Page 11 - EMCAPP-Journal No. 9
P. 11

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
Therapy aims und life aims5                                    the therapy and the subsequently negotia-
It appears important to me to distinguish bet-                 ted treatment contract.
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
                                                           disappear) and a final aim (if the client does not
    hardly achievable in entirety. They belong             wish to experience these feelings again). Both
    to the “life system” of the client, are tied in        kinds of aim should be openly declared and
    with (for the client at least) absolute values.        agreed.
    Here no hierarchy or external imposition is            “Compulsory aims” and “luxury aims”
    permissible, otherwise personal conscience             One could also speak of minimum aims and
    is infringed.                                          maximum aims.
•	 Therapy aims should given a limited and                 •	 “Compulsory aims”: What is the least that
    achievable formulation so that achievement                 must be achieved in this therapy? If these
    or non-achievement can be identified at the                aims are not achieved, the conclusion must
    end of the therapy. Therapy aims belong                    be that the therapy has failed or even caused
    to the “therapy system”, which is based on                 damage (it has then not been worth it).
    agreements and relative values. This sets              •	 “Luxury aims”: What could realistically
    sensible limits to the hierarchy inherent in               be further achieved in this therapy? What
    the system and the power of the therapist.                 would be – from the point of view of client
If therapy aims (e.g. stopping smoking) are                    or therapist, or spiritually – “nice to have”?
made into absolute values (“smoking is a sin                   Such aims often appear attractive and are
and separates you from God”) or if life aims be-               motivational – even if not absolutely neces-
come therapy aims (which leads automatically                   sary.
to failure), hurt and role-confusions result.              It is not unusual for clients or even therapists
If the therapist is at the same time a priest or           to lose sight of compulsory aims and turn their
spiritual leader, discernment and restraint are            attention to luxury aims (examples: primary
appropriate. He should also always ask himself             task and secondary benefits in a group thera-
whether what his intended goal is a therapy aim            py). Or therapists put themselves under unne-
or a life aim. That can prevent misunderstan-              cessary pressure because they have formulated
dings and disappointments on both sides.                   for their work “luxury aims” which they then
Nevertheless, life aims and therapy aims should            do not achieve.
be linked with each other. The achieving of the            In both cases, it is necessary to be open about
therapy aims should also bring the life aims ne-           any conflicting aims and to turn committedly
arer.                                                      again to the compulsory aims.
Instrumental and final aims                                Depth of aim in therapy
•	 Instrumental aims (or intermediate aims)                There is a hierarchy of aims in therapy: that the-
                                                           re are different depths of transformation is al-
5 According to Mahler, Dr. Roland: Zwangs- und Sucht-      ready clear in the biblical account of the healing
störungen. Seminarunterlagen SCS, 2004

   6   7   8   9   10   11   12   13   14   15   16