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Working with Consumers to Create SMART Goals

The topic for this live discussion is: Working with Consumers to Create SMART Goals. A SMART goal is defined as one that is specific, measurable, action-oriented, relevant, and time-bound. If you use SMART goals with your consumers, we invite you to share your success stories or tips.

In addition to OIB-TAC staff, our facilitator for this topic is John McMahon. John has worked as a Vision Rehabilitation Therapist and program administrator in Maine, and as a VRT, Vocational Rehabilitation Counselor, and Low Vision Therapist in Michigan. He currently holds ACVREP certification in Vision Rehabilitation Therapy and Low Vision Therapy. 

Feel free to add a new comment or to reply directly to a previous comment. All discussion will take place on this page, but you may need to refresh your browser every few minutes to make sure you see the latest comments. This is a text-only forum, so no audio equipment is needed. These posts will remain on the site, to serve as a reference for those who may have similar questions in the future. If you would like to submit a question anonymously, you may email DBedsaul@colled.msstate.edu

Comments

Doug Bedsaul's picture

Specific: Choose wording that is clear, concise, and tangible. The goal must specifically state what it is you want to accomplish and should address as many descriptor questions as possible (Who, What, When, Where, Why, and How). It should be well defined, and specific about the expected outcome. Can you share some specific goals for older blind consumers?
Mark Armstrong's picture

Here is an example: The goal is to ensure the consumer or OIB staff member has the ability to troubleshoot minor hearing aid malfunctions. So here is how I wrote it: Please rate your ability to troubleshoot minor hearing aid malfunctions. (Can you describe at least three things to consider when troubleshooting minor hearing aid malfunctions). Perhaps it should be written: Please list or recite three things to consider when troubleshooting a minor hearing aid malfunction.
Bill Tomlin's picture

Mark…that is a great example of a SMART goal for the direct service provider, but when we are working on SMART goals with the consumers the agreed upon goal should be focused on the specific actions that the consumer will accomplish as part of the consumer’s plan to reach independence. To apply this method of goal setting to the consumer it could be written something such as “ The consumer will have the ability to trouble shoot his hearing aid and find faults 3 times out 4 tries within the next 6 months." Thoughts?
Mark Armstrong's picture

Ok, I can agree with this. However, if I am teaching a lesson, I would want to measure the goal during the lesson. I would find it hard to monitor the consumers ability over a 6-month period.
John Mc Mahon, Ph.D.'s picture

Mark, a SMART goal also can work well if you intend on measuring the client's success during one specific lesson. In other words, the SMART goal can be written something like, "The consumer will have the ability to trouble shoot his hearing aid and find faults in 4 consecutive tries by the end of the lesson on May 18, 2018." Written in this manner it still meets all five components of the SMART goal.
Bill Tomlin's picture

Mark I can see this from your role as a nationwide rep it may be different when a provider would be working with “local” consumer. The time bound part aspect of SMART goals would be agreed upon between you the provider and the consumer. There is no real standard on how long it should be, just it needs to be a realistic amount of time to fit the tasks that support the goal to be achieved.
B.J. LeJeune's picture

Mark, I think it is particularly difficult when you only see a person occasionally so maybe the goal could be focused on a lesson and read, "By the end of today's lesson, the consumer will be able to identify and solve (trouble shoot) 3 possible causes for his/her hearing aid malfunctions."
Doug Bedsaul's picture

Measurable: The objective needs to be measurable, allowing you to clearly see if you are progressing as planned. Making the objective measurable assists us to see progress, recognize if the client is moving in the right direction, and see how far away completion is at any given time. This allows a way to monitor progress and revise our plan if needed. What goals have you found to be difficult to measure?
B.J. LeJeune's picture

One of the really nice things about setting measures for the goals is that both the instructor and the consumer can mark progress. It gives both something to shoot for. We see very general goals sometimes like "The student will learn braille." Maybe they just want to learn the alphabet, or maybe they only want to be able to keep phone numbers.
Doug Bedsaul's picture

Action Oriented: What actions do you need to take to achieve the goal? Goals should be broken down into an action plan of smaller tasks or steps to complete. Each action step, or objective, moves a person closer to successfully completing the goal. These actions should be concrete, within our direct control, and identify exactly what will be done.
John Mc Mahon, Ph.D.'s picture

