TABLE 4.

Collaboration and concordance in goal planning.

References; country	Sample characteristics	Aim of study	Study description	Goal planning method	Outcome measures	Findings
Arns and Linney (75); USA	Individuals diagnosed with a SPMI (n = 141) attending psychosocial rehabilitation programs	Measure individualization of goals and determine the relationship with service user characteristics, staff, and program differences	Retrospective analysis of written goals (n = 364)	Individual treatment plans	Measure of goal individualization	The mean goal individualization scores was 2.58/5 with only 7.8% of goals including a measurable criterion and 12.8% including specific details.
Fakhoury et al. (73); UK	People residing in supported housing and diagnosed with schizophrenia or psychotic disorder (n = 41) and housing service staff (n = 39)	To explore the agreement between service users and staff on set goals.	Qualitative – interviews	Self-reported goals	Content analysis of self-reported goals	Poor or no agreement on client reported goals and staff (care coordinators and housing care managers) perceptions of needs/goals.
Falloon and Talbot (74); USA	People diagnosed with SPMI attending a day treatment program (n = 82)	To evaluate the effectiveness of a day treatment program in meeting the needs of service users	Mixed method	Collaborative goal achievement plan (five steps)	Concordance estimated by therapist, goal achievement plan, goal achievement rated	Strong relationship between client involvement and goal achievement – 59% of collaborative goals had good achievement compared with 6% of therapist dominated goals.
Knaeps et al. (68); Belgium	Inpatients in a psychiatric hospital (n = 733) and their clinicians (n = 279)	To compare patient and practitioner perceptions of realistic vocational goals, barriers and support needed	Descriptive quantitative	Self-identified goals	Questionnaires paired for patient and practitioner	A total of 45% of patients have competitive job goals while only 32% of practitioners find this realistic. Patients perceive fewer vocational barriers than clinicians and prefer less intense vocational support options.
Kuhnigk et al. (76); Germany	Physicians with psychiatric expertise (n = 160) randomly recruited through registry; individual physicians (n = 63) recruited patients (n = 105); in addition relatives (n = 50) and payers’ representatives (n = 30) recruited by research team	To investigate and compare the valuation and perceived attainment of treatment goals by various stakeholder groups (consumer, physicians, payers, and relatives)	Mixed method – combined and integrated approach	A list of 20 common treatment goals developed from a focus group. Participants were asked to rank these in accordance with importance.	Focus group and stakeholder interviews	All goals were considered very relevant by all stakeholder groups, but no goal was ranked in the top three by all stakeholders. “Improved cognitive abilities” was ranked highly by patients, physicians, and relatives while payers gave the highest priority to cost-related goals (i.e., work, hospitalizations).
Lecomte et al. (72); Canada	People (n = 165) attending a psychiatric rehabilitation program	Describe rehabilitation goals and assess if services were helping participants meet those goals	Mixed method	CASIG-SR used to assess function in a range of domains and elicit goals	Concordance measured by patient self-rating of importance and support received to achieve goals	The most frequently mentioned goals pertained to improving consumers’ financial situation, physical health, cognitive capacities, and symptoms. Among these goals, the level of concordance was highest for services addressing symptoms and lowest for religious or spiritual goals.
Lenehan et al. (71); Australia	Random selection of individuals (n = 66) receiving services from a non-government organization	Examine if homework tasks are coherent with the goals of individuals receiving mental health recovery support	Mixed method	My action plan (MAP)	CAN-GAP criteria used to determine if homework tasks match goals	Significantly more homework matches than mismatches at categorical level (p < 0.001) and domain level (p < 0.001).
McGuire et al. (70); USA	Veterans with SPMI (n = 21) accessing a psychosocial rehabilitation and recovery center	To understand the consumer perspective regarding treatment plan goals and how this relates to personal and clinical context	Qualitative	Treatment plan goals	Semi-structured interviews	Complex relationship between consumers, providers, and the treatment plan. A range of experiences were articulated including agreement, conflicting understandings, wording and prioritizing goals, and total rejection.
Proctor and Hargate (24); UK	People diagnosed with mental illness (n = 477) attending community health services	Investigate correlations in goal data	Mixed method using retrospective goal data	Goal Attainment Form (GAF)	GAF, Clinical Outcomes for Routine Evaluation Outcome Measure, therapist assessment	Patient descriptions of their problems and benefits of therapy were different from clinicians’ perspectives.
Shadmi et al. (69); Israel	People accessing psychiatric rehabilitation services from 2013 to 2015 (n = 2,345/3,236 survey respondents had matched provider responses)	Examine consumer and provider goal concordance and relationship to attainment	Cross-sectional quantitative	Self-rated goals and provider perspective of goals; self-rated attainment	Linked consumer and provider goals rated for concordance	Overall consumer-provider concordance was 54% – highest for employment (76%), housing (71%), and intimate relationship (52%) and lowest for family relationships (23%), and finances (15%). Consumer-provider concordance was associated with goal attainment (p < 0.001).
Wyder et al. (77); Australia	Inpatients in an acute adult psychiatric ward (n = 55)	Impact of Motivational Aftercare Planning (MAP) intervention on content of recovery plans	Pre-post design	Recovery plans	Content and language of plans pre- and post-intervention	Content of recovery plans shifted focus following MAP, changing from third to first person language, e.g., from decreasing symptoms, clinical stability risk management, and treatment compliance to general wellness and physical/emotional safety, participation in meaningful activities, social connections, and listening to their concerns.