From the Guidelines
To enhance goal attainment in rehabilitation, I recommend implementing a comprehensive approach that includes setting specific, proximal, shared goals, self-monitoring, scheduled follow-up, regular feedback, and increasing self-efficacy, as outlined in the 2016 study published in Circulation 1. This approach is supported by the most recent and highest quality study, which emphasizes the importance of a multi-component strategy in achieving successful behavior change and goal attainment. Key components of this approach include:
- Setting specific, proximal goals in collaboration with the patient, including a personalized plan to achieve the goals
- Establishing a strategy for self-monitoring, such as a dietary or physical activity diary or web-based or mobile applications
- Scheduling regular follow-up to assess success, reinforce progress, and set new goals as necessary
- Providing regular feedback on progress toward goals, including using in-person, telephone, and/or electronic feedback
- Increasing self-efficacy by using strategies such as mastery experiences, vicarious experience, physiological feedback, and verbal persuasion Additionally, the 2021 study published in Health Psychology Review 1 highlights the effectiveness of goal-setting interventions in promoting physical activity, with a medium effect size reported across 45 studies. Overall, the evidence suggests that a comprehensive approach that incorporates multiple components is most effective in enhancing goal attainment in rehabilitation, and I strongly recommend implementing this approach in clinical practice to improve patient outcomes.
From the Research
Strategies for Enhancing Goal Attainment in Rehabilitation
- Setting specific, measurable, achievable, realistic, and timed (SMART) goals is a crucial strategy for enhancing goal attainment in rehabilitation, as it provides a clear direction and focus for the rehabilitation process 2.
- Goal attainment scaling (GAS) is another effective strategy, which involves setting individualized goals and measuring progress towards achieving them 3, 4.
- Breaking down goals into smaller, manageable parts, and providing support and quantification of performance, can also help enhance goal attainment 2.
- Using a standardized method for writing goals, such as the SMART goal framework, can save time and simplify the construction of goals that are sufficiently specific to be measurable 2.
- Involving patients in the goal-setting process and using tools such as the Personal Health Inventory (PHI) to monitor perceived goal attainment, can also be beneficial 5.
Effective Goal-Setting Approaches
- The use of a four-domain framework for goal attainment scaling, which provides a series of questions to research and evaluation teams, can help standardize the measurement of attainment of individualized goals 3.
- Setting project-specific goals, following established rules for goal setting, and conducting follow-up interviews on goal attainment, can also be an effective approach 4.
- Using cognitive behavioral therapy (CBT) techniques, such as delivery of cognitive and/or emotional strategies, coaching, and homework, can also enhance motivation and help generalize strategies to daily life 6.