Occupational therapy for sensory integration disorder: A guide for clinicians
There is a misconception in the field of psychology that clients must be in therapy for years before they are able to benefit. While it is true that some clients may wish to do “deeper work,” many simply want to learn concrete ways to deal with their anxiety so it no longer negatively impacts their lives.
Fortunately, there are many research studies showing that short-term treatment for anxiety can be both highly effective and long-lasting for anxiety disorders, including panic disorder, PTSD, phobias, OCD, GAD, and social anxiety disorder in as few as six to 12 sessions.
This blog will take a deep dive into how to create short-term goals for anxiety, helping clients reclaim their lives in efficient, powerful ways. I’ll provide several examples and templates you can use for treatment planning and formulating SMART goals for anxiety therapy.
Short-term goals for anxiety: setting the stage
One of the most important aspects of developing short-term goals for anxiety therapy is conducting a functional assessment to better understand the properties of your client’s anxiety, as well the factors that are maintaining it.
The four questions below will help you conceptualize your treatment in order to develop SMART goals for your client’s anxiety therapy
1. What is the client's objective level of distress?
It’s helpful to administer a psychometrically valid assessment tool to gain an objective sense of how anxious your client is. These tools will help you and your client understand the relative impact of anxiety, as well as monitor change over time.
For example, the GAD-7 provides measurable outcomes (that SimplePractice scores automatically and plots on a graph), allowing you to measure the severity of generalized anxiety disorder over the course of treatment.
2. What are the client's values and life goals?
Understanding what’s important to your client is essential in developing short-term goals for anxiety therapy. Anxiety therapy involves having the client do uncomfortable things, from thinking about scary situations in cognitive restructuring to actively facing their fears in real time during exposure therapy.
It’s important for clients to understand how much more fulfilling and meaningful life could be beyond anxiety.
3. What is your client avoiding?
Passive avoidance is the fuel to the fire of anxiety, and is an essential element to any evidence-based treatment protocol. Identifying areas where your client is engaging in avoidance will be especially helpful once you start developing short-term goals for anxiety, as it will directly inform what you will have clients begin to do.
Remember, avoidance can be external (e.g., avoiding going to parties, avoiding going to public places) or internal (e.g., distracting, thought suppression).
4. What safety behaviors is your client engaged in?
Safety behaviors have a similar function to avoidance and are equally important to identify, as they also reinforce anxiety while limiting the amount of life your clients are able to have access to.
Like passive avoidance, safety behaviors can include both external behaviors meant to limit anxiety (e.g., carrying a water bottle if somebody has fear of panic attacks) or internal (e.g., compulsively ruminating about a past conversation).
Developing SMART goals for anxiety therapy
Once you and your client have reflected on the four questions above, you will be set up in the best possible way to develop and move towards short-term goals for anxiety therapy.
I personally have found SMART goals for anxiety therapy a very helpful tool, as they tap into the tried and true behavioral principles that have been shown to greatly influence behavior change.
In fact, SMART goals are used across many change-focused modalities, such as CBT and solution-focused therapy. It’s likely you’ve come across the term SMART goal before, but as a reminder, the acronym “SMART” stands for goals that are:
Specific
Measurable
Achievable
Relevant
SMART goals for anxiety therapy should fall in line with the client's personal goals and values), and time-limited (e.g.,occurs within a specified time-interval). .
Examples of SMART goals for short-term anxiety therapy
Below are several examples of how SMART goals might look for specific anxiety disorders, and are written in the first-person (from the perspective of a client):
SMART goals for anxiety therapy: Generalized Anxiety Disorder (GAD)
For one month, I will practice noticing when I am worrying or ruminating, and shift my attention back to what I’m doing for at least 5 minutes.
For the next three months, I will practice mindfulness of breath for 15 minutes, Monday through Friday.
For the next four weeks, I will practice worry time twice a day for 15 minutes, at 9:15 AM and 2:30 PM.
I will practice making one quick decision at least three times per week, and refrain from ruminating about whether it’s the “right” or “wrong” one.
SMART goals for anxiety therapy: Obsessive compulsive disorder (OCD)
For the next two weeks, I am going to track my handwashing compulsions every day using the monitoring form my therapist gave me.
For the next week, I will use one pump of soap instead of two, and I will reduce handwashing from five minutes to four minutes.
I will practice my “touching the doorknob exposure” three times per week this week (refer to the handout my therapist gave me). I will practice on Monday, Wednesday, and Friday when I get home from work and will spend at least 20 minutes on it.
For the next two weeks, whenever I have an intrusive thought, at least one time per day I will practice allowing the thought to exist without trying to replace it or suppress it, for at least five minutes.
SMART goals for anxiety therapy: Social anxiety disorder
I will go up to three strangers this week (Wednesday, Friday, and Sunday) and ask them what time it is.
Over the next week, I will answer one question per class that the professor asks.
For the next two weeks, I will practice my defusion skills at least once per day when I have thoughts that people might be judging me.
I will spend five minutes every day over the next week reviewing my thought records and identifying the 10 cognitive distortions that show up in my thinking patterns.
Other considerations for short-term goals for anxiety therapy
Remember, SMART goals for short-term anxiety therapy are not rigid rules written into stone. They are meant to be flexible and can change session-by-session as the client progresses in treatment or runs into barriers. It’s an iterative process where you help clients set goals, attune to the outcome (e.g., how did it turn out?), and sharpen or expand upon the original goal based on what happened.
Longer-term goals of anxiety therapy are less about reducing symptoms and focus on increasing how much life is available to clients. This is where you can help set longer-term goals such as developing community, making deeper connections, and increasing wellness overall.
Sources
Cape, J., Whittington, C., Buszewicz, M., Wallace, P., & Underwood, L. (2010). Brief psychological therapies for anxiety and depression in primary care: meta-analysis and meta-regression. BMC medicine, 8(1), 38.
Doran, G. T. (1981). There's a S.M.A.R.T. way to write management's goals and objectives. Management Review.
Epton, T., Currie, S., & Armitage, C. J. (2017). Unique effects of setting goals on behavior change: Systematic review and meta-analysis. Journal of consulting and clinical psychology.
Launes, G., Hagen, K., Sunde, T., Öst, L. G., Klovning, I., et al. (2019). A randomized controlled trial of concentrated ERP, self-help and waiting list for obsessive-compulsive disorder: the Bergen 4-day treatment. Frontiers in Psychology.
Roy-Byrne, P., Craske, M. G., Sullivan, G., Rose, R. D., Edlund, et al. (2010). Delivery of evidence-based treatment for multiple anxiety disorders in primary care: a randomized controlled trial. JAMA.
Sloan, D. M., Marx, B. P., Lee, D. J., & Resick, P. A. (2018). A brief exposure-based treatment vs cognitive processing therapy for posttraumatic stress disorder: A randomized noninferiority clinical trial. JAMA psychiatry.
Steele, K. R., Upton, E., Holden, M., Regan, A., Coleshill, M. J., et al. (2025). Intensive 7-day internet-delivered cognitive behavioural therapy for social anxiety disorder: A randomized controlled trial. Journal of Anxiety Disorders.
Wright, B., Tindall, L., Scott, A. J., Lee, E., Cooper, C., et al. (2023). One session treatment (OST) is equivalent to multi‐session cognitive behavioral therapy (CBT) in children with specific phobias (ASPECT): results from a national non‐inferiority randomized controlled trial. Journal of Child Psychology and Psychiatry.
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