Tricks to Take the Pain Out of Writing Treatment Goals
Supervising has taught me a great deal about what trips up SLPs. And one of the most challenging things for new SLPs seems to writing treatment goals. One reason is, of course, that we know these goals will drive the treatment and that they are important; but it is more than that. We want goals to organize our treatment and make it more linear, more hierarchical. We want our goals to be read as a path to development, or recovery: first do this, then move to this and then go on to that. This is, after all, the essence of task analysis.
Speech and language development, or recovery, is not however, linear or even, in many instances, hierarchal. It is so much more, but that is for another post. We also want our goals to address the clients’ most important needs and in some cases we are hard pressed to figure out just what is most important. We also need to have our goals fit in with the guidelines that our employer sets and that just keeps changing on us. So goals become a challenge.
When writing goals keep in mind that goals are supposed to be SMART: specific, measureable, attainable, relevant and timely. A pet peeve of mine are goals that say “the client will improve his receptive/expressive skills.” These are not SMART: First of all they are not specific, but more, importantly, there is no measurable component in them. In a report you can head the respective goals with, “In order to improve his receptive/expressive skills the client will…..” But those sentences are not goals and are certainly not SMART goals.
There are numerous data banks of goals on the Web, but I have never found the goals in any database to be just quite right; they all need to be tweaked for the client. You can certainly look up goals in those databanks, but you have the skills to write goals on your own. They are not that difficult when you think them through. You can use a template such as ___ will ___ by ___ to ___ percent above baseline or ___ percent of the time as measured by ___ or some such formula but you still have to fill in everything from your own mental data bank. You can do this easily by using the answers to some simple questions you must ask yourself.
Let’s look more closely at SMART.
Part of the problem is thinking about goals as a separate entity. Goals are just a way to put what you want to do in therapy in writing. Most SLPs are not uncomfortable about doing therapy so why should goals be a problem? Ask the following questions for a start for your specific goals.
- What are the client’s communicative strengths?
- What are the client’s communicative weaknesses?
- What are the skills contributing to the strengths?
- What skills are deficient and therefore contributing to the weaknesses?
- Which of client’s skills can be used to compensate for deficiencies?
- Which skills that are lacking can I actually help the client attain?
- What do I want to work on first? And now answer: Why do you want to work on that first? That answer will help you determine if you have made a viable choice.
- What are the tasks you will have the client complete or engage in to work on the skill?
- What supports will you provide for the client?
When you have the answers to those questions you have the “specific” for the goals.
Can you define the skill that will determine if the client is doing what you want him to do and can you measure progress in that skill? How will you measure progress? When will you consider the goal accomplished? If you can answer all these questions move on; if not, go back and adjust the goal to something you know you can see or hear and therefore measure.
Do you think the client can actually accomplish this in a year? If the answer is yes, move on. If the answer is no, go back and choose something you think the client can accomplish within a reasonable timeframe.
Will the attainment of this goal serve a communicative function for the client or will it just be something you can do with the client? Will it serve a purpose in the client’s life considering the limits and ramifications of the diagnosis and his cultural and social needs? In the case of an IEP does this goal serve to move the child along to fulfill the common core standards? If the answer is yes, move on if not… yes, you get the picture go back and start again.
Does the goal contain a time frame or a date for accomplishing the goal? And can the goal be attained in that time frame? If yes….
Short-term objectives need to follow the same criteria but they should not just be separate pieces of the overall task but rather steps to getting to the long-term goal. The timeframe for accomplishing each part of the short term objective is, obviously a portion of the long term goal and the objective should actually contain that time frame.
As I stated in my last post, what best facilitates treatment is knowing what you want the client to do and knowing that your treatment is actually addressing this. Well, such knowledge also facilitates goal-writing. Use it to write your goals. You have the skills. You need to convince yourself that you can use them. When you keep that in mind, goal writing can be simple.
Irene Gilbert Torres, MS, CCC-SLP, chair of ASHA’s Multicultural Issues Board, is a clinician in New York City who contributes this ASHAsphere series for beginning SLPs and welcomes treatment questions to address in future posts. She concentrates primarily on infant and preschool evaluations and supervision of graduate students. She is an affiliate of ASHA Special Interest Groups 11, Administration and Supervision; 14, Communication Disorders and Sciences in Culturally and Linguistically Diverse Populations; 16, School-Based Issues; and 17, Global Issues in Communication Sciences and Related Disorders.