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Library · Domain 3. Treatment Planning & Continuity of Care · 3A. Treatment Planning

Task 3A.9

Collaborating on treatment goals

“Collaborate with client to establish treatment goals and objectives” (NBCC, 2027 task 3A.9)

Goals the client helps choose are goals the client is more likely to work toward. Collaboration means the counselor brings clinical knowledge and the client brings their values, priorities and knowledge of their own life. The exam tests shared decision-making and respect for autonomy in goal-setting.

Key points

  • Agreement on goals and tasks, along with the emotional bond, makes up the working alliance as described by Bordin, and alliance quality is associated with outcomes.
  • Ask what the client hopes will be different; questions like the solution-focused miracle question help clients describe concrete goals.
  • Offer clinical input and options, then let the client choose among reasonable options.
  • Use the client's own words in goals where possible.
  • Where client and counselor disagree, explore the disagreement; motivational interviewing approaches help with ambivalence.
  • With mandated clients, find goals the client can endorse within the requirements imposed by the court or agency.
  • Record the client's participation in goal-setting.

In practice

A client mandated to counseling after a DUI says he does not have a drinking problem. The counselor acknowledges the mandate and asks what he would like to get out of the required sessions. He wants his license back and less conflict with his wife, and they build goals around those that also address drinking.

A counselor asks a client the miracle question. The client describes waking up, making breakfast for her kids and calling a friend, and those concrete images become the basis for her goals.

Check yourself

According to Bordin, what three elements make up the working alliance?

Agreement on goals, agreement on tasks, and the emotional bond between client and counselor.

How can a counselor collaborate on goals with a mandated client?

By finding goals the client values within the mandate's requirements, increasing buy-in.

What does the miracle question help a client do?

Describe concrete, observable signs of what life would look like if the problem were solved, which become goals.

NBCC's knowledge and skills for 3A. Treatment Planning

Knowledge of: SMART goals; Biopsychosocial model; Short- vs. long-term goals; Goals vs. objectives; Counseling theories and interventions; DSM/ICD; Behavioral strategies across settings.

Skill in: Aligning appropriate intervention with client need/identity; Developing initial treatment plan; Reviewing and revising treatment plan; Case conceptualization; Goal-setting; Differential diagnosis.

A study guide written by ExamDragon from NBCC's published task; not NBCC material and not part of the exam.