Cited by 754Medical Practices and RehabilitationOccupational Therapy Practice and ResearchStroke Rehabilitation and Recovery

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Writing SMART rehabilitation goals and achieving goal attainment scaling: a practical guide

Bovend'Eerdt, Thamar JH, Botell, Rachel E, Wade, Derick T·2009·Clinical Rehabilitation

DOI 10.1177/0269215508101741

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Abstract

Objective: To describe a practical method of setting personalized but specific goals in rehabilitation that also facilitates the use of goal attainment scaling. Background: Rehabilitation is a complex intervention requiring coordinated actions by a team, a process that depends upon setting interdisciplinary goals that are specific, clear and personal to the patient. Goal setting can take much time and still be vague. A practical and standardized method is needed for being specific. Method: A novel approach to writing specific, measurable, achievable, realistic/ relevant and timed (SMART) goals is developed here. Each goal can be built up by using up to four parts: the target activity, the support needed, quantification of performance and the time period to achieve the desired state. This method can be employed as part of goal attainment scaling and the other levels can be easily and quickly formulated by adding, deleting and/or changing one or more of the (sub)parts. Discussion: The success of goal setting and goal attainment scaling depends on the formulation of the goals. The method described here is a useful tool to standardize the writing of goals in rehabilitation. It saves time and simplifies the construction of goals that are sufficiently specific to be measurable.

