Table 3.

The Practices of Goal Setting and Monitoring

Practice	Description
Goal setting practices
Set goals based on immediate needs	Therapist aids the client in setting a clear goal based on relevant and near-term needs.
Formulate goals that are realistic/achievable	Therapist aids the client in setting goals that are not too complex or too numerous; this criterion facilitates goal achievement.
Formulate goals that are specific and measurable	Therapist aids the client in setting goals in measurable, often approach-oriented, and time-limited terms; these criteria facilitate goal achievement.
Incorporate a vision of the future when formulating goals	Therapist and client envision a future where goals are met versus unmet, which may aid in goal formulation, garner motivation, and solidify commitment.
Formulate goals with specified objectives	Therapist and client identify a task or series of tasks that will facilitate goal achievement; these objectives meet the same criteria as those described for formulating goals (i.e., relevant, achievable, measurable, timed).
Incorporate naturalistic, social support systems when setting objectives	Therapist and client identify a task of series of tasks that, where possible, incorporate available naturalistic supports such as family, friends, and community.
Assess barriers and resources for meeting goals and objectives	Therapist and client engage in problem-solving where barriers, resources, and needed coping skills are discussed.
Provide advice on goal and objective pursuit	Therapist provides advice typically when client resources are exhausted and the client provides a clear signal that advice is wanted and needed.
Get an explicit commitment on goals and objectives	Therapist is very explicit and consistent in seeking client verbal commitment to agreed-upon goals and tasks.
When goals are set, summarize in a written plan	Therapist facilitates creation of an action plan with measurable goals and objectives as well as an explicit plan for goal monitoring.
Goal monitoring practices
Use standardized methods for goal monitoring	Therapist and client agree upon a plan for goal monitoring that includes a standard method of measurement, timing, and structure for the goal monitoring discussion.
Monitor goals at regular intervals	While treatment needs will drive the length of time between goal monitoring discussions, these discussions should occur at regular intervals during treatment.
Carefully select monitoring measures	Therapist selects and proposes a measurement plan that considers feasibility, utility, and psychometric validation.
Recognize the limitations of monitoring measures	Therapist recognizes and is transparent about the limitations of any selected measurement procedure.
Use goal monitoring as a feedback device	Therapist uses goal monitoring to obtain and provide feedback on client progress, needs, and treatment effectiveness.
Use visual, technological, and decisional aids	Therapist uses visual aids such as graphs or other figures, technology such as applications or tablets, and where appropriate, decision aids that inform next steps based on monitoring data.
Engage in a conversation about the goal monitoring data	The therapist and client discuss goal monitoring results, using the data as a platform for affirmation of success and renegotiation of goals and treatment plans, where needed.
Use goal monitoring to maintain client engagement	Therapist uses goal monitoring as a ‘relational check-in’ and as a means of promoting client ownership of their treatment.
Recognize when treatment is working	Therapist uses data on progress to affirm client efforts and promote positive outcome expectancies.
Recognize when treatment is not working	Therapist is open to feedback and transparent about concerns regarding the effectiveness of the selected course of treatment.
Attending to self-determination
Prioritize client choice	Therapist places a clear and explicit emphasis on client choice, responsibility, and autonomy at each step of the goal setting and monitoring process.
Mutually agree upon goals and objectives	Therapist and client agree upon goals, objectives, and monitoring procedures.
Treat client as expert	Therapist recognizes that the client is the expert in their goals, and structures the encounter to reinforce client sense of agency.
Ask questions to promote agency	Therapists uses questions, such as permission-seeking or deferring to client advice and direction, to reinforce client sense of agency.
Attending to motivation
Tailor to stage of change	Therapist is attuned to client motivation, and adjusts their therapeutic approach to match client stage of change.
Explore client motives	Therapist explores a range of factors that may influence client motivation to set and pursue goals; these include values, motives, and the views of others.
Honor client ambivalence	Therapist attends closely to signs of client ambivalence related to agreed-upon goals or objectives, and promptly explores client concerns.
Roll with resistance	Therapist does not fear resistance and rather views it as a cue to renegotiate goals and objectives.
Attending to self-efficacy
Have genuine optimism	Therapist communicates genuine optimism about client capacity to reach goals and pursue objectives.
Provide affirmation	Therapist consistently affirms client qualities, efforts, and progress; these affirmations are thoughtful and genuine.
Reinforce incremental gains	Therapist creates opportunities for client success and incremental goal achievement; when
Ask questions to promote self-efficacy	Therapist promotes client self-efficacy via targeted questions about client qualities, efforts, and progress.