Treatment for eating disorders involves many aspects. There are many types of therapy that can be applied to an individual’s treatment such as cognitive-behavioral therapy, psychotherapy, and self-esteem workshops. Treatment can be done in individual sessions or a part of group work. It doesn’t matter the type of treatment, however, all good treatment plans should involve the setting of goals.
Goal setting can be difficult for some people. Often people set goals that are too easy or too hard, which makes the goals either unattainable or involves no work toward the core issues. Good goals must be hard enough that some effort will be required, but not so much that the individual becomes overwhelmed and gives up. My personal treatment plan involves weekly goal setting with the use of SMART goals. SMART is an acronym that helps the goal setter set a goal that will help them achieve the highest possible success they can with each goal. In order to set good eating disorder recovery goals or goals for any other types of mental illness or addiction, I would recommend that you make a SMART goal. One that is specific, measurable, attainable, realistic, and timely.
Although SMART goal setting may not be a new idea, the following section will go through each letter of SMART in order to help those with an eating disorder set healthy goals.
When setting goals, it helps if they are straightforward but specific. To set a good goal, you should clearly define and state what you would like to happen or what changes you want to make, and what you’re going to do to make these changes happen. This section should include the who, what, where, when, which, why and how of your goal. Whatever you choose to work on, make sure you define it with specificity.
Example: One of my first goals with the Bulimia and Anorexia Nervosa Association (BANA) was about my binging (what). Since my binges always lead to purging, I decided to make a goal to reduce the number of binges I had per week, therefore reducing purges as well (why). I clearly defined how many binges I wanted to remove from my week (two), how I was going to do it (with meditation, distraction, support and urge logs), who would be my supports, when I would reduce the binges (at night time), and where I would do this (at home and at BANA). Being specific allowed me to have a full understanding of what I wanted to change and how to go about doing it. Leaving no questions unanswered helps to remove any chances of failure from your goal setting.
In order to set a good goal, it must be measurable. “If you can’t measure it, you won’t be able to manage it.” In this aspect of goal setting, numbers and measurements are key. In order to measure behaviors that need changing, you must be aware of the frequency and quantity of the behavior. For some this means keeping track of the behaviors in a notebook or in a chart. Then, to make the change, you must identify how many times you want this behavior to be changed or removed from your chosen span of time. Tracking makes it possible to see that the change is actually being made, which not only helps with goal setting but also can boost morale and make the individual feel good about the healthy changes being made.
Example: When I wanted to set a goal about how much I weighed myself in a day, I first had to figure out how often I did this behavior on any average day. After I tracked the frequency, I decided with my clinician that to start, I would reduce this number by one each day. I continued to mark off when I weighed myself in order to see if the changes were working. Once I knew that I could handle this change, I was able to reduce it further. Having a measurable goal really helped me manage it and my emotions surrounding the behavior change. It helped me make a healthy change and helped me to feel good about it by actually seeing the measurement of change.
To make a goal SMART, it must be attainable. Like I mentioned before, if the goal is too hard, the individual may become overwhelmed and not complete the goal. When goals are too out of reach, people are more likely to put off attempting them at all and will procrastinate and make excuses, which isn’t helpful to recovery. People usually make unattainable goals with good intentions but as they realize the difficulty of such goals, they start to fear the huge change they committed to making. This un-attainability also can lead to feelings of guilt, shame, and failure when they do not complete the goal. They then will blame themselves or their treatment plan, when in reality, the goal was simply too out of reach.
Example: When I was working on reducing the number of binges per week, I first shot for reducing one per day. After feeling guilty and depressed when I could not complete this goal, my clinician reminded me that SMART goals must be attainable. So I instead set my goal to reduce only two binges per week to start off. This goal was much more attainable but still was a challenge. As I got better at completing this goal, I started reducing it more, keeping in mind that I shouldn’t push myself too hard otherwise my goal would fail.
Realistic goal setting goes hand in hand with attainability. Just as you shouldn’t make goals too out of reach, they should also not be too easy. Goals should be challenging but do-able. Goals should also be relevant to the behaviors and disorder you want to change. Realistic goals require effort, but only to the point of attainability.
Example: Sometimes I was tempted to set goals that were either irrelevant or too easy, in order to avoid having to deal with difficult feelings and behaviors. It was easier to set over simplistic goals than to face the music that is recovery. However, this type of thinking leads to no change, so I had to start setting realistic goals. Instead of saying I would add one cup of water per day, I said I would add two cups of water with a snack. Adding the snack made the goal more challenging but still do-able for me, which made it more realistic.
Good goal setting involves setting a timeframe for when you will complete this goal. Specify whether you want to complete it in one week, month, or by next year. Remember, goals can be short term or long term. I would recommend setting many smaller goals to help you reach your long-term goal. However, not setting a time limit on a goal reduces the urgency and often leads to people not working on the goal at all. Setting a realistic time frame gives people a target to work towards and will help set the individual into action.
Example: Throughout my treatment with BANA, I have been setting many smaller weekly goals during my psychotherapy education group. All of these small goals are helping me work towards my long-term goal of recalibrating my body and letting it find its set point (weight that is influenced by intuitive eating and genes) by becoming bulimia free. I have set this goal for two years from now. It is a long time, but the smaller goals are helping me to reach it. It also is a realistic and specific time frame, since the body can take a year or two to get back to normal. By setting weekly goals, it helps me to stay on track and to stay active in my recovery.
SMART goal setting is the backbone in eating disorder recovery. In order to set goals that will help you work towards your own recovery, you must set goals that are SMART. Setting goals that are specific, measurable, attainable, realistic, and timely will help individuals with eating disorders work towards their goal of being eating disorder free. If you follow your SMART goals, recovery will still be a hard road, but it will help you stay on the right road: the road to recovery.
For Learning your treatment goals and options go to this article on Psychotherapy Education on Eating Disorders here- http://substanceforyou.com/eating-disorder-treatment-psychotherapy-education/
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