How do you navigate conversations with clients who seem unsure about their goals in therapy?

I would always say start small like really really tiny change that one would like to see happen even at the end of the first or second session. When people see results that are more tangible that can be a good motivation in itself to create hope and hence ideas for goals that are realistic and beneficial.

Motivational Interviewing (MI) is a client-centered approach that I find incredibly effective for working with clients who are unsure about their goals. MI helps me engage with clients in a way that respects their autonomy and encourages them to explore and resolve their ambivalence. I believe that clients are the best experts on their own lives and have the intrinsic motivation needed for change. My role is to facilitate this process by asking open-ended questions, listening reflectively, and summarizing their thoughts, which helps them uncover their values and aspirations more clearly.

Building a strong rapport is essential when clients are uncertain about their goals. I focus on creating a safe and trusting environment where clients feel comfortable sharing their thoughts and feelings without fear of judgment. By showing empathy and understanding, I help clients feel heard and respected. Reflective listening is a key part of this process, as it not only shows that I’m paying attention but also helps clients hear their own concerns and aspirations, often leading to clearer insights about their goals.

Ambivalence is a natural part of the change process, and I acknowledge this as a crucial aspect of therapy. When clients seem unsure about their goals, I work to explore their ambivalence without pushing them towards a quick decision. I help them examine the pros and cons of change, which often reveals their underlying values and priorities. By validating their feelings and uncertainties, I empower clients to consider their options more thoughtfully and move towards more meaningful and self-directed goals.

My goal is to elicit and reinforce change talk from clients, which includes any language that suggests a desire, ability, reason, or need for change. I carefully listen for these statements and reflect them back to clients to strengthen their own motivation. For instance, if a client mentions feeling unhappy about their current situation, I might reflect on how they’re starting to envision a better outcome. This method helps clients articulate their motivations for change more clearly, which is often more persuasive than any argument I could present.

Developing discrepancy is a technique I use to help clients see the gap between their current behavior and their ultimate goals or values. When clients are unsure about their goals, they may not fully see how their current actions are misaligned with where they want to be. I guide them through discussions that help them articulate this gap, which often clarifies the need for change. By highlighting this discrepancy, clients can better understand why change is necessary and align their actions with their broader aspirations.

Once clients start recognizing their motivation for change, I focus on consolidating their commitment to their goals. I summarize their expressed desires and plans and encourage them to take specific steps towards their goals. This might involve setting concrete actions they’ll take before our next session or clearly articulating their commitment. Verbalizing this commitment helps reinforce their resolve and creates a sense of accountability. By making their commitment explicit, clients are more likely to stay focused and motivated in their journey towards achieving their goals.