[Establishing and changing therapeutic goals in psychiatric-psychotherapeutic treatment]

At the onset of psychotherapy, treatment goals are frequently not fully defined. They have to be set during treatment and can be changed in its course. An overview of the current literature on treatment goals from patients' and therapists' perspectives is given. Based on a case report of a patient suffering from panic disorder, the process of setting and changing goals and its influence on therapeutic technique and outcome are described. Finally, a case is made for the importance of "negotiations" between patient and therapist about treatment goals, which helps in building up a constructive therapeutic relationship and a helpful therapeutic process. The point in time of goal-setting, the achievability of treatment goals, and the patient's handling of unattained goals appear to be of particular significance.