Goal-setting is an important way of marking progress for patients and instilling a sense of achievement. Goals elicit hope and when reached, demonstrate success.

Setting goals: short-term, medium-term, long-term

Goals can be short, medium and long term. They should be realistic, achievable and meaningful to the patient.

Short-term goals in the treatment of health anxiety can be related to the techniques used in therapy (e.g. being able to control excessive checking, or being able to resist looking up health issues on the internet; having successfully done the latter, a medium- or long-term goal could be using the internet again but being able to evaluate the information obtained in a non-threatening way).

Longer-term goals can be more difficult to set, as often patients with health anxiety cannot see a meaningful long-term future for themselves. They have just been preoccupied with illness or premature death. For this reason, it is important not to set these goals too early, that is to say, before the patient has started to make a cognitive shift. At the time the goals are made they should be seen as achievable, fitting in with the progress made in therapy.

Sometimes goals suggest themselves during therapy sessions. For example, the patient may say: ‘Because of all my problems we've not been able to have a holiday for years. I feel bad about this because I know my wife would like to get away, if only to visit the children’. This particular comment immediately suggests two potential goals, a medium-term one to visit the children (which would probably seem a relatively safe start), and the possibility of a proper holiday on their own in the longer term. For this example, it may be too early to mention this as a goal, but it could be suggested: ‘Has it been long since you visited? Would you like to be able to visit them again at some point?’. You could then note this down for bringing up at a later stage.

Some patients really struggle to come up with goals and often cannot produce one on the spot.