Goal Development

Purpose of Goals

• provide clear understanding of plan among client, family, and/or child

• measures how effective your treatments have been over time

• identifies roles that you and the client have in reaching new milestones

• are reviewed by reimbursement services and will reflect clients need for participation in desired occupations

• will document a client’s progress as you modify, discontinue, or add new goals to the clients care

Goals are dependent on

• theory

  • FOR/model should be reflected on how you expect the client to change over time, and should be kept in mind when writing goals

• clients wants, interests, likes, and dislikes

  • goals should be a direct reflection on what is important to the client

• setting

  • ex. not working on driving in acute care

• OT standards and Framework

  • goals should reflect scope of practice and use terminology

Focus of Goals

• restorative (post illness/injury)

• habilitating (never developed)

• maintenance (sustain current performance)

• modification (not focused on skills, but on environment/task

• preventative (minimize risk of)

• health promotion: enhance the contexts and activities to enable maximal participation in life

Types of Goals

• long term

• short term

Long Term Goals

• are based on discharge projections in many settings OR a designated time frame that is established for you

  • need to be meaningful, measurable, and occupation based

Short Term Goals

• steps toward long-term goal and must be measurable and behavioral with occupation based terms

T/F? Goals should be well written so that other OTs know what you are doing

T

ABCD/ABCDE

Audience

• who will do the behavior (client)

Behavior

• what the audience will do (something you can see or hear the person doing or saying)

Condition

• circumstances that support the behavior, help to clarify the goal (can represent something in the enviro that is necessary for the behavior to occur)

  • ex. “client will dress themselves with clothes that have no fasteners

    • clothes that have no fasteners are the condition

Degree

• measurable part of the goal (tells how many, what percent, what degree

Expected Time

• when the goal is expected to be met

COAST

Client

• may be a person, organization, or population

Occupation

• reflects the occupation the client will perform

Assistance

• assistance level required in order for the client to perform the desired occupation (can be physical, verbal, or gestural)

Specific condition

• conditions can include modifications to the environment, equipment, or technique

Time

• timeline for achieving the goal (should be reasonable and achievable

RHUMBA

Relevant

• must be a clear relationship between areas of occupation identified during the eval process as being in need of intervention

How long

• realistic estimate of the time you expect it will take to reach the goal

Understandable

• has to make sense to the reader

Measurable

• quantitative (frequency, accuracy, grade, degree, level of independence)

Behavioral

• has to be observed, not inferred

Achievable

• goal is reasonable and likely to be met in the time frame established

SMART

Significant

• will make a significant difference in the client’s life

Measurable

• clear target to aim for, aka how will you know when the goal is met

Achievable

• must be reasonable

Related

• clear connection to occupational needs

Time-limited

• has a chronological end point

Ways to Measure Change

• frequency/consistency

• duration

• level of assistance

• quality of performance

• complexity of task

• participation level

Frequency/consistency

ex. percentage, trials

Duration

ex. time to complete tasks; repetitions

Levels of Assistance

ex. max, mod, min, standby, setup, adaptive equipment, prompting, independent

Quality of Performance

ex. errors, accuracy, pain, safety with performance

Complexity of task

• multi-step

• one-step