7.4 Goal setting

i) Goal setting

Underlying Philosophy

Consider how the values of case managers will influence the process of goal setting- whether goals are set with people, for people or resources are given to people to set their own goals, what issues are chosen for goal setting.

  • Key values that should inform goal setting:
    • autonomy in decision making,
    • empowerment
    • least restrictive environment
    • community participation.

Framework for goal setting

Case Managers may use an overall framework within which to set individual goals.

  • Holistic approach – is when the overall aspect of the clients life is managed.
  • Structured approach – is when the service set the goals specifically to address clients needs

ii) Factors to consider when developing goals

1. Goal development vs goal imposition

Working together with people to develop goals produces more effective outcomes than imposing goals on people. An additional challenge in working with a person with a TBI is that impairments may decrease their awareness or insight, complicating goal setting.

2. Give exact behavioural description of goals

This is self-explanatory. It is important for goals to be clear and easy to understand, not using complex words or descriptions.

Here is a two page handout give a taxonomy of goals

3. State goals positively rather than negatively

This is self explanatory.

4. Create short-term goals vs long-term goals

Break down goals so they are easily achievable and less daunting for clients.

5. Look at improvement vs maintenance

This is self-explanatory. Other factors to consider: • who to include? • the role of the agency • reviewing the goals.

6. Writing goals

Remember - goals need to be specific, measurable and time limited. Some examples are:

  • independently use public transport
  • increase opportunities for social interaction
  • improve arm function
  • improve personal hygiene
  • improve independent living skills
  • obtain driver's licence
  • improve cooking skills
  • explore part-time work options
  • participate in a range of sporting/recreational activities
  • improve group participation skills
  • improve memory
  • attend woodwork group twice a week
  • improve tone of voice

 

iii) How to deal with unrealistic goals

Strategies for dealing with unrealistic goals, such as:

  • Allow a person to learn through experience (if unsuccessful, revise goals)
  • Develop compensatory strategies (reach the same goal but in different manner)
  • Investigate alternatives (goals that address the same need through a different activity)
  • Set priorities (out of range of goals, begin with those more likely to be achievable)
  • Break things down into smaller achievable steps
  • Give clear feedback and withdraw support (consider the impact this will have on an ongoing relationship).

 

 

 

An outline for an individual program plan::

1. Physical/mobility/transport
  • Physical abilities, driving ability, public and alternative transport
2. Relationships
  • Maintenance of existing relationships, sexuality
3. Accommodation
  • Includes respite
4. Autonomy
  • Goals regarding decision-making
5. Communication
  • Speech, non-English-speaking background, phone, reading, writing
6. Living skills
  • personal care – showering/shaving/grooming/dressing/eating/hair and nail care
  • health – health and medication/substance use/abuse issues
  • food preparation
  • household chores – washing dishes/vacuuming/bed making/washing and ironing
  • money management – budgeting
  • time management – organising and keeping appointments
7. Social and personal skills
8. Recreation and leisure
9. Vocational
  • education and training

Taxonomy of goals

A detailed taxonomy of goals is here (PDF)