How to Get Patients to Set and Achieve Goals


Health & Wellness

“A goal is a dream with a deadline.” Napoleon Hill

New Year’s resolutions are still on the radar so it is still a good time to ask your patients what they hope to achieve this year, healthwise. We know from the science of goal setting, that those who have stated goals are far more likely to reach them.1 Nearly half of Americans make new year’s resolutions and less than 10% reach them.2 Why the dismal results?

Most people do not know how to apply the tool of mental contrasting, a way of setting a goal and listing highly specific and sequential steps to get there. We often find ourselves setting ambitious goals year after year, but don’t mentally contrast our present reality to our desired future. In order to avoid indulging in fantasy thinking, help patients backward plan from their goals. Don’t let them indulge in goal setting without asking the how, when, where and of getting there. Consider mental contrasting the jet fuel to goal accomplishment.

Goal accomplishment can be made more successful when people are asked to specify precisely what will get in their way. If the barriers to success are not acknowledged, they are likely to repeat failure patterns. Each barrier must be acknowledged and have a remedy. For example, I work with many people on weight loss journeys and there are many reasons why people are overweight. Most people can identify 1-2 behaviors that are the root cause, such as nighttime bingeing or powerlessness over sugar. So the degree to which we expect ourselves to be successful in goal attainment hinges on this barrier recognition.

Mental contrasting helps people identify a roadmap to success, so to combat nighttime eating, people must be sure they do not go into the evening too hungry and find another activity that more directly meets their needs. If they are addicted to sugar, the only way around powerlessness is not to put it in the body- cutting down is not a remedy for addiction. Specifying the problem makes it possible to accurately remedy.

Mental contrasting taps into the necessary energy needed to commit to long-term goals and a better future.3 Ask your patients what they want to achieve this year—be very specific—with a goal, then next ask what they want in 6 weeks, 3 months, 6 months. What specific behavior patterns to do they need to interrupt in order to be successful? Long-term weight loss or any goal accomplishment requires making dramatic changes in current patterns and these can begin small and get more ambitious.

Once patients get clear on what is in their way of success, they become more aroused to change behavior. The patients I work with who have been most successful in weight loss have accurately specified their destructive eating patterns. To move patient’s goals from fantasy to action, have them look closely, fiercely and honestly at the gap between what they have and what they want.

May you live your intentions in 2014 and Happy New Year.


  1. Oettinger G, Pak H, Jyeon J, Schnetter K. Self-regulation of goal-setting: Turning free fantasies about the future into binding goals. 2001;80(5):736-753.
  2. Turning Over a New Leaf in 2014? Marist Poll. 2013 Dec 23. Available at:
  3. Oettinger G, Gollwitzer PM. Strategies of setting and implementing goals. In Maddux JE, Tangney JP (eds). Social Psychological Foundations of Clinical Psychology. New York: The Guildford Press; 2010:114-135. Available at:

Dr Eileen T. O’Grady is a certified nurse practitioner and wellness coach who specializes in getting people unstuck from lifestyles that do not support wellness. She can be contacted at