Goal directed

Goal directed

Goals

Goals are what the client wants to achieve.
Goals belong to you, not to workers, clinicians or service providers. 
Rehabilitation programs exist so that you can achieve your goals.  Rehabilitation goals typically focus on improvement.
Clients have life goals after rehabilitation – including maintain goals and prevent deterioration.
Attendant care, when required, is part of achieving your goals.

Benefits of setting goals

Setting client goals:

Helps you motivate yourself – i.e. it is easier to work towards achieving your goals when those goals are explicit and you are clear about what you are wanting to achieve.
Makes it clear to everyone what the you are wanting to achieve.
Makes it easier for everyone working with you to work together as a team and coordinate their efforts to achieving the goals.
Makes it easier for everyone to see how well things are working: Are the goals being achieved?

Individual service plans

Individual service plans are needed so that the steps needed to achieve the gaols are documented and everyone involved is working together.

Individual service plans:

• Start with your goals
• Establish the steps needed to achieve your goals
• And then design the actions and services needed to achieve the steps.

To be useful goals must describe what's to be achieved

Useful goals describe what the client wants to achieve, not what the client or service provider is supposed to do.  The program describes what is to be done.

Jill’s goal: To be able to care for her child independently.

Jill’s program: Jill does her home exercise  program and attends occupational therapy sessions. 

She does this because she wants to be able to care for her child independently.

Sometimes goals do not reflect what the client wants to achieve in their life. For example if Jill’s goal were written as: To do the home exercise  program each day and attends occupational therapy each week this would not be an appropriate goal, as it is focussing on what Jill has to do, not what she wants to achieve.

 

Useful goals

Setting goals is an art.
Useful goals have some of the following characteristics:
                                Specific
                                Measurable
                                Achievable
                                Relevant
                                Time-bound
Goals are more likely to be achieved when:
There are steps and an action plan that map out what has to be done to achieve the goal.
When the degree of achievement of the goals is monitored and the action plan is adjusted to better achieve the goal.

Specific

A goal is what the client is aiming for.

When a goal is specific the client knows what to aim for, when and how much.
For example, ‘John will join his friends on a fishing trip’ is specific, ‘John will increase his social interactions’ is not. 
For example “Beating your best time at walking” is specific where as “doing your best” is not.

“Measurable”

It must be possible to identify when the goal has been achieved (“measurable’). 

For example, these are “measurable” goals:

• Jill will return to work 20 hours per week over 4 days by end March 2014.
• Jack will host a dinner party including cooking a two course meal for himself and three friends at his home within 12 weeks.
• Karen will perform the family grocery shop every week.
• Jack will walk from home to the bus stop with a walking stick and stand-by assistance.

It is possible to know when these goals have been achieved.

These goals are not measurable (and therefore not useful goals):

• Jack will increase his contribution to family life.
• Jill will increase her community participation.

Achievable

Useful goals must be achievable goals.

Ideally, goals should be achievable but challenging. 

What is achievable for a  client will depend on many factors, e.g. the nature and impact of their injury, what they could do previously, their age, social situation, resources available and so on.
It is useful to think about shorter and longer time frames.  What is an achievable 3 to 6 month goal and what’s a goal in the longer term.

Relevant

Useful goals are relevant to the client.

When asked: ‘Is this goal something you want to work towards?’ or ‘Is this goal important to you?’, or ‘Does this goal matter to you?’   the client should answer “Yes”. 

If the client doesn’t answer “yes” the goal probably isn’t relevant to them or they are not seeing the connection between the goal and what they are really wanting to achieve.

Time-bound

Goals must be time-bound to be useful.

When will the goal be realistically achieved?  Without a time frame, there is less urgency to start taking action towards achieving the goal.  This is best specified by a date, rather than by a length of time e.g., ‘by February 2013’, rather than ‘in 3 months’ time’.

Action Plan

For goals to be useful for the client, goals need an action plan that maps the steps and actions needed to achieve the goal.

The action plan is driven by the goal.

Monitoring achievement

For goals to be useful for the client the degree of achievement needs to be regularly monitored and  the action plan modified if necessary.