There are many different approaches to therapy. Each is based on certain assumptions about people and how they can achieve their goals. This piece gives an introduction to ‘choice therapy’. Such an approach is strongly influenced by existential psychology and expressed in theories such as reality therapy, logotherapy – plus the work of some self-help groups. The article shows how a practitioner might facilitate such a session.

Choice therapy rests on certain assumptions. These include that it is important: to create a caring atmosphere; to have high expectations of people; to treat the client like a responsible adult – even if they are not behaving that way; to expect them to take responsibility; to clarify how they can shape their future; to help them to set clear goals; to make clear contracts about working together; to clarify the person’s ‘controllables’; to clarify their possible choices – the options - for achieving their goals; to clarify the consequences of each option; to explore creative solutions; to employ the person’s strengths to reach their goals; to encourage them to choose the route they want to take to shape their future; to provide support, knowledge and tools on the journey; to get some early successes; to work together for as long as you both wish on the road towards achieving their goals.

Let’s imagine you have had several years experience practicing this approach. Here is a snapshot of how you might facilitate such a session. But it is obviously does not provide a qualification for actually practicing the therapy.

1) You can create a caring environment and help the person to clarify their goals.

Imagine somebody has asked for your help in tackling a specific challenge. They may want to take more control of their life, overcome a setback, tackle a particular problem or whatever. The first step is to have an informal conversation over the phone. You listen, say you are happy to help, explain your way of working and then ask the person to reflect on whether they would like to go ahead. Let’s assume they want to meet. Here is what you can do during the first session.

Start by creating an encouraging environment. Welcome the person and make them feel at home. Invite them to again explain the reason they are looking for help. It is vital to accept their feelings are real for them – even though they might sound crazy to other people. This is the ‘first empathy’ – showing that you understand the person’s actual situation. You will soon move towards the ‘second empathy’. This is focusing on the person’s aspirations – what they want to feel, do and achieve – their picture of success. Explain what you can and can’t offer. If the person wants to proceed, make clear working contracts. Agree on your and their role in working to achieve their goals.

Let me give an example. Recently I was approached by a person – let’s call him Derry - who felt overcome by stress. He often broke into cold sweats, felt ill and got angry with loved ones at home. Certainly he could learn techniques for managing the stress, but the causes were obviously deep. So I explained we could achieve this short-tem goal but, if he wished, also focus on his medium and long-term goals. Derry said this would be useful, because he felt deeply unhappy at work. We agreed on the contract. My responsibility was to listen and clarify his goals – then provide support and tools he could use to succeed. His role was to shape his future and do whatever he felt appropriate to achieve his goals. Derry accepted there were no ‘miracle cures’ and bought into the working contract.

You can now clarify the person’s goals. There are several guidelines when taking this step. It is important: a) To state the goals in positive terms. For example, Derry said: “I want to feel less stressful.” So we translated this into a positive goal: “I want to feel calm in a specific situation.” b) To clarify the person’s short term goals but, if appropriate, also their medium and long-term goals. Derry wanted to focus on his life-goals. These included working in a culture where he felt at ease – one that was supportive yet stretching. c) To clarify his ‘controllables’. For example, a person can control their attitude, they can’t control other people’s opinions. d) To revisit their goals and translate these into a clear picture of success. e) to, if they have several goals, list these in order of priority – then focus on the first topic they want to tackle.

Certainly this sounds ‘logical’ – but it must be done in a warm and encouraging way. You then have the basis for working well together. Imagine you are conducting such a session. Try completing the following sentence.

The specific things I can do to create a caring environment,
make clear working contracts and clarify the person’s goals are:

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2) You help the person to choose and pursue their strategies for achieving their goals.

Start by tackling the first goal. Invite the person to consider all the potential routes they can take to achieve success. Whenever possible, draw these out from the person. If appropriate, you can also share other potential routes. This is an opportunity to share your knowledge – but watch the person to see which ideas resonate – then add these to the strategies for moving forward. Invite the person to consider the consequences of each route – the pluses and minuses. At the end of this section you may want to summarise by saying something like:

“Looking at the goals you want to achieve, there are many different strategies you can follow. Option A is to: _____ Option B is to: ___________ Option C is to: ________ There are probably many more options, some of which we will explore in a moment. Each route has both pluses and minuses. If you choose Option A the consequences are: ___________ Option B the consequences are: ____________ Option C the consequences are: __________ Some options are more attractive than others, but ultimately it is going to be your choice. Shall we explore some other possible solutions?”

There are many approaches to exploring creative solutions – such as brainstorming, sharing practical tools, exploring successful patterns or whatever. “But what if a person goes into ‘Yes, but,’ mode?” somebody may ask. “What do you do then?” Return to the beginning and clarify the goals they want to achieve – the ‘what’. Be positive and encourage the person – but do not try to ‘persuade’. The person ultimately has the right to behave as they wish. There will be consequences, of course, both for themselves and other people. Assuming the person wants to achieve their goals, it’s then time to move onto potential creative solutions.

Returning to the session with Derry, for example, I invited him to explore his positive history. Looking back at his life, when had managed stress successfully? What had he done right then? How could he follow similar principles in the future? Fifteen minutes later he had clarified his successful pattern and translated this into an action plan for staying calm. Derry’s key issue revolved around feeling in control. This was exemplified in difficult meetings at work where he felt attacked. Looking ahead to the next such meeting, we clarified the results he wanted to achieve and rehearsed tackling the actual situation. Derry felt good about his strategies, but was still concerned about losing control.

So he made an action plan for staying calm. This involved taking the following steps. a) To recognise the potential warning signs. Such as starting to feel distant and dizzy, which then led to cold sweats. b) To implement his successful pattern for staying calm. This meant ‘buying time’ by, for instance, getting up to pour a cup of coffee, breathing calmly and clarifying the results he wanted to achieve in the situation. c) To be calm, speak slowly and try to find positive solutions with the other people. If this was not possible, instead of being rushed into a decision, he would promise to get back to them with suggestions. Derry and I role-played the situation and kept going until he felt satisfied with his chosen strategy. We then moved onto the next topic he wanted to tackle – finding a stimulating role in a supportive yet stretching culture.

Different people will, of course, follow this path in their own way. Try completing the following sentence.

The specific things I can do to help a person to explore their choices,
consequences & creative solutions – then choose their way forward are:

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3) You can continue to help the person pursue their chosen strategies towards to achieving their goals.

Imagine the person has put their action plan into practice. Start the second meeting by clarifying what they want to explore – their desired ‘take aways’ from the session. Before getting into those topics, however, ask if it is appropriate to review the action plan. Invite the person to describe: a) The things they did well; b) The things they could do better next time; c) The things they have learned and can apply in the future. You can then move into the first topic they want to explore in this second session.

Choice therapy starts by providing a caring environment. It then involves helping the person to clarify their goals, explore the potential choices, consequences and find creative solutions. The key differentiating factors, however, stem from the basic assumptions about people. These include encouraging people to take responsibility, be creative and pursue their chosen strategies. It is then providing support to help them achieve ongoing success. You would, of course, follow these principles in your own way. Try completing the following sentence.

The specific things I can do to continue to
help the person to achieve their goals are:

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