Goal setting in rehabilitation: an overview of what, why and how

Setting goals with the patients and monitoring their achievement is a core practice within much rehabilitation, but the evidence base behind this practice is patchy. This issue of Clinical Rehabilitation has seven articles concerned with various aspects of goal setting, and this Editorial sets them in context. It considers the theoretical basis underlying goal setting, especially in rehabilitation. It argues that a goal is the intended outcome of a specific set of interventions. It suggests setting goals has benefits beyond simply motivating the patient and team; it may coordinate activities and ensure that all necessary goals are identified. It reviews whether goals should be SMART (and what SMART means), and emphasizes that there may be a hierarchy of goals on two axes (time, abstractness). It reviews the benefits and problems of goal attainment scaling and, finally, considers the ethical problems associated with goal setting. It concludes that goals should not necessarily be completely SMART, and that goal attainment scaling may only be useful as a measure in research. It emphasizes the need for much more research into the cost-effectiveness of this activity.