Behavioral Health Minute

October 2008 - Create vision for the future

The short summary

Patients’ putting into words what the goal is… where they want to be going… provides direction and energy.

The modestly longer reflection

Quoting Yogi, if you don’t know where you are going, you’re probably not going to get there.  Future vision… patients creating a definition or image of where they want to be going… provides direction and energy, and provides a positive anchor point for our conversations with them about coping and health behavior choices.

People often come to us with the mindset that they will tell us what is wrong with their lives, medically and psychosocially.  It is of course vital to listen to and honor what patients tell us about what is wrong.  It is equally important, however, to help patients move beyond the conversation about what is wrong and to put into words what the goal is and where they want to be going.

Someone challenged by anxiety or depression: How do they want their life to be different?  Someone having a hard time with diabetic control: How do they want their approach to diabetes to be different from what it is now?  Someone complaining of chronic pain: What would they hope to be doing differently if they were coping with pain better?

Examples of conversation starters about future vision:

• Where do you hope to be going with this?
• What would tell us that you are getting somewhere?
• 6 months from now, what will we be seeing about how you have moved forward with this?
• What would I notice about you if you were a little more on top of things?
• When have there been times when you have been handling this in a way that feels good for you?
• (Picking up on pts’ language): When you say you hope to have more “light and happiness” in your life, tell me more about what this means to you.”

Follow-up

Ask patients with psychosocial or lifestyle concerns how they would like their lives to be different.

Fred Craigie, PhD, 10/08