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a) in the eyes of politics and society? are derived from professional knowledge-
b) in the eyes of the commissioning authorities? based considerations from which various
c) in the eyes of the cost-carrying agency? strategies are developed. They must reflect
3. What commission can I – going beyond what professional responsibility; the standard is
has been mentioned – formulate for myself on the effective achievement of the final aims.
the basis of • Final aims (or end aims) can only be measu-
- professional knowledge and ethical principles red by standards of ethical responsibility.
- my spiritual view and calling? They are derived from the patient’s aims for
the therapy and the subsequently negotia-
Therapy aims und life aims 5 ted treatment contract.
It appears important to me to distinguish bet-
ween life aims and therapy aims. Awareness, for example, can be both an instru-
• Life aims are, as a rule, a life-long challenge, mental aim (to cause the patient’s symptoms to
hardly achievable in entirety. They belong disappear) and a final aim (if the client does not
to the “life system” of the client, are tied in wish to experience these feelings again). Both
with (for the client at least) absolute values. kinds of aim should be openly declared and
Here no hierarchy or external imposition is agreed.
permissible, otherwise personal conscience
is infringed. “Compulsory aims” and “luxury aims”
• Therapy aims should given a limited and One could also speak of minimum aims and
achievable formulation so that achievement maximum aims.
or non-achievement can be identified at the • “Compulsory aims”: What is the least that
end of the therapy. Therapy aims belong must be achieved in this therapy? If these
to the “therapy system”, which is based on aims are not achieved, the conclusion must
agreements and relative values. This sets be that the therapy has failed or even caused
sensible limits to the hierarchy inherent in damage (it has then not been worth it).
the system and the power of the therapist. • “Luxury aims”: What could realistically
be further achieved in this therapy? What
If therapy aims (e.g. stopping smoking) are would be – from the point of view of client
made into absolute values (“smoking is a sin or therapist, or spiritually – “nice to have”?
and separates you from God”) or if life aims be- Such aims often appear attractive and are
come therapy aims (which leads automatically motivational – even if not absolutely neces-
to failure), hurt and role-confusions result. sary.
If the therapist is at the same time a priest or
spiritual leader, discernment and restraint are It is not unusual for clients or even therapists
appropriate. He should also always ask himself to lose sight of compulsory aims and turn their
whether what his intended goal is a therapy aim attention to luxury aims (examples: primary
or a life aim. That can prevent misunderstan- task and secondary benefits in a group thera-
dings and disappointments on both sides. py). Or therapists put themselves under unne-
Nevertheless, life aims and therapy aims should cessary pressure because they have formulated
be linked with each other. The achieving of the for their work “luxury aims” which they then
therapy aims should also bring the life aims ne- do not achieve.
arer. In both cases, it is necessary to be open about
any conflicting aims and to turn committedly
Instrumental and final aims again to the compulsory aims.
• Instrumental aims (or intermediate aims)
Depth of aim in therapy
There is a hierarchy of aims in therapy: that the-
5 According to Mahler, Dr. Roland: Zwangs- und Sucht- re are different depths of transformation is al-
störungen. Seminarunterlagen SCS, 2004 ready clear in the biblical account of the healing

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