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Goal Setting


Life’s Game of Football: Setting Goals & Navigating Obstacles

Michael Watts, MSW, RSW
Medical Social Worker: (formerly, Diabetes and Endocrine Clinics, Alberta Children's Hospital)
Assistant Professor: Mount Royal University 

 

 

In my article on the 'Stages of Change', one phase I discussed was the “Action Stage.” To review, the action stage is the stage in which the patient has a firm commitment toward change, and devises plans and goals to assist her with navigating change.

setting goals with type 1 diabetesGoals. Think of that word for a moment.  What comes to mind? I often wonder how many people set goals, struggle to follow through with them and subsequently completely give up. Does the phrase New Year’s resolutions ring a bell?


In my experiences in serving others, I’ve come to realize many people do not understand the multiple layers involved in formulating and achieving a goal.  For example, it’s one thing to
say “My goal is to test my blood sugars, at lunchtime, everyday!” and it’s another thing to plan to test your blood sugars, at lunchtime, everyday.

The focus of this article is to assist patients with devising goals and applying strategies to assist him with successfully achieving desired goals.

Before I get into 'Life’s Game of Football', it is important to understand that goals must be:
 

Realistic: Is the goal achievable? If not, you may set yourself up for failure.

Specific: Are you clear about the goal you actually want to achieve? If you are too ambiguous, or unclear, you run the risk of losing focus, and subsequently, giving up.

Measurable: Are you able to measure, or track the progress toward, your goal? If you are unable to measure or track your progress, similar to not being specific, you run the risk of losing motivation, or getting frustrated or confused. As a result, you may quit your journey prematurely.


Life’s Game of Football

Now that you understand the layers to consider in order to have optimum opportunity for goal attainment, it's time for some football!life's game of football


For those of you not familiar with football (and I’m not referring to the round ball generally decorated with black and white hexagons, I’m talking about good old North American football), here is a quick tutorial.  The offense’s (consists of 11 players) aim is to get past the defense, wh
ich also has 11 players, in order to cross the GOAL line in order to receive points.

The offensive team has coaches, scouts and other applicable professionals whom assist them at improving their chances of reaching the “goal line” during games. The players practice several hours per week, watch film clips of the upcoming defensive opponents, identify limitations and build on strengths in order to afford themselves the best chance of reaching the goal line during the game. With courage, hard work, focus, commitment, dedication and support, offensive teams usually achieve their goal of scoring points, despite how mighty the defense may be. The offensive team reaches its goal because its members plan effectively.

obstacles to overcoming diabetes

Patients, for example, who wish to achieve a goal related to improving their diabetes self-care, may go through similar processes related to goal achievement as football offenses do. Although an offence’s process of achieving the desired goal may include avoiding 300 pound men who are simultaneously attempting to thwart the offence’s efforts, an individual with diabetes may experience similar intimidating obstacles or challenges, which get in the way of him achieving the desired goal.


The second layer of achieving a goal is to identify 1-3 defenders, err, obstacles or challenges, which the patient believes will get in the way of her achieving the desired goal.  Next, the patient must display the courage and humility needed to consult with the health care team (including a Medical Social Worker, such as myself), parents, or friends -- similar to coaches, and scouts in football -- in order to explore strategies, plans and techniques necessary to successfully navigate the obstacles and challenges.  The patient should utilize her supports in order to devise strategies and plans for each identified obstacle or challenge.


Many adolescent patients I work with struggle to test at lunch due to a lack of self-care accessibility prior to the lunch bell ringing. If you read my previous article, you understand most adolescents neglect to retrieve their testing supplies, which are usually in his locker, in favor of being with peers at lunch.

Over the years, I have encouraged patients, especially those whom have the liberty to leave campus with their friends for lunch, to have their testing supplies accessible to avoid having to run to their locker when the lunch bell rings, and risk missing out on precious time with peers during lunch hour. More recently, I’ve been encouraging the patients I work with to view their diabetes as an entity they have to have a relationship with. Patients are encouraged to consider the positives associated with being involved in a healthy relationship and are also encouraged to consider the negatives associated with being in an unhealthy relationship.

After affording the patient several moments to think about the characteristics of healthy versus non-healthy relationships, I ask the patient to identify 1-3 areas of his relationship with diabetes that are healthy, and 1-3 areas that are unhealthy.

I provide the patient with praise, and encourage her to continue with the processes that promote a healthy relationship with her diabetes; I guide the patient in setting 1-3 realistic, specific and measurable goals which aim to promote a healthier relationship with diabetes.


  Examples of this would be:
    • Using cell phone alarms as a strategy to remind to test 
    • To take insulin
    • Enhancing her personal understanding about diabetes
    • Getting involved in diabetes initiatives

 
I hold the view that being actively involved with a partner, or in this case with diabetes, serves as a protective factor in keeping the relationship strong. The act of setting realistic, specific and measurable goals, and experiencing some success along the way can create a sense of accomplishment and satisfaction for the adolescent. In their book “Reclaiming youth at risk: Our hope for the future”, Brendtro, Brokenleg and Van Bockern (1998) state that when an adolescent’s need to be competent is satisfied, motivation for further achievement is enhanced.  In other words, the authors are saying if an adolescent can devise goals, stay committed and experience success, there is an intrinsic desire to experience more success.


Those acting as “coaches or scouts” for the adolescent as he navigates obstacles and challenges associated with diabetes self-care must be willing to provide praise, support, encouragement and be able to hold him accountable as he works towards his goal of building a healthy relationship with his diabetes care.   Many football coaches stress the importance of “everyone doing his job.”  I hold the view that if everyone involved in the adolescent’s care team (including the adolescent) “just does his job”, opportunities for the adolescent to experience a healthier relationship with diabetes is more likely.

achieving goals with type 1 diabetesThe third and final layer of achieving a goal is for the patient to realize the difference between “getting there”and “being there”. When I work with adolescent patients who want to set goals, I encourage them to understand that “getting” to a goal requires courage, hard work, focus, commitment, dedication and support.  I go onto mention that “getting there” (successfully achieving a goal) develops one’s character, confidence, self-esteem and integrity, and most importantly, enhances motivation for more success in life.

In contrast “being there” involves having a goal in mind, but not wanting to apply the courage, hard work, focus, commitment, dedication and support necessary to be successful.  From my experiences, adolescent patients who simply want to “be there” tend to fabricate numbers to impress their parents or members of their health care team, experience consistent slips (relapses into old patterns and habits), and generally don’t want to fight old ways of being in order to achieve goals.  From my experiences, patients who simply want to “be there” often find themselves stuck, or in the Contemplation stage in the Stages of Change process.
 

As you can see, goal achievement involves multiple layers of preparedness.  As the old saying goes, if you fail to plan, you run the risk of planning to fail.  If you care for a child or adolescent who has self-care goals in mind, consult with your clinic’s psychosocial team for support.


References:

Brendtro, L.K., Brokenleg, M., & Van Bockern, S. (1998). Reclaiming youth at risk: Our hope for the future. Bloomington Indiana: National Educational Service.

 

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The above information was reviewed for content accuracy by clinical staff of the Alberta Children’s Hospital Diabetes Clinic.

This material has been developed from sources that we believe are accurate, however, as the field of medicine (in particular as it applies to diabetes) is rapidly evolving, the information should not be relied upon, as it is designed for informational purposes only. It should not be used in place of medical advice, instruction and/or treatment. If you have specific questions, please consult your doctor or appropriate health care professional.


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