On Goal Setting & Advice Giving

I believe that one of the mistakes that those in the various and affiliated helping professions can find themselves making is falling into is the trap of giving advice (speaking of, this post isn’t advice to anyone: it’s just my beliefs. Take it, leave it, modify it…the choice is entirely yours).

I am of the very strong belief that the only ones who should ever be giving out advice professionally are consultants which is a very different role (and one I’ve often held as a business consultant) than the roles held in the helping professions.

Consulting is a very different practice than working in the helping professions. In consulting I am being paid to provide professional advice based upon very specialized knowledge I have, within the scope of my education, training, and experience. In the helping professions, we are paid to help our clients elicit the answers that exist within themselves, and to be a guiding light, and a reflection board for them, so that they can make their own decisions.

The Problems With Giving Advice

There are two main problems I see with giving advice (and you can read this in a plethora of text books, conference proceedings, and on more blogs than this one. This idea is not unique and it’s certainly not originally mine):

  1. The worker becomes responsible for the advice.
    This means that if the advice fails the client, the worker is responsible. This also means that If the advice helps the client, the client doesn’t get to claim victory over their work.
  2. The advice is coming from the helper and the helper’s perspective.
    We are not experts on our clients or our client’s lives. The client is the expert on themselves, not us. This means that we, as the helper, are saying what we think is best for the client, rather than listening to the client and helping them verbalize what they think is best for themselves.

Advice giving isn’t the only, or main problem though.

I have worked with a number of various helping professionals who will agree with what I wrote above in its entirety…and yet, when it comes time to write a client’s goals and service plan, will then let their pen fly across the paper: using their words, their thoughts, their beliefs of what their client’s goals are, instead of the client’s words, the client’s thoughts, the client’s beliefs, the client’s goals.

The exact same problems exist here/with this as they do in the section above.

When I studied Motivational Interviewing is when I learned what – for me – is the ideal in goal setting, and it looks a little like this: Instead of making goal suggestions, or asking a client “what are your goals?” I ask a client a scaling question:

“On a scale from 1-10, with 1 being the farthest away from being where you want to be, and 10 being you’re exactly where you want to be, and everything in life is near perfect, and unicorns are dancing around you as we speak, where are you right now?”

Then the client will respond, and say they say something like:

“Well, right now I’m at a 4.5”

And then I might say:

“Wow, a 4.5! Okay, how do you know you’re at a 4.5, and not a 4?”

And I will then, in the words of one of my many incredible teachers and mentors, Mr. Sobota: “shut up and stare at them.” while I reflectively listen.

When the client is done, I will generally use an affirmation, or a reflective statement based on what they said. And then I’ll say:

“So, on that same scale, if you were to take the leap from 4.5 to 5, what would be different? What would being at a 5 look like?”

I then shut up and stare at them again. When they’re finished, I then go:

“So what would you need to do, to get from a 4.5 to a 5?”

And here’s where it gets totally critical: you shut up and stare at them again. As soon as they start telling you what it will take for them to get from a 4.5 to a 5 you start writing as fast as you can, because what they’re telling you is their entire goal list and service plan…literally, they’re telling you everything they need to do to get to the next step closer to where they want to be, so take good and detailed notes. 

After this, at least for this session, it’s generally smooth sailing: you should have a lot of:

“So what I hear you saying is…[read back what you wrote down as reflective statements/affirmations]…so if I understood you correctly, you would like to work on [goal] and you believe that you can accomplish this goal by [action]…”

You can then take all of those (now confirmed/adjusted and then re-confirmed) notes, and transpose them to whatever agency goal/service plan forms you’re forced to work with.

Guess what’s missing from here? Any of my interests, any of my biases…any of me determining what I think my client wants…and since it all came from my client they are the one who bears responsibility if their plan doesn’t work (and then you can help the tweak their plan, if that’s the case, or work through roadblocks int he exact same way)…but they client is also the one who gets to claim victory when their plan DOES work! THEY did it! CHEERLEAD THE HECK OUT OF THEM!

What if my client is making the wrong choices? Selecting the wrong goals? What if what they’re choosing will get them sent back to jail or won’t help them reach recovery?

Generally speaking, it doesn’t matter a lick if you agree with your client’s goals or not. There are, of course, exceptions: if those goals are robbing a bank, or injuring themselves or someone else, or anything similar to any of these situations…then what you think becomes very important and safety is paramount (codes of ethics, and laws almost everywhere support this).

That said, even in a drug treatment program the client may not have a goal of entering into recovery…and that’s okay: the consequences are theirs, not yours. A client who may need to see a job coach as part of their probation may not want to engage in services. That’s okay too: you’re not the parole officer. You’re merely presenting the client with an opportunity to engage in work or not and informing them of what the consequences might be if they engage, or if they choose not to engage. What they choose to do with that opportunity (and the consequences: positive, negative, or neutral) are their’s to bear alone.

