this in this way?

Do you say this to your clients?

If not, then why not?

If yes, then why do you say this?

Were you taught to say this, at the beginning of your career?

If yes, then in which school of psychotherapy?

Would you say it the same way or differently? If differently, then what would you say?

Literature

1. Natalya V. Kiselnikova (Volkova) -- deputy director, head of the Laboratory of Counselling Psychology and Psychotherapy, FBSSI Psychological Institute of the Russian Academy of Education, Ph.D.

2. Research area: psychology of personal problem solving, representation of problem, counselling psychology, psychotherapy.

3. Vladimir F. Spiridonov -- head of the laboratory, Laboratory for Cognitive Research, Faculty of Psychology, Russian Presidential Academy of National Economy and Public Administration, D.Sc. Research area: problem solving, bottom-up and top-down mechanisms of insight, heuristic strategies, embodied cognition in problem solving, representation of problem.

4. Elena V. Lavrova -- senior researcher, FBSSI Psychological Institute of the Russian Academy of Education, Ph.D.

5. Research area: psychotherapeutic practices, effectiveness of psychotherapy and counselling.

6. Evgeniya A. Kuminskaya -- researcher, FBSSI Psychological Institute of the Russian Academy of Education.

7. Research area: psychotherapy, psychotherapists' competence, psychological counselling, personal problem solving.

8. Svetlana V. Markova -- associated researcher, FBSSI Psychological Institute of the Russian Academy of Education; , psychologist, Medlin Treatment Center (Atlanta, USA), Ph.D. Research area: clinical psychology, methods and effectiveness of psychotherapy.

9. Mariya M. Danina -- senior research fellow, FBSSI Psychological Institute of the Russian Academy of Education, Ph.D.

10. Research area: psychotherapeutic practices, effectiveness of psychotherapy and counselling research, high tech in mental health.

Abstract

The purpose of the study was to develop a method to assess the different characteristics of goal setting among psychotherapists with varying professional experience, and also to trace the relationship between the parameters of goal setting and the effectiveness of psychotherapy. To do this, a productive methodological basis can be a procedure for the study of professional thinking used in the psychology of expertise. The authors identified the characteristics and conditions of goal setting that contribute to the better achievement of goals. The basis for the development of the method was an assumption that the analysis of someone else's psychotherapeutic session from an expert position should stimulate the specialist's ideas about the standard goal setting process. The authors developed a grid of categories for the analysis of structured interview records. Studies using the developed procedure can be carried out in the following areas: 1) identifying the characteristics of goals that are more or less effective in the context of therapy outcomes; 2) studying the transformation of a goal setting process in connection with building up the professional experience of a psychotherapist; 3) revealing the peculiarity of the representation of a client's problem by psychotherapists with varying degrees of expertise; 4) studying the features of goal-setting and the representation of a client's problem by psychotherapists of different approaches. The approbation of this methodology for studying goal setting among therapists with more than 10 years of experience allowed us to identify the main characteristics of the problem and target state descriptions that correlate with the effective achievement of psychotherapeutic results, according to other research.

Keywords: goal setting, psychotherapy, counselling psychology, research methods.

Целью исследования выступала разработка метода, который позволил бы оценить различия в характеристиках постановки целей психотерапевтами с разным профессиональным стажем, а также проследить взаимосвязь между параметрами постановки целей и эффективностью психотерапии. Для этого, с опорой на методологические основы изучения профессионального мышления, используемые в психологии экспертизы, авторы определили особенности и условия постановки целей, способствующие их лучшему достижению. Основой для разработки метода послужило предположение, что анализ чужой психотерапевтической сессии с позиции эксперта должен стимулировать представления специалиста о целеполагании и выявить наиболее типичные способы постановки цели и их особенности. Авторы разработали сетку категорий для анализа записей структурированных интервью. Разработанная процедура может решать следующие задачи: 1) выявление характеристик целей, которые более или менее эффективны в контексте результатов терапии для клиента; 2) ответ на вопрос о трансформации процесса постановки целей и характеристиках сформулированных целей в связи с наращиванием профессионального опыта психотерапевта; 3) выявление особенностей репрезентации проблемы клиента среди психотерапевтов различной степени компетентности; 4) изучение особенностей постановки целей и представления проблемы клиента среди психотерапевтов разных подходов.

Представлены результаты апробации методики на выборке терапевтов с более чем десятилетним опытом работы. Выявлены основные характеристики целевого состояния (достижимость, невключение третьих лиц, четкая формулировка, позитивность), которые, согласно предыдущим исследованиям, коррелируют с эффективным достижением психотерапевтических результатов.

Ключевые слова: целеполагание, психотерапия, консультативная психология, методика исследования.

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