J. Negotiate Specific Rehabilitation Goals With The Patient

OBJECTIVE

Specify the planned treatment regimen and promote patient adherence.

ANNOTATION

1. Negotiate treatment goals that specifically identify and address relapse risks.

2. Review with the patient results of previous efforts at self-change and formal treatment experience, including reasons for treatment dropout.

3. Use empathic and non-judgmental (versus confrontational) therapist style.

DISCUSSION

When both parties agree on what is to be accomplished and how this is to be done, the chances of achieving a good outcome are enhanced (Putnam, 1994; Sanchez-Craig & Lei, 1986). Discussing treatment history and expectations can reduce reliance on previously ineffective treatment approaches and prevent attempts to achieve goals likely unattainable during the current episode of care.

EVIDENCE TABLE

	Recommendations	Sources of Evidence	QE	R
1	Negotiate specific rehabilitation goals with the patient.	Heinssen et al., 1995 Miller, 1995 Miller & Rollnick, 1991 Sanchez-Craig & Lei, 1986 Sobell et al., 1992 Stark, 1992	II-1	A
2	Review previous treatment and efforts at self-change with patient.	Stark, 1992	III	B
3	Use empathic and non-judgmental (versus confrontational) therapist style.	Hser, 1995 Miller et al., 1993 Najavits & Weiss, 1994	I	A

QE = Quality of Evidence; R = Recommendation (See Introduction)