What our job is, as workers, as helpers, is to help our clients enumerate what their goals are, to help them elicit from within themselves the way in which they  believe they will best be able to reach those goals, and if the client’s goals aren’t safe, or may have devastating consequences it is our job to help them understand what those potential consequences might be, to work with them to ensure that they (and others are safe), and to help them see alternatives.

However, at the end of the day, our clients must be the ones to develop their goals, to develop their own service and care plans, and to make their own choices. Sometimes those choices are incredible and beautiful to behold. Sometimes those choices will land them back in jail, which can be terribly painful to watch…but that’s okay too: they have every right to make that choice, especially if they’ve worked with you to examine all of their potential options, and all of the potential consequences that can be foreseen, based upon their goals and interests.

Neurological/Rheumatological Fuckery

So quick medical update: I’m in a flareup again (like, not quite acute…but reaaaaaaaly close…like if acute is a 10, I’m at a 9.7). Walking is exceedingly difficult, muscle/pain weakness are making me ambulate like a toddler (but I have Zappy the Wonder Walker, for which I’m extraordinarily grateful).
 
My PCP & Neurologist both think there’s more to the diagnosis than Fibromyalgia, so my Neurologist is writing a letter to the Mayo asking for another consultation when I go back there in August for the Fibromyalgia Clinic.
 
However, thanks to adaptive technology (my Rollator Zappy, and voice-to-text software) I am still a happy (if uncomfortable) camper. Added bonus though: when orientation tour groups gawk, you get to tell them that you’re part of an anti-aging study being conducted on campus, and that things are going great, they just haven’t figured out the walking part yet.

America The Beautiful (In Its Imperfection)

“We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable rights, that among these are life, liberty and the pursuit of happiness. That to secure these rights, governments are instituted among men, deriving their just powers from the consent of the governed. That whenever any form of government becomes destructive to these ends, it is the right of the people to alter or to abolish it, and to institute new government, laying its foundation on such principles and organizing its powers in such form, as to them shall seem most likely to effect their safety and happiness. Prudence, indeed, will dictate that governments long established should not be changed for light and transient causes; and accordingly all experience hath shown that mankind are more disposed to suffer, while evils are sufferable, than to right themselves by abolishing the forms to which they are accustomed. But when a long train of abuses and usurpations, pursuing invariably the same object evinces a design to reduce them under absolute despotism, it is their right, it is their duty, to throw off such government, and to provide new guards for their future security.” – From the United States Declaration of Independence, July 4, 1776; Emphasis Mine.

This has been a hard year for Lady Liberty. It’s also been a hard year for Lady Justice. It’s been a hard year for me. It’s probably been a hard year for you. It’s been a hard year for all of us. But we’re going to continue to resist. We will obstruct.

So my America is a thousand languages, it’s multiple shades of skin color. It’s amazingly different foods from different countries from my incredible neighbors who – like my family – immigrated here, and like my family, many as refugees.

Either you understand that America isn’t white and Christian, or you don’t understand history: where we’ve come from, and where we’re going.

People fly the confederate flag and raise the Nazi salute as if they’re free speech issues, instead of a continuation of a war. But we’re going to move forward. We’re going to drag this country forward. We’ll punch Nazis and Fascists if we have to…but we’re going to get there.

Because this is an incredibly beautiful country, built on genocide, slavery, and the bloodshed of a revolutionary and civil war, and while we haven’t known peace

Creating Spaces of Awe

So from today’s Every Day, Holy Day: 365 Days of Teachings and Practices from the Jewish Tradition of Mussar (by Alan Morinis) we are given the following to ponder:

“Once it has become clear to one that wherever he may be, he is standing before the presence of the Holy One, there will come to him of itself, the awe and fear of going astray in his actions so that they do not accord with the majesty of the Blessed One.” – Rabbi Moshe Chaim Luzzatto (1707-1746)

The phrase that we’ve been using as our reminder phrase (for those who follow along with this book as part of their Mussar Practice) is “the beginning of wisdom is awe” and our practice this week has been to “put yourself in places that bring out the experience of awe in you.”

One of the things I admire most about Judaism is that it – generally speaking – starts in our homes (wherever that home may be, and whatever kind of tent it may look like). Judaism doesn’t entreat us to go to far off lands to change the world. Instead – through practices like Mussar and Tikkun Olam, we are taught to transform the world starting in our very own homes, our own neighborhoods, our own yards, and streets, through thousands and millions of tiny, small, wonderful acts.

