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Help The Client Realize Progress in Specific Ways

Specificity is important in setting goals, taking action and in realizing progress. In these two

cases I show how being specific makes a huge difference.

Clients need to see realistic progress from week to week. Realizing that progress is being

made is motivating and gives the client hope that the problem can be resolved. One of the

common ways to help clients see progress is with the scaling question (Presbury, Echterling &

McKee, 2008, p. 87; Littrell, 1998, p. 127). While the scaling question is one way to help clients

see progress, the following story illustrates another way of helping clients see progress.

Realizing Progress

Perry worried excessively about his health. He had experienced pain in his chest and

obsessed about it. He had been to his doctor and a heart specialist; though both assured him that

his heart was healthy, he still worried.

I suggested three options Perry could use when he obsessed. First, he could hear the voices

of his doctor and the heart specialist assuring him that his heart was healthy. We practiced

creating the voices so that he was confident that he could create them anytime he needed them.

Second, he could use paradoxical intention (Frankl, 1975, 1978, & 1984). When he began to

obsess, he could exaggerate the obsessing until it became ridiculous and he could laugh at

himself. We also practiced this exaggeration technique so that he was confident that he could

use it. Third, he could make a list of the evidence that proved he was healthy and a list of the

evidence that proved he was ill; then he could compare the two lists. We made the lists and he

put them in his wallet so that he could review them anytime he needed them. He left my office

confident that he could overcome his obsessing with these three options.

Two and a half weeks later, Perry called to make another appointment. In the session he

told me that he had not obsessed about his health for two and a half weeks, but the morning he

called he had awakened with a pain in his chest and obsessed to the point of having a panic

attack. He was able to quickly calm down and, as he investigated the pain, he realized that it was

muscle pain caused by having slept in an uncomfortable position.

What would you have said to Perry at this point? How would you have helped him see

the progress he had made? Write your response.

I asked Perry to compare how he would have handled this situation a month ago to how he

handled it now. Had this occurred a month ago, he realized, he would have worried about it for

days instead of only minutes, which showed him how much progress he had made. He left my

office feeling confident.

In a follow-up two weeks later, Perry reported that he still had times when he would

momentarily panic, but he could calm himself by using one or more of the three options we had

created. He was pleased with the outcome, not troubled by his inability to totally eliminate the

panic.

Perry’s story shows two realities. First, it shows how important it is for the client to

recognize progress. By Perry comparing how he would have handled the situation a month

earlier with how he handled it in the present, he gained confidence with his ability to handle his

obsessing and panic. Perry’s story also shows that a problem does not always need to be totally

solved for the client to be okay. For whatever reason, Perry was unable to totally eliminate his

worry and panic. However, because he could quickly overcome the panic when it occurred, he

was satisfied with the experience.

In the following case I assist the client to be specific in his plan of action. He already had

the motivation he needed, what he lacked was a specific plan of action. Once he had a specific

plan, he was able to execute it and be successful.

The more specific a client is, the more likely it is that the issue will be resolved. Presbury,

Echterling & McKee (2002, p. 211) wrote: “By encouraging your clients to be detailed and

specific in describing their current circumstances and future goals, you are helping to set the

stage for therapeutic change. When clients state their concerns in behavioral terms and depict

their circumstances with attention to the particulars, they are making it more possible for you to

re-label, addressing the facts of the situation. And when clients describe their goals in such

detail, they are creating a vision that offers vividness, power, and hope for a better future.”

The following story illustrates how being specific helped a client resolve his issue.

Moving From Abstract to Concrete

Motivation is a word that is used frequently but is so vague that it has little practical

meaning. This was the case for Ian, who was a sophomore in college majoring in pre-med. He

had a 3.2 grade point average, which had to be higher if Ian were to be accepted into medical

school. He stated that his problem was a lack of motivation to study more.

How would you help Ian gain motivation? Write down as many alternatives as possible.

We began to discuss specifically what he needed to do to raise his grade point average.

After considering how many hours a week he needed to study, we wrote these hours on a

calendar so that he knew exactly when he would study. We outlined the place where he could

study so that he could walk around and talk out loud as he studied. In our discussion, we

considered his rewriting his notes after every class and reading through his notes every day. We

also discussed accountability and how he would check in with his accountability partner every

night concerning how well he had kept his study commitments.

When our session ended, Ian reported that he felt motivated and confident that he would

succeed, and we agreed to meet the next week to see how he was doing. When he returned the

next week, he noted that he had kept his schedule and was very pleased, confident that he would

continue to successfully keep the schedule.

When grades came out at the end of the semester, Ian called to announce that he had made a

4.0 for the semester. He thanked me for helping him become motivated.

We really didn’t work on motivation, did we? We worked on stating in very specific terms

what Ian would do to be successful academically. Ian already had the desire to be successful

when he came to see me, but his problem was that he did not have a specific plan on how to

accomplish what he wanted. Once he knew specifically what he needed to do, he was able to do

it.

It is very important to assist clients in stating very specifically the actions that are needed for

the goal to be accomplished. Generalities lead to failure. We could have talked for weeks about

motivation but, until we stated in specific terms what needed to be done, Ian was not

“motivated’.

Exercise: What is something you would like to accomplish but do not have the motivation

to be successful? Create a very specific, realistic plan of action. The more specific and detailed

it is, the more powerful it will be. Notice how your motivation changes as you initiate the plan.

Help your clients create specific plans for what they want to accomplish. Notice the difference

in the success rate of those who have very specific plans and those whose plans are more general.

Also, when you have been working toward a goal, how many times have you beat yourself up for

not having yet accomplished the goal instead of celebrating the progress you have made? After

you begin to focus on your successes instead of your failures, notice the difference. Help your

clients recognize the progress they make from week to week and notice how this energizes them.