Our mentors and page authors are not necessarily psychologists or therapists. Even when they are, this page is not medical or psychological advice and they are not creating a doctor/therapist-client relationship. You should consult a professional if possible and they can tell you whether this advice applies to your situation. If this is an emergency, you should call your national emergency number, like 911, or a mental health hotline, like 1-800-950-6264.
Creating a problem list and goals is crucial to getting better and tracking/monitoring your success. Take a few hours one week and a few pages of your journal and get it all down.
Creating a Problem List
First, create a list of all the problems you’re facing. Just get it all on the page. This can also help you figure out diagnoses for some of your thought patterns and figure out what’s going on. There’s a lot of stigma surrounding mental health vocabulary, so don’t worry if you aren’t ready to “name your condition.”
Problem lists can be further broken down into social stressors, mood and emotions, and physical issues.
- Social stressors: parents/spouse/other relationship issues, finances, friends/networking, vacation or trip planning, health of your family, conflict at work, desire to be famous, successful or rich, etc.
- Mood and emotions: depression, suicidal tendencies, anger management, sadness, loneliness, lack of hope, mood swings, etc.
- Physical: Sleep issues, chronic pain, diseases, illnesses, physical disability, blood pressure or eating issues, weight, drugs or drinking, etc.
Creating SMART Goals
Now that you know what you’re dealing with, you need to figure out where you want to get.
The first step in CBT is knowing why you’re here. Obviously you have problems you’d like to fix, patterns of thinking that aren’t adding value to your life. First, diagnose your problems by creating a diary of your feelings. Notice what patterns of thinking you adopt regularly. Notice what you want to fix.
Then create SMART goals. You can put your goals on the first page of your CBT journal. Your goals should be:
- Specific: They should be as narrow as you can make them and include all the details you want to achieve. Examples include a precise amount of time you want to sleep each night or how many minutes of exercise you want.
- Measurable: Your goals should be measurable. This is easy with sleep and exercise, but harder with emotions. If your goal is to be happier, you have to come up with a way to measure it. Maybe you record your mood three times a day and see if it changes over a few weeks of CBT.
- Attainable: Your goals should be attainable. You’re never going to be happy every hour of every day and if that’s your goal, you’re going to be disappointed. With some serious mental issues, it’s sometimes not possible to be cured completely, but it’s always possible to work on management and live a full life.
- Relevant: Your goals should be related to the underlying emotional or life issues you’re having that you want to fix. For some people, fixing sleep isn’t actually going to help them achieve their happiness or mood goals. If your goal is to fix your relationship with a long-lost parent, it may not actually be a relevant step towards treating your depression.
- Time-bound: Finally, your goals should be time-bound. You have to have the time to work on your goal, it has to be something you can achieve, and it has to be a goal you can see progress in in a few weeks. Set yourself deadlines. For example, during the COVID 19 crisis, you probably can’t work to a goal of being less anxious during parties. You shouldn’t say you want to write a book and then not include a time deadline. Remember procrastination is your enemy and you have to beat it.
For an example of a good goal, your goal could be to sleep 7.5 hours a night and sleep peacefully. It could be to make sure your average emotion (as documented throughout the week) is happiness or hope. It might be to have more energy or to feel more productive, but then make sure you have a way to measure it, such as by the weekly diary logging your energy from 1-100 every day.
In general, goals like “be happy” or “be less stressed” aren’t good goals, even if you’re very good at sticking to mood diaries and measuring them. That’s because they aren’t really specific enough. When do you want to be happy? What specific times do you want to be happy in? Do you want to be happy for some other reason, like you want to be more productive or more pleasant around your family? Make sure you’re digging down and writing up all your goals.
Solve Your Problems From Easy to Hard
Now that you have your goals, figure out what order you’re going to tackle them in. Start with one and never work on more than two or three at a time. Your goal is to slowly and surely get better, while make sure the new habits stick. If you go too fast, CBT may not work as much.
If you suffer from multiple mental illnesses or issues you want to work through, you’re not alone. Many of us have depression and anxiety, stress and autism, ADHD and borderline personality disorder. Once you’ve diagnosed yourself and established your goals for the long-term, work on your issues from easiest to hardest.
Often an easier issue to fix is stress, minor depression, or situation-specific anxiety. This allows you to free up your brain and emotions to put in the heavy lifting of dealing with death, anger management, clinical depression, or more. It’s also important you see progress to stay motivated.
Fix Behaviors First, If You Can
As the CBT model shows, the goal should be to improve your emotions through changing your thoughts and your behaviors. Changing your emotions is often impossible, and changing your thoughts are hard, so one easy way to start is fixing the behaviors you want to change that you have control over.
For example, you could reduce how much you drink or smoke, increase how much you exercise, talk to people on the phone even if it gives you anxiety, or force yourself to get out of bed and shower in the mornings. This isn’t a complete fix at all, but it can help give you a little energy and boost to work on your thoughts, the real heart of CBT.