1. Introduction to goal-directed rehabilitation

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Use of goals is a core element of delivering quality rehabilitation.

Goal. That towards which effort is directed; aim or end.1

Macquarie Dictionary

Goals are not a prediction of recovery or what will happen, but a desired outcome that is the result of effort.2

In the context of rehabilitation, goals have two characteristics:

  • A goal is an intended future state. This is usually a change from the current situation. Although, in some circumstances, maintaining a current state in the face of expected deterioration, might be a goal.
  • A goal is the intended result of personal effort and therapeutic intervention. It is a consequence of actions undertaken by the person and their rehabilitation team. A goal is not, nor should be, a simple prediction of what will happen.
Timeline of process showing effort from person and rehab team, with the steps in the process: identify aspirations, understand goals, agree actions, complete actions, monitor and review.
Figure 1: Goals in rehabilitation

Goal setting is sometimes referred to as goal planning. It is a formal process in which a rehabilitation professional or team and the person and their family negotiate goals for rehabilitation and recovery. How this happens may vary across different rehabilitation contexts. But the essence of these meetings should be consistent.

Why goals are important in rehabilitation

Goal setting is a complex and multidimensional process involving:

  • the person with the health condition
  • their family and carers
  • clinicians
  • coordinators.

Goals change over time with a wide range of factors influencing the rate and types of changes. Goals are invaluable in rehabilitation because they:

  • increase the person’s engagement and sense of involvement throughout the rehabilitation program
  • promote understanding of rehabilitation
  • improve outcomes, health-related quality of life, self-reported emotional status and self-efficacy
  • increase team efficiency
  • identify and meet the person’s expectations of rehabilitation
  • enable tracking of progress and changes to goals
  • facilitate the person’s control and choice
  • provide the person with a sense of responsibility.

Two common features in goal setting which lead to improved outcomes and experience are:

  • having measurable goals
  • involving patients.

Why we involve the person in goal-setting

The importance of engaging with the person and finding their personal rehabilitation goals is highlighted in the following patient stories.

Stephanie's Journey

Stephanie

Watch Stephanie's Journey (video).

Stephanie makes a point of saying that the goals were always vetted by the therapists. She really felt that they should have allowed her to try for herself, even if she failed.

Key point: Enable people to lead the planning of their rehabilitation. Key phrase: 'Just give me a go.'

Paul

Paul had a stroke and created a website to share his experience in the hope that it can help raise awareness and benefit other stroke survivors. He talks about how setting goals kept him on track.

Read Paul's blog post about his ‘what have I got to lose’ approach to recovery and setting goals.

Key point: Goals give focus to recovery. Key phrase: 'What have I got to lose?'

Support resources

Explore more about quality rehabilitation with these resources.

Rehabilitation service delivery: audit tool for best practice
Plan and review a quality rehabilitation service in NSW Health.
Source: Agency for Clinical Innovation

Package of interventions for rehabilitation - Module 3: Neurological conditions
Consider interventions for specific conditions.
Source: World Health Organization

References

  1. Macquarie Dictionary. Sydney: Pan Macmillan Australia; 2024. Goal; [cited 2 Jul 2024].
  2. Wade DT. Goal setting in rehabilitation: an overview of what, why and how. Clin Rehabil. 2009;23:291-295. DOI: 10.1177/0269215509103551
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