From the Guidelines
Goal attainment scaling is a personalized method for setting and measuring progress toward specific goals in therapy or rehabilitation, as evidenced by its positive results in several clinical trials involving geriatric rehabilitation, brain injury rehabilitation, and mixed rehabilitation patients 1. This approach involves identifying meaningful objectives for an individual, establishing a scale to measure outcomes, and tracking progress over time. To implement goal attainment scaling, the following steps can be taken:
- Collaborate with the client to identify relevant goals that are important to them
- Create a scale for each goal where the expected outcome, less favorable outcomes, and better-than-expected outcomes are clearly defined with observable behaviors or measurable criteria
- Regularly assess progress using this scale and adjust goals as needed The use of goal attainment scaling has been recommended in guidelines for stroke rehabilitation, emphasizing the importance of developing comprehensive goals that cover the level of disability and include psychosocial goals 1. Key benefits of goal attainment scaling include:
- Providing individualized measurement of progress
- Increasing client motivation through personalized goals
- Offering a structured way to document improvements that might not be captured by standardized assessments This approach is effective across various settings, including physical rehabilitation, mental health treatment, educational interventions, and geriatric care, as it adapts to each person's unique circumstances and priorities.
From the Research
Definition of Goal Attainment Scaling (GAS)
- Goal Attainment Scaling (GAS) is a person-centered and collaborative approach to assess the effectiveness of an intervention on personally relevant goals 2
- GAS is not a "scale" but a heterogeneous group of methodologies, including many variations and lack of consensus on high-quality GAS 2
- GAS is a method for quantifying progress on personal goals, allowing for the measurement of goal achievement on a 5-point scale ranging from -2 to +2 3, 4
Applications of GAS
- GAS can be used in rehabilitation settings to quantify the achievement of goals set by patients and therapists 3, 4
- GAS has been applied in various fields, including physical and neurological rehabilitation, brain injury rehabilitation, and occupational therapy 3, 4, 5
- GAS can provide a structure for objective documentation of patient progress, team conferences, and program evaluation 5
Methodological Considerations
- There are various approaches to GAS, and the literature emphasizes the need for caution when using the T-score 4
- The use of medians and rank tests appears to be appropriate, given the ordinal nature of GAS 4
- Setting the patient's initial level to -2 and describing all five GAS levels in detail is preferable 4
Reliability and Validity of GAS
- There is strong evidence for the reliability, validity, and sensitivity of goal attainment scaling 6
- Empirical support was found for the validity of goal setting, but research demonstrating its reliability and sensitivity is limited 6
- GAS appears to be a sound measure for use in physical rehabilitation settings with working-age and older people 6