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6.6: Goal Setting

 centred_careGoal setting

Goal setting was discussed in module 3.6 ‘Setting the Tasks’. Examples of defining a problem and goal statement were offered including a video extract of Kelly and her psychiatrist following a three-step approach: the actual problem, what happens because of it and how she feels about that. These stages guided Kelly to set her own goals.

Having considered your personal risk factors for health you could write a problem statement here so you can consider goal setting. For example,

“I live an extremely busy lifestyle; as a result I am overweight, have FH of diabetes and am not as fit as I should be and I am at risk for a heart attack or a stroke; this worries me when I stop to think about it.”

You may also like to write the goal that you would like to achieve in the medium to longer term (6 – 12 months). For example,

“I want to lose 7 kilos and exercise at least 3 times a week for one hour together with my partner” or “I would like to do the City to Surf fun run next year with my partner.”

Goals also need to be broken down.  If you are too busy you will need to take control of your time; if you want to do something with your partner, this needs to be negotiated and a mutually convenient time made.  

Goal setting also needs to be SMART and problems and goals need to be measured and recorded. This is explained in the table.

S

Specific

Significant, Stretching

What is it I want to achieve?

M

Measurable

Motivational, Manageable

How will I know when I have got there? 

A

Attainable

Achievable, Agreed, Appropriate

Can I achieve this? What will I need?

R

Relevant

Realistic, Results, Resourced

Am I being realistic? What are the likely problems?

T

Time

Time frame, Trackable

Can I do this in a reasonable time frame?

Goal setting enables specific and achievable targets for individuals to focus on. The process breaks down problems or behaviours that need to change into small achievable goals. By breaking down goals, it highlights goals which are not SMART and prevents the frustration and disappointment of not achieving what is planned.

self_managementMotivational interviewing

Motivational interviewing (MI) was discussed in module 2.5 as an effective process to support behaviour change and to deal with barriers. There has been recent interest in using MI to support change in health behaviours and conditions such as smoking, diet and physical activity(1, 2) and MI has shown to be successful with individuals who are low in terms of readiness to change.(3)

The aim is to provide a process for thinking about and expressing reasons for and against change, how current health behaviour may conflict with health goals and how current behaviour or health status impacts on achieving  life goals. Numerous studies on the impact of MI in modifying chronic disease behaviours such as diet and physical activity, smoking cessation and medical adherence, indicate that MI can be incorporated into a range of health promotion and disease prevention interventions.(4)

reflectReflective exercise

Complete a goal statement with guidance from the following questions.

This activity can be completed using motivational interviewing or the worksheets provided at the end of this page (SMART worksheet; Goal setting worksheet; Advantages and disadvantages of change worksheet).

Please keep a record of your thoughts and comments.

Stage 1: Thinking of changing

What do you plan to change? Why would you like to make these changes? (SMART worksheet)

Stage 2: Preparing for change

How will you do this? When will you start to make changes? (SMART worksheet)

Stage 3: Making changes

What are the pros and cons of making this change? What difference will this make to your life?(Change worksheet)

Stage 4: Maintaining changes

What resources do you need? Who else can support or help you? (SMART worksheet)

How can you use your signature strengths to help maintain your well-being and any changes you have made? What have you learnt in this process?

Will this have any impact on how you help patients self manage?


The following resources can be used to support you in your quest to set goals. 
  • SMART worksheet
    A new worksheet should be used for each new task that you would like to undertake.
    SMART Worksheet.pdf
  • Goal setting worksheet
    This worksheet allows the user to determine their own time frame and to complete the column on the left of the table within the time frame that best suits their situation.
    Goal Setting.pdf
  • Advantages and disadvantages of change worksheet
    This worksheet allows the user to consider the advantages and disadvantages of change and also the advantages and disadvantages of not making the change.
    Change Worksheet.pdf

If this has been useful, it is may be worth revisiting goals for yourself on an annual basis. This is something that your patients could also benefit from.

ReferencesReferences 

  1. Emmons K, Rollnick S. Motivational interviewing in health care settings: Opportunities and limitations. American Journal of Preventive Medicine 2001;20:68–74.
  2. Resnicow K., DiIorio C, Soet J, Borrelli B, Ernst D, Hecht J, Thevos A. Motivational interviewing in medical and public health settings. In Miller W, Rollnick S. Motivational interviewing: Preparing people for change. 2nd ed:251–69. New York: Guilford Press, 2002.
  3. Rollnick S, Miller WR. What is motivational interviewing? Behavioural and Cognitive Psychotherapy 1995;23:325–34.
  4. Resnicow K, DiIorio C, Soet JE, Borrelli B, Hecht J. Motivational interviewing in health promotion: it sounds like something is changing. Health Psychology 2002;21(5):444–51.
    Continue to Module 6.7: Checking Progress and Dealing with Barriers

Project support

ImageProject support

This RANZCP Chronic Condition Self-management project is supported by funding from the Australian Better Health Initiative: A joint Australian, State and Territory government initiative.

RANZCP

ImageAbout RANZCP

The Royal Australian and New Zealand College of Psychiatrists (RANZCP) is the principal organisation representing the medical specialty of psychiatry in Australia and New Zealand.

The College is responsible for training, examining and awarding the Fellowship of the College qualification to medical practitioners.