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January 15, 2007
Do you ever feel like a dentist pulling teeth when it comes to getting a goal out of the client? Clients often seem to have problems identifying goals in the WIC setting, but why? For some it may be the fear of giving the wrong answer when asked bluntly “What is your goal?” -- especially when asked to set a nutritional goal by a nutrition professional. Many may find this type of question unfamiliar or baffling. Still others find the concept of goal setting foreign or threatening. So, how can we get the information we need?
In order to understand our role, let’s look at goal setting in simple terms. Goals are defined as anything that someone is willing to put effort towards to bring about a desired outcome. We set goals every day without even thinking about it. We wake up in the morning determined to get to work on time or brush our teeth before leaving the house. We may not call these goals, but the desired outcomes are clear. We are willing to arrive at work on time to get out on time and willing to brush our teeth every day to have healthy teeth for a lifetime. During a counseling session a client might express a desired outcome but not call it a goal. Our role as counselors is to reflect this desired outcome back to the client to help her define it as a goal and move forward with it.
If I asked you to “State one goal having to do with your counseling techniques,” what would you say? A broad, general question is difficult for anyone to answer on the spur of the moment. Now if I asked the same question a little differently – “Say you wanted to improve your counseling style, what do you think would be the first step?” – now what would you say? The second question is a more subtle way of asking you to define a goal -- to figure out the best starting point for you to take towards improving your counseling style.
Working with a client to set a goal can be approached in many ways. The successful counselor uses subtle questions and/or listens for cues from the client during the conversation to set meaningful goals. Here’s a list of subtle questions you can use to find out a client’s goal without even using the word “goal.”
- “You have mentioned that you are concerned about __________, what is it that you want to change about that?”
- “We talked a lot about ____________, how would you like for things to be different?”
- “Most times it is easier to take things one step at a time. What do you think is the first step?”
- "If things worked out exactly as you like, what would be different?"
- "I know that it seems like an uphill battle to __________, but now that we've discussed some options that have worked for other participants, do you think any would work for you? If so, which one?"
- "Would you like to talk about some ideas that have worked for other moms and see if any work for you?"
Successful counselors often never use the word goal until after the client has already expressed something they are willing to change.
Remember that goal setting is personal. As nutrition professionals we may want a client to set a goal that will result in a positive health outcome. However, we need to remember that we want clients to succeed at their goals. Suggesting small, reachable goals – taking baby steps – is another way to help your clients change behaviors. Even if you think a client needs to go cold turkey on certain behaviors - bottles, sodas, candies, Cheetos®, research shows that if you introduce this idea the client becomes more resistant and defensive about the behavior. It’s best to allow the client to make small simple changes and feel successful with those goals
When making a goal, it is important to meet a client where she is. For example, you speak with a mom at length about her child's bottle habits. She expresses a desire to wean her child off the bottle by the age of 2. As a counselor you may not agree with the mother's desired outcome of weaning at age 2 – preferring to wean a child at 14 months – but you must understand that any movement toward change – in this case weaning from the bottle – is going to provide this child with a better health outcome. In other words, you must meet the client where they are in the change process.
Instead of thinking of your counseling session as pulling teeth, think of it as mining for diamonds. Everyone has something they would like to change or discover about himself. We can help facilitate this change through effective counseling.