Question: I have worked with clients who seem to lack specific goals for therapy and who just want to talk. While I understand the value of building a strong therapeutic relationship and offering a safe and supportive space for clients to express themselves, I worry that I may not be able to provide the direction and focus that these clients need to achieve positive outcomes.
I would like to ask for your guidance on how to approach clients who don’t seem to have specific goals for therapy. How can I engage these clients in a way that helps them identify their needs and work towards concrete goals? How can I encourage these clients to set goals and take steps towards achieving them? I understand that every client is different, and that some may require a more open-ended approach to therapy.
However, I want to make sure I am still able to provide effective support to clients who don’t have specific goals in mind. I would appreciate any advice you can offer on this issue.
Response from Dr. Chua: Therapy is collaborative. While your client might not have any specific goals, your assessment should reveal what would be useful to focus on in therapy. Some therapies come with a goal. For instance, a goal of group therapy is to learn how to relate better to people and improve relationships. By joining the group, I’m agreeing to that main goal. I have yet to meet anyone who comes to therapy who is satisfied and happy with their lives. Most people come to therapy because there’s at least some degree of discontent. Something bothers them. They might not know exactly what bothers them but they know they feel troubled. The client will probably articulate this when telling you why they came to therapy (“because something bothers me”).
Here, the natural goal of therapy could be figuring out the problem (what is bothered, when did it start, etc) and then figuring out a way to live in a way that the client feels less troubled. If a client comes in “just to talk”, then that’s their goal. But it also raises many questions. Are you the only person the client is talking to? Are there other people in the client’s life that they can receive emotional support from? What does the client want to talk about? What are your client’s concerns?
As you can see, providing a safe space for exploration is not mutually exclusive to information gathering and moving towards a place of growth. A safe place doesn’t mean you just receive, but you are actively processing, understanding, exploring and connecting. And through that process, a direction will emerge. If you are doing a more goal-oriented therapy like CBT, you will still do something similar. Therapy always moves forward towards growth and change.
I started by saying therapy is collaborative. So, your client must agree with the purpose and direction of therapy. If “just to talk” isn’t a goal you can work with, or you find it difficult, then you need to be honest with your client – but they get the final say on the direction and purpose of their therapy.
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