Part 2: Getting Started with CBT: Setting Goals

Before you can make changes and develop new habits and ways of thinking, it’s important to understand exactly what you want to change and what differences you want to see. Once you have determined where you are now and where you would like to go, a beginning and an endpoint, you can use the skills and techniques in this workbook to help you progress from point A to point B. This chapter will help you develop a road map to guide you in the work ahead.

Understanding the Problem

The first step is developing a specific, concrete understanding of what you want to change. This may be trickier than it sounds because we’re used to viewing our problems subjectively and sometimes vaguely—for example, you might have a general feeling of discontent or say, “I’m unhappy” or “I can’t seem to get it together.” When we view our problems subjectively, it’s as if we’re sitting inside the problem and can’t see outside of it.

As you use this workbook to help make changes, you will move toward a more objective view of your experience and problems. Viewing the problem from a distance, you’ll be able to see it more clearly. Defining your problems objectively will help you start to make this change. With an objective perspective, you’re working with the facts, not how good or bad something feels. When we work with our individual CBT clients, we often see significant changes at this early phase of therapy just through learning to objectively describe their problems and experiences.

Use the following guide and worksheet to develop an objective understanding of the issues that you would like to address.

Step one: Begin by recognizing overarching concerns. In this phase of collaborating with our CBT clients, we take a broad approach, identifying the general issues that have been affecting them. From there we can hone in on specific objectives.

Some examples include low mood or depression, low self-esteem, shame, anxiety or excessive worrying, low productivity or difficulty getting things done, anger, habits you want to change like smoking or drinking, or difficulty asserting yourself. You might also be struggling with things that are not on this list. Really, any problem you’re having or anything you’d like to change is fair game for CBT.

As you learned in the last chapter, it’s our reactions to situations that tend to cause problems rather than the situations themselves. If you find that your issues are external events or situations, like losing a job or breaking up with a romantic partner, try to think about how that event has impacted you. For example, having a negative interaction with a friend might result in your avoidance of similar social interactions, resulting in social anxiety. (Learn about CBT for social anxiety).

Step two: For each general issue, describe what that problem looks like in your life. Be specific. Many issues can look different for different people.

For example, if you go to a doctor for treatment of a strange pain, you probably wouldn’t say, “My problem is that I’m in pain,” and leave it at that. You’d explain where you feel the pain, how strongly you feel it, when it first started, whether it is stronger at certain times of the day, and whether anything you do makes it worse or better. You might also describe how the pain feels—is it sharp and stabbing or dull and throbbing? When you feel it, does it come and go in waves, or is it consistent? Here, you’ll go through a similar process of describing the issue as if you were helping someone else understand exactly what is going on.

Are there certain thoughts, actions, and emotions that go along with the issues you identified? Here’s an example:

General issues: lack of assertiveness, low self-esteem

Specific Description of Issue #1 (issue: lack of assertiveness)
I have trouble expressing my opinions to friends and at work. I think that I have to agree with everything my friends say or they’ll be angry with me. At work, I don’t speak up during meetings because I worry that I don’t know the right things to say. I’m afraid to ask anyone out on a date because I’m sure they would say no.

Thoughts:
”I don’t know what to say,” “I’m not qualified to be here,” “I always say the wrong things.”

Emotions:
Fear, anxiety, worry

Actions:
Going along with what other people say and do, hiding my own views

Specific Description of Issue #2 (issue: low self-esteem)
I don’t think that I’m worth as much as other people. I don’t like myself, and I don’t think other people really like me either. I think people are just trying to make me feel better when they pay me compliments or say I did a good job on something.

Thoughts:
”I’m useless,” “I’m not as good as other people,” “Why bother trying? I won’t do well.”

Emotions:
Shame, sadness, hopelessness

Actions:
Not trying as hard as I could, pulling away from other people, isolating myself.

Having read through these examples, now it’s your turn to identify your issues and clarify what you’d like to work on. Use the button below to complete the worksheet for identifying and clarifying your issues. If this situation is familiar, read about CBT for Social Anxiety.

Setting Goals

Now that you clearly understand your starting point, it’s time to set some goals to understand where you want to end up. You’ll develop goals that are specific and achievable—goals you can reach. When researchers design experiments, they determine beforehand exactly how they’ll know whether they met their objectives (or confirmed their hypotheses)—not just “Patients who take Drug X will get better” but “Patients who take Y dose of Drug X will show a reduction in symptoms of illness Z compared to patients who took a placebo, as measured by A, B, and C.” What does it mean to get better, and how will you know if you actually improve?

If you could skip ahead to after you have practiced all of the skills and techniques in this workbook for a good period of time, and everything went precisely as you would have hoped, how would your life be different? What exactly will have changed? Are there specific things you’d be able to do that were too difficult before? Are there certain things you want to be able to do?  

Step one: Write down your ultimate goals. These will be changes in each of the general issues you described above. For example, if one of your issues is “low mood or sadness,” an ultimate goal may be “improved mood.”

Step two: As you already did with your general issue, you will now make your ultimate goal more specific. What does this goal mean? How will you know if you have met this goal? Use your specific description of the issues to guide you. For example, if one of your specific descriptions of an issue like anxiety is that you “avoid situations that make me nervous, like parties where I might not know everyone,” one of your specific goals may be to “accept invitations to and attend more parties, even if I might not know people there.” Another specific goal may be to “throw a party and ask my friends to each invite a friend I don’t know.”

Step three: Highlight actions that are consistent with your goals so you know if you’re getting closer to reaching them.

See below for an example, and then complete your own goal-setting sheet.

Ultimate Goal #1: ___ increased assertiveness____________

Specific Goals:
___I want to express my opinions more, including telling my friends what I really think and speaking up in meetings at work. I want to ask someone out on a date, initiate a social plan with my friends, or call or text a friend out of the blue just to chat. I want to believe that I have something to contribute to conversations._____________________________________________

Actions consistent with my goal:
___ Speaking up in social and professional settings, initiating social contact and social plans

Ultimate Goal #2: ___ improved self-esteem____________

Specific Goals:
___I would like to feel better about myself, including thinking that I am worthwhile. I want to know that my work has value and understand and focus on my strengths rather than the weaknesses I see. I want to engage more with my friends instead of avoiding socializing because I might feel bad.

Actions Consistent with My Goal:
___ Connecting with friends and socializing, making lists of my strengths and reminding myself of them, trying harder in my work

Before you move on to the next part of this workbook, stop and complete the Identifying Issues and Goal-Setting worksheets. Take time to think about your issues and goals as you write them down. The more thought you put into this portion of the program, the more likely it is that you’ll have a clear path to obtaining your goals later. Remember, this is your blueprint for the rest of your work in this program.

It may be difficult to face these issues, to write them down, and to think about the changes you want to make, especially if you have been trying to avoid thinking about these problems or if you have been feeling this way for a long time and any change seems difficult. But you have just taken a big step toward making those very changes just by understanding and clarifying the problem and setting goals. You have created a plan that you can use as you move forward and that you can add to as you progress.