Session Three: Things That Are Important To Me

Youth & Drugs and Mental Health: First Contact

Goals For Session 3

1. Reassess treatment/use goals.
2. Find out whether clients tried any new alternative responses since the last session.
3. Continue to explore the connection between triggers and consequences.
4. For groups, continue to highlight commonalities and build group cohesion.
5. Complete the Things that Are Important to Me exercise with the following goals:
   • Help clients talk about the future (i.e., hopes and expectations).
   • Create discrepancy.
   • Explore the role of use in achieving goals.
   • Review goal achievement:
     • status six months ago
     • current status
     • anticipated progress in six months.
   • Try to determine plans and next steps to achieve goals.

Check-in

Session 3 starts out again with the I exercise. Although asking about triggers and alternatives to use is always an integral part of this exercise, a counsellor can probe these issues in more detail based on what was discussed in the Triggers, Consequences and Alternatives exercise during Session 2.

Life Goals and Values

Session 3 includes the Things that Are Important to Me exercise, which relates to clients’ life goals and values. Several therapeutic approaches, such as solution-focused and motivational interviewing, support the usefulness of exploring life goals and values. Clarifying what life goals a client wants to achieve and assessing where he or she is now helps develop discrepancy, one of the key elements of Motivational Interviewing (Miller & Rollnick, 2002). Discussing the things that are important to them helps clients acknowledge their aspirations, strengths and competencies, rather than focusing exclusively on problematic areas of their lives, reflecting a solution-focussed perspective.

Understanding clients’ life goals also allows for a discussion of how use affects progress towards such goals. Clients may think that drug use helps them to reach some goals, such as being popular. However, most clients will acknowledge that alcohol and other drug use impairs their ability to achieve life goals to some degree (e.g., completing school or being healthy).

The Things that Are Important to Me exercise should also include a discussion of what concrete steps clients can take to start progressing toward their goals. The “Top 10 Ways of Achieving Your Goals” is included in this exercise to help clients decide what the next steps are to achieving their goals. However, it is important for the counsellor to help in translating the life goals into concrete steps or activities for the client to work on, ideally, within the next week. Counsellors can assist in this part of the exercise by helping clients select short-term goals that are realistic and measurable.

Guidelines For The Counsellor

1.  Check-in.

Discuss progress over the past week. For tips, see Check-in in Session 1.

Help clients see patterns in their use or change strategies:

• “What strategies from last week’s triggers, consequences and alternatives exercise did you try?”
• “How have these last few weeks been for you - better, worse or about the same?”

Help clients to use strategies other than avoidance:

• “Avoiding triggers is the first step for a lot of people. What are the good things and not-so-good things about doing that?”
• “What is the next step?”

2. Introduce the Things that Are Important to Me exercise.

“This exercise is about finding out what you want from your life. Read through the whole list and pick the top 10 things that are important to you or that you want to work towards.” (For larger groups, have them pick out 10, but discuss only the top two or three items.)

Affirmation: “It looks like you want to make some changes in your life and that you know what you want.”

Make steps towards goals more concrete:

• “When you picture yourself doing that, what are you doing?”
• “What are the steps to get there?”

Look at the impact of drug use on achievement of goals:

• “How do drugs fit into your goals?”
• “Where were you six months ago in relation to your goals?”
• “Where do you see yourself six months from now?”
• “What about your use?”

3. Wrap up.

Integrating life goals:

• “What is one thing you can do this week that would help you move a step closer to one of your life goals?”

• Print