Re-Thinking Goals
My goal for this blog post is to get you to think about goals in different ways and as essential components of your clinical and educational practice. Since I have come up with this explicit and meaningful (to me) goal, one that is hopefully in the sweet spot between too easy and too difficult, I should be highly committed and motivated to achieve this goal. This is in contrast to a goal, for example, that was imposed on me by someone else or that I perceive as too difficult or not interesting.
I was inspired to re-think about goals by the keynote address at the Academy of Pediatric Physical Therapy Annual Conference several weeks ago in Omaha, Nebraska. The speaker, Lesley Pritchard, shared her research and other related evidence that reinforced some ideas and introduced some new ones. Some of the reinforced ideas are in the first paragraph and include that goals need to be challenging and meaningful and that other factors such as the individual’s self-determination and perceived competence and autonomy are moderating factors that influence goal attainment.
A new idea Dr. Pritchard shared with the audience, and one that relates directly to her research, is the importance of engaging the child in this process. In a recent study, evidence emerged that children, including children as young as five years old, and those who use communication strategies other than verbal, were able to identify functional and attainable goals for themselves. In some cases, these goals differed from those identified by their parents and health-care providers and generally tended to be more functional. The researchers used an “Engage” approach and a “child-first” strategy to encourage child input into identifying their own goals. This included a sentence completion tool with phrases like “I would like to be able to _________ at the end of therapy so I can _________ .” In follow up interviews, the children indicated that this was an opportunity to contribute to crucial decisions about their lives, and so the process of participating in physical or occupational therapy became very motivating for them.
In going forward, I plan to do a much better job of asking children what their goals are. The ENGAGE format provides some structure for that, and it seems that a key is the conversation around the goal itself and the collaborative problem-solving necessary to try to figure out how to achieve the goal. Of course, the parents and caregivers must be involved in these conversations as well. Ideally this leads to happy and healthy children and families in the short term, and optimal long-term outcomes as well.
P.S. So have I achieved my goal for this blog post? If you have any goal-related feedback for me (also an important part of the process), please send that along!
Pritchard L- keynote address- Academy of Pediatric Physical Therapy Annual Conference. 2023. Omaha, Nebraska
Pritchard L, Phelan S, McKillop A, and Andersen J. Child, parent, and clinician experiences with a child-driven goal setting approach in paediatric rehabilitation. Disability and Rehabilitation. 2022: 44 (7); 1042-1049