Occupational therapy goals and how to create excellent occupational therapy goals; SMART goals; examples of goals with all of the necessary components; and do’s and don’ts for writing OT goals will be covered in this blog post.
You have already conducted a full evaluation on your client. Now it is time to come up with occupational therapy goals for their treatment plan. The next step is to take the data you collected and translate it into meaningful goals to pursue in occupational therapy. If you practice in pediatrics, the goal should be also be important to the parent or caregiver. Information about goals comes from the occupational profile, standardized testing, reason for referral, and your analysis of the evaluation. The data you collected in the evaluation serves as baseline data. This will help you track progress for your client, inform intervention choices, and ultimately give your client a foundation for success.
A SMART goal is an acronym for a goal that consists of five different essential factors: Specific; measurable; attainable; relevant; and time-based. This is a great tool for occupational therapists and other health professionals when composing goals and checking that each goal contains all of the essential components.
Specific: This section refers to the tangible outcome. What does the client want to do? For example: Laurie will complete a 5-step task of making tea; Aaron will cut out a circle; Mary will wash her hands. Be sure that you know the client’s current level of performance.
Measurable: This piece is essential for both reimbursement and tracking progress. It gives concrete data on the degree of the client’s performance. The measurable piece of a goal can come in many different forms: Duration (within five minutes); pain level (client reporting a maximum pain level of 4/10); portfolio collection (for something tangible the client created); client satisfaction (using the Canadian Occupational Performance Measure). Another important factor to consider: Who will track the data? Sometimes therapist collection of data is sufficient but where carryover is essential, the therapist may want to designate a teacher, health professional, or caregiver to track the data.
Attainable: This is an important area to consider how much time you have with the client along with their current level of functioning. Can the client re-learn to tie their shoes in their short acute care stay? Likely not. However, the same client may be able to wash their hands with a visual aid and no more than one verbal cue.
Relevant: An essential component for occupational therapy, it is important to ensure that your client wants to reach their goals. Motivation can have an enormous impact on progress. While the process of coming up with relevant goals begins when you take your client’s occupational profile, it should be considered throughout the process. If you are unsure, share your goal ideas with your client and ask for feedback.
Time-based: In a written occupational therapy goal this may look like “within five days,” “at the time of discharge,” or “by April 1st, 2022.” The time given will vary by clinical setting. In an acute care setting, goals may be written for three days. Inpatient rehab goals could be several weeks long. In the educational system, students who have an IEP often have goals written for an entire year.
Examples of SMART Occupational Therapy Goals
By June 15, 2022, given one verbal cue and environmental set-up by therapist or caregiver, Joseph will prepare a cup of coffee, as measured by his ability to complete the task in 4/5 attempts.
By September 30, 2022, given adaptive paper, Kate will correctly sequence letters with 80% accuracy in 3 out of 4 consecutive trials, as measured by portfolio collection.
By January 3, 2022, to demonstrate improved bilateral coordination and self-care skills, Brandon will don and doff shoes independently in 4/5 trials, as measured by caregiver report.
The Do’s and Don’ts of Occupational Therapy Goal Writing
• Don’t write a goal that you do not have baseline data for. Without this foundation you will not know what criteria to add for your client or if the goal is attainable or even necessary. This would also provide a significant challenge for writing progress notes.
• Do consider their prognosis when selecting goals. Criteria for an otherwise healthy client recovering from an hip replacement will vary greatly from a client who is living with chronic multiple sclerosis.
• Don’t assume that an ADL or IADL is meaningful to your client. While a grocery shopping goal can encompass many of the skills that your client is working on, they may greatly prefer to order their groceries to be picked up.
• Do consider goal-writing exceptions for Individualized Family Service Plans (IFSPs). Since in this practice setting, the family unit functions as the client, goals are often written to be simplified. For example, a goal may be measured upon whether the child completed a task or not.
• Don’t put in more than one measurable objective. This is a common mistake that makes tracking goals more challenging than necessary. Instead, make sure you prioritize and then separate important goals into unique objectives. For example, rather than “use a dynamic tripod grasp to draw a 5-part person” create one objective for grasp and another objective for visual motor skills.
• Do create a system for tracking data over time. This may look like a visual representation on graph paper or computer software that automatically generates a visual as you input numerical data.
Creating intentional occupational therapy goals is essential for client motivation, tracking progress, helping with occupational therapy SOAP notes and getting reimbursed, and ultimately, client success. By listening to your client and creating SMART goals you can ensure that your client’s goals have all of the necessary components for them to be successful.
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