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Background
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BackgroundMethod
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Background
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MethodInfluential
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BackgroundMethod
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Background
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Background
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Method
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“The transcript of the interview served as a discussion start point for the occupational therapists to set, collaboratively with the client, one realistic goal using a goal setting chart (see Appendix 1), based on the publications of Ruble et al. (2012) and Bovend’Eerdt et al. (2009).”
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“17) Cancer is a progressive disease with an unclear prognosis, which may explain why relatively few timed goals are set.”
BackgroundMethod
Detecting change in patient outcomes in a rural ambulatory rehabilitation service: the responsiveness of Goal Attainment Scaling and the Lawton Scale
Baggio, L., & Buckley, D. (2015) · Australian Health Review · doi:10.1071/ah14218 · Cited by 6
Eclectic approach as the natural way of development in neurorehabilitation of adults
Mikołajewska, E. (2012) · International Journal on Disability and Human Development · doi:10.1515/ijdhd-2012-0103 · Cited by 6
“, m SMART [4] – Can significantly increase effectiveness of the rehabilitation – Promotes innovations in therapy – Increases patient-therapist relationship – Increases therapist-patient ’ s family/caregivers relationship – Can significantly increase patient ’ s quality of life”
Background
Finding the right balance with participation in exercise and sport for individuals with multiple sclerosis: protocol for a pre and post intervention feasibility study
Smith, M., Williams, G. P., & Barker, R. N. (2020) · BMJ Open · doi:10.1136/bmjopen-2019-035378 · Cited by 6
Implementation of a Pilot Leadership Curriculum for Physical Medicine and Rehabilitation Residents
McIntyre, M., Alavinia, M., & Matlow, A. (2020) · American Journal of Physical Medicine & Rehabilitation · doi:10.1097/phm.0000000000001482 · Cited by 6
Commuter Choices: A clustered, quasi-experimental trial of a social cognitive approach to increasing active commuting among office workers
Walsh, A., Washington, T. L., Petrunoff, N., & Heesch, K. C. (2021) · Journal of Transport & Health · doi:10.1016/j.jth.2020.100998 · Cited by 6
Exploring the Risk Factors of Interactive E-Health Interventions for Digital Addiction
Alrobai, A., McAlaney, J., Phalp, K. T., & Ali, R. (2019) · IGI Global eBooks · doi:10.4018/978-1-5225-8900-6.ch040 · Cited by 6
Complications of intrathecal baclofen therapy for spasticity: A single-centre cohort of 170 individuals
Gahier, M., Hirardot, T., Buffenoir, K., Perrouin-Verbe, B., & Gross, R. (2025) · Annals of Physical and Rehabilitation Medicine · doi:10.1016/j.rehab.2024.101919 · Cited by 5
Osteopathic Treatment and Evaluation in the Clinical Setting of Childhood Hematological Malignancies
Barbieri, M., Zardo, W., Frittoli, C., Rivolta, C., Valdata, V., Bouquin, F., Passignani, G., Maggiani, A., Jankovic, M., Cossio, A. D., et al. (2021) · Cancers · doi:10.3390/cancers13246321 · Cited by 5
“None of the osteopaths who participated in the final OE had any prior knowledge of the initial goals that had been established [36].”
Background
Rationale and Protocol for a Pilot Randomized Controlled Trial of a Cognitive Prescription Intervention for Reducing Dementia Risk Factors Among African Americans
Fazeli, P. L., Hopkins, C., Vance, D. E., Wadley, V. G., Li, P., Turan, B., Bowen, P. G., & Clay, O. J. (2022) · Nursing Research and Reviews · doi:10.2147/nrr.s339200 · Cited by 6
Measuring what gets done: Using goal attainment scaling in a vocational counseling program for survivors of childhood cancer
Pole, J. D., Williams, B., Giuseppe, G. D., Guger, S., Stasiulis, E., Greenberg, M., Spiegler, B. J., & Edelstein, K. (2023) · Cancer Medicine · doi:10.1002/cam4.5576 · Cited by 5
Technology-Assisted Upper Limb Therapy (TAULT): Evaluation of Clinical Practice at a Specialised Centre for Spinal Cord Injury in Switzerland
Kuchen, D. B., Hubacher, B., Ladner, A., Velstra, I., & Widmer, M. (2023) · Healthcare · doi:10.3390/healthcare11233055 · Cited by 5
Exploring learning communities’ actions and perceived impact on healthy weight approaches across Dutch municipalities
ter Bogt, M. J. J., Bevelander, K. E., Molleman, G. R. M., van den Muijsenbergh, M. E. T. C., & Fransen, G. A. J. (2025) · BMC Public Health · doi:10.1186/s12889-025-22072-0 · Cited by 5
“…the LC member who formulated the action indicated on an update form the extent to which the action was accomplished on the Goal Attainment Scale, which is a structured approach to indicate on a 5-point scale the extent to which the result of the action is achieved compared with expectations [38].”
Goal Attainment Measure for Stroke Self-management
Kimmel, B., ANDERSON, J. A., VonVille, H. M., Stonecypher, K., & Shegog, R. (2020) · Heart and Mind · doi:10.4103/hm.hm_5_20 · Cited by 4
Cognitive Rehabilitation for Neurocognitive Late Effects in Adult Survivors of Childhood Acute Lymphoblastic Leukemia: A Feasibility and Case-Series Study
Egset, K. S., Weider, S., Stubberud, J., Hjemdal, O., Ruud, E., Hjort, M. A., Eilertsen, M. B., Sund, A. M., Røkke, M. E., & Reinfjell, T. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.724960 · Cited by 5
“Thus, for several reasons, a more objective outcome measure of daily life EF such as the goal attainment scale (GAS, Kiresuk and Sherman, 1968; Bovend’Eerdt et al., 2009) or informant reports (e.g., spouse) should be considered in future research.”
Theoretical frameworks for project goal‐setting: A qualitative case study of an organisational practice in Nigeria
Ogbeiwi, O. I. (2022) · The International Journal of Health Planning and Management · doi:10.1002/hpm.3471 · Cited by 5
Engineering Rehabilitation: Blending Two Tool-supported Approaches to Close the Loop from Tasks-based Rehabilitation to Exercises and Back Again
Carayon, A., Garrido, J. E., Martinie, C., Palanque, P. A., Barboni, É., Lozano, M. D., & Penichet, V. M. R. (2023) · Proceedings of the ACM on Human-Computer Interaction · doi:10.1145/3593229 · Cited by 5
“1 presents an overview of the goal directed rehabilitation process [3].”
Background
Game-supported cognitive strategy training for slowed information processing speed after acquired brain injury: study protocol for a randomised controlled trial
Abelmann, A. C., Kessels, R. P. C., Brazil, I. A., Fasotti, L., & Bertens, D. (2023) · BMJ Open · doi:10.1136/bmjopen-2022-067108 · Cited by 5
“Three personal treatment goals are set-up using Goal Attainment Scaling (GAS) (33,34).”
BackgroundMethodInfluential
Transforming interprofessional pedagogies: Pivoting from the flipped classroom to an online approach
Taylor, S. J., Odiaga, J. A., Gierlowski, T. C., Guglielmo, M. J., Little, L. M., Rodríguez-Morales, G., Richter, L., & Souza, S. (2023) · Journal of Interprofessional Education & Practice · doi:10.1016/j.xjep.2023.100683 · Cited by 5
