Goal setting is a funny old thing. It’s a bread and butter intervention for rehabilitation professionals (OTs, Physios, Dieticians, SALTs etc), and commonly used by groups of nurses, medics and psychologists too. Say ‘Goal Setting’ to these groups of people and they’ll nod in apparent understanding. Yet we know remarkably little about Goal Setting in practice**. And given its prevalence in healthcare that has huge patient and service implications.
Goal Setting is so commonly used it appears obvious. Our recent survey found that 98% of community rehabilitation services reported that they asked patients about their goal priorities http://www.ncbi.nlm.nih.gov/pubmed/25243765. You can understand why, therefore, that people sometimes question whether such an intuitively obviously and frequently used intervention should really be a priority for research. And yet it is precisely these issues that make it a burning topic…. because if Goal Setting is commonly used, I suggest it is almost as commonly misunderstood.
Goal setting, after all, is like cleaning your teeth. What? Bear with me. Did you clean your teeth today? “Of course”, you reply (if you didn’t go and do so now!). But precisely what do you mean when you say so certainly that you cleaned your teeth today? Did you use a tooth brush? “Yes, silly question”. And did you brush twice a day (or in the last 24 hrs) for at least 2 minutes, with the correct technique? “Hmmm”. And what about flossing, it’s shown to make tooth and gum hygiene much more effective. “Ehhhh”. And so it is with Goal Setting.
When we talk about Goal Setting, we are really describing a complex intervention with multiple components that requires considerable knowledge, skill, commitment, and aptitude to deliver (flexibly, but consistently) in practice. Given its prevalence and centrality to practice, it really is odd that people are (generally) not much more concerned about its everyday delivery, effectiveness and value. Perhaps, in part, it’s because it’s so like cleaning your teeth.
* A late night blog from Rio – inspired by a conference presentation by Prof. Jeffrey Braithwaite today and a Malcolm Gladwell anecdote.
** Though we do know a bit more now than a few years ago.