Dr. Persons' comments raise an issue which I have been thinking about... Just what are the goals of therapy? In Cognitive Therapy I talk explicitly with the client about the goals of therapy at the outset of our work and we reach an agreement about just what we are trying to accomplish. Usually symptom reduction is an important goal because this usually is an important part of what the client wants to accomplish. With "deep" issues such as changing core beliefs, resolving family of origin issues, etc. we often work on these as a step towards achieving lasting symptom reduction, not as a goal in itself.
However, Kathy doesn't come into therapy saying that she wants to overcome her depression. In the initial installment of this case presentation we learn that "what brought her to treatment was a wish to move further emotionally from her current level" and that she was "eager to get help with her emotional growth." Here we have a client who apparently is quite depressed but who resists working to alleviate her depression and instead states her goals in terms of emotional growth.
Ages ago when I received my training in psychodynamic therapy and in Client Centered Therapy, the goals of therapy were not explicitly discussed. One simply started doing therapy and assumed that eventually something valuable would be accomplished. How can we best approach this? Should therapist and client talk explicitly about goals for therapy, should one simply start doing therapy without being explicit about what the therapist hopes to accomplish, or are there other options?