A Specific, Measurable, Achievable, Relevant, Timed (SMART) Nursing Project Reduces Anxiety, Depression, and Post-Traumatic Stress Disorder in Parents of Childhood or Adolescent Osteosarcoma Patients
Guo, L., Lin, C., & Qu, J. (2024) · The Tohoku Journal of Experimental Medicine · doi:10.1620/tjem.2023.j107 · Cited by 6
Response Shifts in the Canadian Occupational Performance Measure: A Convergent Mixed-Methods Study
Ohno, K., Oi, R., Harada, A., Tomori, K., & Sawada, T. (2024) · American Journal of Occupational Therapy · doi:10.5014/ajot.2024.050487 · Cited by 5
Towards Augmenting Mental Health Personnel with LLM Technology to Provide More Personalized and Measurable Treatment Goals for Patients with Severe Mental Illnesses
James, L., Maessen, M., Genga, L., Montagne, B., Hagenaars, M. A., & Gorp, P. M. E. V. (2024) · Lecture notes of the Institute for Computer Sciences, Social Informatics and Telecommunications Engineering · doi:10.1007/978-3-031-59717-6_13 · Cited by 5
“A well-defined Measurable goal is a goal that can be tracked to monitor progress [3].”
Background
Critical Dialogue and Capacity-Building Projects Reduced Alcohol and Substance Use in a Randomized Clinical Trial Among Formerly Incarcerated Men
Windsor, L. C., Benoit, E., Lee, C., Jemal, A., Kugler, K. C., Smith, D. C., Pinto, R. M., & Musaad, S. M. A. (2024) · Substance Use & Misuse · doi:10.1080/10826084.2024.2352611 · Cited by 5
“In accordance with specific, measurable, attainable, relevant, and time bound (SMART) goal setting (Bovend’Eerdt et al., 2009), participants systematically identified long-term personal goals, focusing on feasible, measurable, and specific steps.”
Process evaluation of a randomised controlled trial - prevention of sickness absence through early identification and rehabilitation of at-risk patients with musculoskeletal disorders (PREVSAM)
Ekhammar, A., Larsson, M. E. H., Samsson, K. S., & Bernhardsson, S. (2024) · BMC Health Services Research · doi:10.1186/s12913-024-11758-7 · Cited by 5
“In the health plan, the patient’s goals and milestones inspired by the “SMART” approach [22], i.e., be specific, measurable/ meaningful, achievable/activity-based, realistic/relevant, and timed, are documented, together with a clarification of responsibilities and which optional treatments…”
Shared Medical Appointments to Improve Equitable Access to Rehabilitative Care for Long COVID
Cheng, A. L., DeFranco, A. R., Furman, M., Hackert, S. M., Hunt, D. M., Marschall, J., & McQueen, A. (2024) · Cardiopulmonary Physical Therapy Journal · doi:10.1097/cpt.0000000000000266 · Cited by 5
Goal setting for faecal incontinence: A patient-centred approach
Aston, B., & Sheehan, L. (2010) · Gastrointestinal Nursing · doi:10.12968/gasn.2010.8.3.47649 · Cited by 5
An interview guide for clinicians to identify a young disabled person’s motivation to work
Faber, B., Wind, H., & Frings‐Dresen, M. H. W. (2016) · Work · doi:10.3233/wor-162337 · Cited by 6
“A SMART goal clariﬁes exactly what is expected and the measures used to determine if the goal is achieved and successfully completed [56].”
Training Goal Writing: A Practical and Systematic Approach
Nobriga, C. V., & Clair, J. S. (2018) · Perspectives of the ASHA Special Interest Groups · doi:10.1044/persp3.sig11.36 · Cited by 5
Needs and treatment options in chronic traumatic brain injury: A feasibility trial of a community-based intervention
Borgen, I. M. H., Løvstad, M., Røe, C., Forslund, M. V., Hauger, S. L., Sigurðardóttir, S., Winter, L., & Kleffelgård, I. (2020) · Cogent Medicine · doi:10.1080/2331205x.2020.1731222 · Cited by 5
“A SMART-goal approach was adopted (Bovend ’ Eerdt et al., 2009).”
Method
Exploring the Risk Factors of Interactive E-Health Interventions for Digital Addiction
Alrobai, A., McAlaney, J., Phalp, K. T., & Ali, R. (2018) · IGI Global eBooks · doi:10.4018/978-1-5225-7666-2.ch020 · Cited by 5
Coaching-Based Teleoccupational Guidance for Home-Based Stroke Survivors and Their Family Caregivers: Study Protocol for a Superior Randomized Controlled Trial
Zhang, L., Yan, Y., Sun, Z., Ge, X.-J., Qin, X., & Lin, K. (2022) · Evidence-based Complementary and Alternative Medicine · doi:10.1155/2022/9123498 · Cited by 6
“*e SMART principle will satisfy this requirement and play a vital role in structuring and quantifying plans to ensure that participants achieve their goals [40].”
From individualised treatment goals to personalised rehabilitation in osteoarthritis: a longitudinal prospective mapping study using the WHO international classification for functioning, disability and health
Štefanac, S., Oppenauer, C., Zauner, M., Durechova, M., Dioso, D., Aletaha, D., Hobusch, G. M., Windhager, R. H., & Stamm, T. (2022) · Annals of Medicine · doi:10.1080/07853890.2022.2131326 · Cited by 5
“Each participant sets up their own goals, following the “SMART” criteria which request goals to be Specific, Measurable, Acceptable, and defined in Time; this allows monitoring the patient’s progress in a reliable manner [30,38,55].”
Background
Role of Nutrition and Rehabilitation in the Prevention and Management of Sarcopenia and Frailty
Wakabayashi, H. (2020) · Springer eBooks · doi:10.1007/978-981-15-2365-6_8 · Cited by 5
Goal analysis in patients with limb spasticity treated with incobotulinumtoxinA in the TOWER study
Fheodoroff, K., Scheschonka, A., & Wissel, J. (2020) · Disability and Rehabilitation · doi:10.1080/09638288.2020.1804627 · Cited by 5
“In agreement with the most frequently used methods at each study site, goals could be, but were not required to be, based on SMART (specific, measurable, achievable, realistic, and timely) [20] and/or RUMBA (relevant, understandable, measurable, behavioral, and achievable) [21] criteria.”
Method
The utility of goal attainment scaling in evaluating a structured water dance intervention for adults with profound intellectual and multiple disabilities
Matérne, M., Frank, A., & Arvidsson, P. (2021) · Heliyon · doi:10.1016/j.heliyon.2021.e07902 · Cited by 5
“Twenty-one of the participants had a GAS goal setting on a five-level scale from -2 to þ2 (Bovend'Eerdt et al., 2009; Russell et al., 1995); the remaining seven had a goal setting with only 3 levels (-2, 0 andþ2) of the GAS scale because in these cases the goal wasn't amenable to formulating and…”
BackgroundMethodResultInfluential
Improved Glycemic Control in Adults With Serious Mental Illness and Diabetes With a Behavioral and Educational Intervention
Schnitzer, K., Cather, C., Thorndike, A. N., Potter, K. W., Freudenreich, O., MacLaurin, S. A., Vilme, M., Dechert, A., Wexler, D. J., & Evins, A. E. (2020) · Psychiatric Services · doi:10.1176/appi.ps.201900336 · Cited by 5
“Group leaders employed a directive approach to assist participants in setting a weekly SMART (specific, measurable, achievable, realistic, timed) behavior goal (8) related to the weekly discussion topic (i.”
Method
Developing a mixed methods framework for process evaluations of complex interventions: the case of the National Exercise Referral Scheme Policy Trial in Wales
Moore, G. F. (2010) · ORCA Online Research @Cardiff (Cardiff University) · Cited by 5