It is important to remember that the action component of the SMART goal model relates to the action of the client. Often times we see examples that describe the action of the instructor rather than the client. One such example could look like, "Teach three ways to adapt medication labels with an accuracy rate of 100% over the next 30 days." Although this appears to be a very clear, concise goal, the beginning part of it tells us the action the instructor will take, not what the client will do. Therefore, just making a slight change in how it is written makes it action oriented to the client. Here is an example: "Client will identify medication labels with an accuracy rate of 100% over the next 30 days."
Doug Bedsaul's picture

Relevant: Goals and objectives need to be meaningful and significant to your client. They must be formed with a reasonable belief that your client can complete it successfully. The goals and objectives should be do-able within the availability of resources, knowledge, and time. How do you decide if a goal is relevant for an individual?
Mark Armstrong's picture

I think relevancy links back to the assessment and the agreed plan of action with the consumer.
Doug Bedsaul's picture

Relevant would definitely be judged, in part, by the assessment. Could anyone share a quick example of a goal that was not relevant to a particular client?
Mark Armstrong's picture

How about, Over the next three months, the consumer will improve self-advocacy skills by planning and scheduling transportation to medical appointments.
Doug Bedsaul's picture

That goal would be relevant, assuming the consumer needs transportation to appointments in that time period. Relevant also entails meaningful to the consumer. While it may be meaningful to us to have the consumer arrange their own transportation, a relevant goal would also need to be meaningful to them.
B.J. LeJeune's picture

One error we see sometimes is that goals are not ends in themselves. For example, the goal of threading a needle. No one wants to sit around threading needles. The goal may be to sew on a button or do simple mending. Threading a needle is one of the steps to reaching the goal of sewing. I think this is part of relevancy.
Doug Bedsaul's picture

Time Bound: A time-bound objective identifies a realistic time frame for its successful completion. This time frame needs to allow enough time to achieve the goal while providing a target date for its completion. Some measurable milestones along the way can help gauge progress and support forward movement in the instructional process.
Susan M Lindeman's picture

Consumer will receive independent living skills, services and training in his/her place of residence over the next 6 months through instructions and examples that will allow her to effectively adapt to her current living situation including his/her deteriorating vision.
Kendra Farrow's picture

Hi Susan, A SMART goal should be fairly specific. For example, the consumer will correctly fill her weekly medication planner 4 times by September 1.
Susan M Lindeman's picture

I work at an independent living center and we usually have an overall goal, a short term goal and methods. Your example is one we would add under methods. Is that wrong?
Kendra Farrow's picture

Depending on how your case management system is organized, it may fit better under a differently termed section.
Susan M Lindeman's picture

That is what I think too. Maybe a long term goal of independence maintenance and short terms goals specific to the case.
Kendra Farrow's picture

In our terminology we would call your long-term goal a vision statement. Your short-term goal would be the SMART goal, and the methods would be what we term the action plan. An action plan includes the specific steps needed to reach the SMART goal.
Susan M Lindeman's picture

Thank you. That clarifies a lot!
Kendra Farrow's picture

An action plan is even more detailed than the SMART goal, but supports the SMART goal. An example of an action plan would be: -Consumer will identify each medication correctly 4 consecutive times - consumer will open all pill containers with out assistance 4 consecutive times - consumer will correctly fill pill compartments of a weekly planner 4 consecutive times.
Mark Armstrong's picture

Thanks for the clarification Kendra!
Jean Kenevan's picture

Many times I provide information on a possible goal but that's where it ends. For example, someone expresses difficulty with writing out checks. I offer suggestions - darken lines on checkbook, large print checkbook, checkbook guide, magnification. Then the person says, "thanks, I'll consider all that" and that's where it ends. I'm assuming that I never got to working on that check writing goal then? But I did provide some information.
B.J. LeJeune's picture

Hi Jean, Yes, I believe what you provided was information services rather than something that required instructional goals. If they decided that they wanted to learn to pay using a magnifier and you were going to help the learner do that, you would set up a goal like, "The learner will be able to successfully and legibly write out checks for her rent, telephone, and electric bill using a checkbook guide and bold tipped pen each month until September 1."
John Mc Mahon, Ph.D.'s picture

