Goal setting and action planning in the rehabilitation setting: development of a theoretically informed practice framework

Background: Setting and achieving goals is fundamental to rehabilitation practice but has been criticized for being a-theoretical and the key components of replicable goal-setting interventions are not well established. Purpose: To describe the development of a theory-based goal setting practice framework for use in rehabilitation settings and to detail its component parts. Methods: Causal modelling was used to map theories of behaviour change onto the process of setting and achieving rehabilitation goals, and to suggest the mechanisms through which patient outcomes are likely to be affected. A multidisciplinary task group developed the causal model into a practice framework for use in rehabilitation settings through iterative discussion and implementation with six patients. Results: Four components of a goal-setting and action-planning practice framework were identified: (i) goal negotiation, (ii) goal identification, (iii) planning, and (iv) appraisal and feedback. The variables hypothesized to effect change in patient outcomes were self-efficacy and action plan attainment. Conclusions: A theory-based goal setting practice framework for use in rehabilitation settings is described. The framework requires further development and systematic evaluation in a range of rehabilitation settings.