Authors: Bovend'Eerdt, T. J., Botell, R. E., & Wade, D. T.
Affiliations: Oxford Brookes University and Oxford Centre for Enablement, Nuffield Orthopaedic Centre, Oxford,
Nuffield Orthopaedic Centre (GB)
ORCID: Wade, Derick T
Venue: Clinical Rehabilitation
Publisher: SAGE Publications
Published: 2009-02-23
Volume: 23
Issue: 4
Pages: 352-361
ISSN: 0269-2155 (ISSN-L)
1477-0873
DOI: 10.1177/0269215508101741
OpenAlex: W2131171698
Cited by: 754
References: 19
Citations by year: 2026: 54 · 2025: 64 · 2024: 76 · 2023: 66 · 2022: 66 · 2021: 73 · 2020: 60 · 2019: 57 · 2018: 43 · 2017: 36 · 2016: 45 · 2015: 25 · 2014: 30 · 2013: 25 · 2012: 12
FWCI: 28.78
Type: journal article
Language: en
Open access: closed
Licence: journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations: Clinical Rehabilitation (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
Health Sciences › Health Professions › Occupational Therapy › Occupational Therapy Practice and Research
Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
Keywords: SMART goals, goal setting, goal attainment scaling, rehabilitation goals, goal formulation, patient-centered goals, interdisciplinary rehabilitation
MeSH terms: Goals, Humans, Occupational Therapy, Patient Care Planning

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Writing SMART rehabilitation goals and achieving goal attainment scaling: a practical guide

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