Hi Jean. Great question. You are correct in thinking that you didn't actually quite get to the goal setting phase of an assessment. From your example it sounds like the consumer stated the difficulty and you responded with information about the methods she could use to accomplish this task. What is a bit unclear is if the client was asking for information or training in how to do it. That being said, if a person is asking for the information, then the goal would be related to her listing or describing the information being shared with her.
Sandy Neyhart's picture

In order to accomplish the goal of reading her recipes, the staff will train Margaret in the use of a 3 x lighted magnifier over the next 7 months to ensure Margaret is using the devices correctly on recipes as well as other reading materials throughout her home.
Bill Tomlin's picture

Sandy I think you are close here. Specific (read her recipes), measurable (ensure Margaret is using the device correctly), action oriented (staff will train Margaret), relevant (read materials and I assume her recipe cards), and time bound (next 7 months). But you are focusing on the staff task of training not Margaret’s task of using the 3x lighted magnifier. So in this example you combined the direct service provider’s and the consumer’s task into one goal. Thoughts?
Sandy Neyhart's picture

It took several tries to put that together and I think practice is needed to ensure it is comes easier....a rewrite would reflect more on Margaret demonstrating the correct use of the 3x lighted magnifier?
Bill Tomlin's picture

Sandy, you are spot on. It takes practice with using SMART goals. One of the reasons we teach this method is to help you and your direct service providers to add some rigor into your client goal setting. The thinking behind this is to have a clear path to case closure once the client has met their goals (or identify why the client was unsuccessful with meeting their goals).
B.J. LeJeune's picture

I think you may have a mixture of learner (Margaret) goals and instructor goals here. Margaret's goal might be, "in order to accomplish the goal of reading recipes, Margaret will use a 3 x lighted magnifier to successfully cook at least 3 recipes from her Good Housekeeping Cookbook by July 4." She might also have a more general goal of "By July 4th, Margaret will successfully read a variety of materials in her home office using a 3x magnifier and the lighting at her desk including medicine bottles, her daily devotional, her incoming mail, and check register."
Matthew Haynes's picture

Here in Alabama we have been making changes to our functional assessment, plan, and how we document services. The new plan has a pre-formatted goal that states that in all areas under the plan the consumer will be able to perform independently or with minimal assistance by the expected end date of the plan. As the plan is updated it will show if the consumer could perform these areas independently or with minimal assistance. For case documentation we are looking at reformatting our documentation so that our staff will first outline the goal of the consumer, then the training provided, and then the outcome. Writing in this new format will take training and time for our staff to learn. However, I think it will better reflect the impact on the consumer and put less emphasis on the instruction provided by staff. We feel that this is a good compromise to have a general goal on the plan and then more specific goals in the documentation. To include SMART goals for each individual area on the plan would make the plan a very long document. Asking for more specific details in the case documentation will give more details on how the consumer improved in each area of the plan.
Kendra Farrow's picture

Hi Matt. Since each case management program is unique, it is important to figure out how you want the information arranged for your system. There are 3 parts to a smart goal: 1) Vision- this is very general like the consumer will be more independent in preparing lunch; 2) The SMART goal - The consumer will prepare a hot lunch in the microwave 3 consecutive times by September 1; 3) Action Plan - a- consumer will identify correct controls on the microwave 6 consecutive times, b- the consumer will read instructions from the package using her 5x magnifier 6 consecutive times, c- consumer will open package and handle microwave container safely 6 consecutive times. To help your staff put each item in the place you desire it to be located, you may have to rename these elements. For instance if you want the vision statement to be on the plan, you might call it the "plan goal". In the case notes you may call the SMART goal the "objective" and the action plan might be called the "lesson plan". It is also possible for a vision statement to have more than one SMART goal. For instance our consumer may also want to learn to prepare a cold sandwich. Since this goal has completely different steps from making a hot meal in the microwave, it requires a separate SMART goal and action plan.
Erin Cates's picture

As itinerant providers of OIB services, clients are not a captive audience as they are when receiving services from a center-based venue. VRTs struggle with time. So, could some of the SMART Goal setting and writing be done with client by telephone after meeting and assessment their home functioning? Forming SMART goals can feel academic to some clients who are on the base of Maslow's hierarchy of needs and meaning. Erin and Mary