Child friendly adaptation of the GBO by Livvy Hall, Great Ormond Street Hospital

Livvy Hall, a Clinical Psychology trainee has adapted the GBO into a more child friendly version. The adaptation was developed whilst Livvy was on placement at Great Ormond Street Hospital (GOSH).

This adaptation is aimed at children aged 8 years old and under but may be helpful with older children to and those children who find visual cues more helpful than verbal instructions.

fig 1. Detail from the GOSH adaptation of the GBO

The adaptation was made with permission from Duncan Law, the developer of the GBO. Like all the other GBO tools, the GOSH adaptation is licensed under ‘Creative Commons’ meaning it is free to download and use by anyone.

PDF versions of the adaptation can be downloaded here

Cultural differences in goal-setting and GBO: please share your experiences

Goal-oriented practice and the use of the goal-based outcomes (GBO) tool has spread to a range of settings in physical and mental health in recent years.  It is used across Europe and in North America, Japan and Australasia and is being translated into different languages.  This spread means that the practice and the tools are increasingly being used across different cultures.  

We would like to hear from you about your personal and clinical experiences of using the GBO or goal-oriented practice with people across different cultures.

We are interested in things like:

  • What have you experienced in terms of different cultural attitudes to goal setting?
  • What ideas or techniques have you found helpful in explaining goals and the GBO?
  • What differences have you noticed in the sorts of goals that are set across different cultures?
  • What differences are there in peoples understanding of the concept of goals, goal-setting and rating goal progress?
  • What experiences have you had using the GBO with translators?

Please share your experiences via the ‘leave a reply’ link below or via the ‘contact’ page

Goal-Oriented Practice

Duncan Law

January 2019

Goal-oriented practice argues that the starting point of any intervention and the primary focus of therapy should be: “What do you want to change?”.  ‘What do you want to change?’, invites the client to share their hopes and wishes for the outcome of a therapeutic encounter: what they want to be different as a result of the effort and what resource they will need to invest in the therapy  – in short it asks for an expression of the client’s ‘goals’.  

Goal-orientated practice necessarily includes the need to understand the ‘problem’ through diagnosis or formulation, but it emphasises the primary purpose of therapy from being one of ‘understanding’ to being one of ‘change’.  This is not to play down the power of understanding as an intervention in creating shift, but in goal–orientated practice the emphasis is on the client’s wish for change and the therapy and therapist is guided by, and focused on, the change goal: “what I want to be different”.

In this sense goal-orientated practice is a therapeutic stance rather then a therapeutic model. Once a therapy goal has been collaboratively agreed it is possible to use any suitable intervention to reach it. Goal -orientated practice does not dictate any particular therapeutic model in which to reach the goal, but rather provides a focus, or a direction of travel, that the therapist and client have agreedto work on together to reach.  It works on the pluralistic principle that there are many potential vehicles that can take you towards the same destination. 

Goal-orientated practice is simply any therapeutic encounter that works towards helping a person move towards what they want to get out of the endeavour of a therapeutic intervention. A ‘goal’ is simply a shorthand for “what I want to be different if therapy is successful”.  Whatever phrase we choose to name ‘goals’, it is the concept behind the phrase: ‘goal -orientated practice’, that is of importance here. 

It might be argued that this is no different in purpose from pretty much all therapy.  The difference with goal -orientated practice is the degree to which the goals are made explicit, collaboratively agreed, perceived as jointly owned, and form a focus for change. In goal–orientated practice the goals of the client and the goals of the therapist are made explicit, and the therapy takes place where these goals overlap, are co-constricted and collaboratively agreed.

This blog is adapted from Law, D. (2018) ‘goal-oriented practice’ in Cooper and Law (eds) Working with goals in psychotherapy and counselling’OUP 

Goal-based outcomes – helpful ideas tracker: the GBO-HIT

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Sometimes we need to get helpful ideas and information that might help us make changes in the future. For some people, what they want and need is just get the ideas and information that they can use to put things into practice themselves what we might call self-help. For others they may want guided self-help with a practitioner who can coach and encourage change through.  For others still, they may want to engage fully in therapy as a process of change.

The GBO-HIT is a very simple way to track if clients feel they are getting the ideas they need to help them with the things they want to change.  It can be used to track if clients feel they are getting helpful ideas and can then be used to facilitate discussions about this.

The tool has a suggested goal: ‘I feel i have learnt as much as i need, to manage what i came for help with’ and also has space for more client led ideas or ‘learning goals’ that can also be tracked and discussed.  The GBO-HIT can be used along side the original GBO tool to track other goals the client may have

Tracking helpful ideas may not be useful for everyone – it was designed to be used with guided self-help interventions but is applicable wherever ideas and information or psycho-eduction is a focus of the work.

Free to download and use PDF copies of the GBO-HIT can be downloaded here

This page can be used to rate goals in each session

GBO-HIT pg2

This page can be used to track progress over a number of session

GBO-HIT pg1