Unusually for me, this post is not associated with a piece of published research. I have been mulling over ways to help people set goals that are really meaningful to them rather than superficial ones that are all too easily forgotten or avoided, and being informed by ACT (Acceptance and Commitment Therapy) I’ve been looking at values clarification as one way of tapping in to this. At the same time as doing this I’ve been doing a little reading around the occupational therapy Kawa model which uses the river metaphor to describe ‘life flow’, or words to that effect.
I’m not a strong advocate of descriptive models really, because I am more concerned about models that help to explain or predict phenomena in the world, but at the same time I use metaphors a lot in therapy. Metaphors are a bit like the Biblical parables – vignettes that help illustrate or present a concept in language that the person understands. Some of the metaphors I use are the car – pain is like an unwanted hitch-hiker that jumps in and sits on your lap while you’re driving, and while we may never get the pain to go, we can shift it into the back seat or the boot (trunk) of the car where it’s not in the way as much. And life balance is illustrated by the four wheels that all need a similar amount of attention or the vehicle won’t travel straight; the direction the vehicle is heading in represents the values while the road is the specific set of tasks or activities the person is engaged in.
I’ve talked about a squatter moving in to the family home, eventually sitting on the couch and maybe even on your lap getting in the way – pain can be like that. Again, it might not completely leave your premises, but you might be able to help it shift into the garage or garden shed while you carry on with what is important to you in your home. And tools in a toolkit representing the various ways to approach a situation – you can grab a hammer, but that might influence you to think that all your solutions must involve nails, where it might be more useful to pick up a spanner or a screwdriver, depending on the situation. And you need portable tools that you can carry with you rather than having to go into the workshop to use a router, but a router is useful for certain other tasks.
Why this talk about metaphors? Well, the river metaphor is one that I’ve included in the worksheet I’m including in this post. I’ve found it really helpful when working with clients so they can see that there are many ways to achieve a specific goal, or that ‘live’ the values that are important to them. Yes, we discuss the riverbed which includes all the contextual things like community and family and even personal strengths and vulnerabilities; we also discuss the things that can divert us from our intended path – like the trees that fall in the way (adversity or events that stop us in our tracks), the dammed up area where community and family are not ready to allow us to go – and what happens when, instead of expressing and ‘fnding a way through’ the thoughts and emotions, they break through the dam and release pent-up energy while often destroying the very things that were containing and constraining movement.
Luckily for me, living in Canterbury, braided rivers are a feature of our landscape, so it’s easy to talk about the myriad little streams and rivulets that wander across the riverbed and how they change depending on weather, water flow from snow melt, or even dry up when there is insufficient rainfall.
So this exercise starts with suggesting that some sort of magic (I’ve indicated a wand doing the trick here) that can take away the impact or effect of the pain – the negative thoughts and emotions, the fear of flare-ups, and the functional restrictions. I ask the participant to think about how someone looking at their lives might know this magic had happened – what would be important for the person to do now that they didn’t have to fear the effect of their pain. Then I have a list of values to start the thinking process for identifying the values that lie beneath the activities. The values list is by no means exhaustive – and really, I do think this process is better when it is discussed rather that simply a pen and paper exercise – but it’s there to start the thinking and help expand beyond day-by-day activities. It’s about finding out why getting up and dressed is so important, and what the person gets out of being at work, and what they would like their friendships to be about, and how they’d like other people to view them at the end of their life.
Once some values are identified, I ask the person to choose five – which, believe me, is not easy to do!
Then write down the value and a sentence that represents what that value looks like when it’s in action. For example, if a value is to be a ‘caring and loving parent’, a sentence might be something like ‘I honour and care for my family to the best of my ability’. If a value is ‘Calm’, the sentence might be ‘I remain calm even during difficult times’.
One of my values is to have a balanced lifestyle – so my sentence could be ‘to make sure that every day has a balance of work, creativity, relaxation and time with people’.
The next step is to use these values sentences on a daily basis – when making a decision about engaging in an activity or establishing a goal, to ask whether the activity or goal represents or is aligned with any of the values the person has chosen. If it doesn’t – then maybe that goal or activity is not going to contribute to what is important in the person’s life.
The worksheet is here – in Word format – and you’re welcome to alter it and turn it into something that might work with your clients.