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Components of Goals: Back to Basics

Neely Sullivan, MPT, CLT-LANA, CDP

August 31, 2021

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Question

What are the components of a well-written goal? 

Answer

Components of Goals

Goals are written as behavioral objectives. The behavioral objective is that skill that results in the desired consequence. It has to be well-defined so that our observations and measurements of behavior can be taken. A baseline is initially established so that then we can compare the client's progress.

The behavioral objective or goal represents the action plan by which we are going to help our clients get better. That goal is going to have five components. First is the participant, and that is the person who's going to exhibit or perform the skill or desired behavior. Second is the behavior. This is the task or skill that the person will do. The third is the condition, which is the requirements or circumstances necessary for the client to perform this behavior. Fourth is measurement. This is set objective criteria in which we have to be realistic, and it has to be measurable and observable against which we are going to measure their performance. Fifth is their product or functional outcome. This is the result of the behavior as it correlates to their activities of daily living, so the functional result of their performance.

Here's an example.

  1. Client (Participant)
  2. Will identify (Behavior)
  3. Articles of clothing upon presentation (Condition)
  4. With 80% accuracy (Measurement)
  5. In order to increase core ADL vocabulary (Functional Outcome)

Let’s go through all these components. The participant is the person who is making the change and receiving the skilled service. The client should be the participant. The therapist should never be the participant. We are never writing goals for ourselves.

The behavior has to be functional. We need to know how the client's level of success in therapy will affect their performance of daily life activities. What are the expected functional outcomes as a result of participation in that therapy program? Behaviors may be skills that are underlying factors to improved functional performance or functional tasks themselves.

The conditions have to be realistic. The expected outcomes should be appropriate for the client's current medical diagnosis, prognosis, and prior style of living. We need to know the level of assistance and the context in which that behavior occurs or the type of cueing that may be the criteria under which that behavior is judged. Here is an example of documentation. “Through the cues of trained caregivers” would be an appropriate statement or condition to include when measuring the client's response to strategies being developed. Keep in mind that goals can change during the course of treatment. This is okay, we just have to document the new goals and the reason for the change.

Measurement includes the tools we use to quantify a measure of the client's level of performance. Use objective data to describe function. These measurements may be a percentage, time, distance, number of trials, or level of assistance to complete the task.

The outcome describes the client's current level of function is versus the anticipated discharge level of function. The desired end result should be written in functional terms. This statement answers the question, so what? At times that may be difficult to relate a goal to functional activity. It may be helpful to consider the planned discharge location and the prior level of function when you establish your goals so that the client is able to achieve that desired outcome.


neely sullivan

Neely Sullivan, MPT, CLT-LANA, CDP

Neely Sullivan, PT, CLT-LANA, has worked with diverse client populations ranging from pediatric to geriatric in a variety of clinical settings.  These experiences and multiple courses on the topic have allowed her to treat and develop client care programs for clients living with lymphedema and wounds. She has served in multiple levels of regional and corporate management positions. In these positions, Neely has developed policies and worked closely with interdisciplinary teams to ensure that clients living with lymphedema and/or wounds have the opportunity to attain their highest level of function and quality of life. She is a certified lymphedema therapist and has most recently been responsible for the identification, implementation, and evaluation of clinical programs in long-term care settings.  Neely currently provides educational support to 13,000+ therapists nationwide as an Education Specialist for Select Rehabilitation. Neely has lectured nationally and at the state level on the topics of Lymphedema and Wound Care Management. She has authored publications focusing on edema and lymphedema management. 


Related Courses

Justifying Medical Necessity in Documentation: Screens to Skilled Services
Presented by Neely Sullivan, MPT, CLT-LANA, CDP
Recorded Webinar

Presenter

Neely Sullivan, MPT, CLT-LANA, CDP
Course: #3973Level: Intermediate2 Hours
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Providing excellent client-centered services depends on documentation that clearly illustrates the medical necessity of the client. Participants in this webinar will learn how to evaluate and articulate the medical necessity of their client, illustrate the complexity of their skills to support the necessity of your treatment plans, and recognize through examples what constitutes appropriate documentation. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.

Management of the Client with Compromised Respiratory Function
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This seminar reviews the background and scope of respiratory illness (including COVID-19) and introduces strategies for assessing and implementing treatment interventions designed for clients with compromised lung function. Finally, this course includes reimbursement and documentation principles to ensure efficacy in this area by therapy providers. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.

Swell to Well: Wound Management for Clients Living with Lymphedema
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Course: #3666Level: Introductory2 Hours
  'very detailed'   Read Reviews
This seminar will describe the anatomy and physiology of the lymphatic system in relation to risks for developing wounds. This session will also focus on different types and stages of wounds commonly occurring and outline wound management interventions for individuals living with lymphedema. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.

Wound Care Staff Education: What Clinicians Need to Know
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Course: #3945Level: Intermediate2 Hours
  'good course'   Read Reviews
A systematic approach to wound care staff training can result in a positive outcome for therapists, staff, their clinic, and most importantly, their clients. Using multiple examples, this course examines key elements (role of multidisciplinary team, documentation and reimbursement, prevention, wound assessment, and wound treatment) of effective education and introduces strategies for making wound care learning engaging and fun to support delivered wound care services. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.

The Impact of Functional Interventions and Client Advocacy on Wound Healing
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Course: #3772Level: Intermediate2 Hours
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This session will review the foundations of client advocacy for individuals at risk for skin breakdown and introduce strategies for implementing client-centered treatment interventions across rehab settings. Learners will review common wound management interventions and then apply components of advocacy to this client population using case examples. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.