This is very similar to what we talk with clients about in Solutions-Focused Brief Therapy, Motivational Interviewing, and Cognitive Behavior Therapy: to change others, sometimes it’s necessary to change yourself (through behavioral changes)…we can only control our own actions, but what is beautiful about that is that our actions have consequences, and sometimes those consequences are truly meaningful, and truly wonderful.

I have been feeling very overwhelmed recently (summer classes can do that, especially four of them, alongside learning to live with a new, very pesky, disability), and a bit dysthymic (more so than usual, but I think that’s probable due to a lack of sunlight as I stare at books and papers instead of the great outdoors).

Because of this, my home office (which I usually love and treasure) and my bedroom (which is usually my sanctuary) have fallen into a spot where they don’t produce awe, but rather a bit of dread…and what a shame, especially in light of this week’s Mussar practice!

So tonight, my Shabbat experience will be to create a space where I can once again find awe, so that I can have the beginning of wisdom once more (in that I can finish writing some papers, and then start on some other homework assignments, so my stress will go down, and I will be underwhelmed instead of overwhelmed).

These are those Mussar moments: the real, the tangible, the small, the pragmatic.

I’ll count on the best resource I have ever found for anyone (especially those with disabilities, or mental health conditions) to organize, clean, and get one’s life back in order: Unf*ck Your Habitat: You’re Better Than Your Mess by Rachel Hoffman, to get me through this process…and probably a good dose of Harry Potter and the Order of the Phoenix on Audible while I work.

“So while you’re back at the Mayo Clinic…”

Just finished up at the doctor; while we’re going over everything he was like “The problem with Rheumatology is that it’s not like Doabetes where we can just look at your A1C…so while you’re back at the Mayo Clinic in August please see if they’ll take investigate the possibility of Inclusion Body Myositis…”

Okay Doc…

Squirrel Squad

So on my 3DS I have the three original Pokémon (Red, Blue & Yellow) as well as Pokémon X & Moon. I recently reset Pokémon Red and have decided I’m going to try and level up Squirtel to LVL100 in the Viridian Forest by having him fight hundreds of caterpies before I take on Brock, just to see what happens. I’ll let you know how it goes 🙂

Bitch & Moan

So first – I am so incredibly thankful for the WordPress iPhone App. I’d prefer to be at my desk writing right now, but my body’s on day 5 of a flareup and I spent most of the day sleeping, followed by a good few hours finishing a paper, and I just can’t sit at my desk anymore, and I can’t sit in a position in bed to use my laptop either, snd my arms are in too much pain to type, so I’m super glad this is an option. 

I was also about to self sensor and then realized: fuck it, it’s my blog, I can write, bitch, moan, and complain about whatever the fuck I want to here…that’s the whole fucking point.

So that said: I’m on day five of a flare up because my PT wanted to see my pain limits and levels (which was depressing in and of itself because it took ten minutes of barely and activity to fuck up five+ days of my life, and make absolutely everything miserable; I can’t even find a position to sit/exist in comfortably).

Adding this bullshit to my general level of pain and fatigue, I’m amazed I’ve gotten any work done at all. I keep on reminding myself I just have to get through this summer, and then it’s just field placement and two more courses (one class each semester) until graduation.

Fortunately, Akiva (my cat) is super snuggly, I have Netflix, and I’m almost done writing out my work schedule (including time built in for Fibromyalgia Fuckery) to get me through the rest of the summer courses.

One of the hardest things to get used to is forgiving yourself for not being able to do things/giving yourself permission to not check off everything on you to do list because your body just won’t let you.
It’s all a very shitty learning process. And right now it’s a shitty learning process where I can barely walk, everything hurts, and there’s no way of getting comfortable at all.

So it’s not so much that I don’t have superpowers anymore….

…it’s just that those superpowers are morphing, and changing into something different, something slower, perhaps something more empathic, and narrowly defined.

Having gone from sleeping 3 hours (maybe) a night and infinite energy…to Fibromyalgia, and no energy, and pain, and trouble ambulating, and needing to sleep all the time, and feeling fatigued all the time, and having Fibrofog (instead of constantly being clear headed)…it’s very much like loosing a super power…that said, for some things there’s coping skills (like writing things down, keeping a very well detailed calendar, keeping the house neat and organized so I don’t need to spend energy on it, and keeping my bag organized so I always know where things are instead of having to try and find them, etc.)

But with that said, It’s frustrating, it’s aggravating, sometimes it’s maddening. It causes me to have to re-arrange (cognitively) all of my previously understood abilities…and even things like planning to read chapters for class takes more time, and can be thrown off by the whims and flotsam and jetsam of my neurology.

I am coping, I am getting through…but I am also very new to this new piece of my self mosaic, and it is going to take quite sometime to integrate it into my idea of self.