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Goal setting & action planning

"Goals give you a compass in order to direct your path through life. Goals focus your thoughts and actions on areas that have precise purpose and meaning." Catherine Pulsifer

Working with people to identify something they want to do is one of the simplest yet most effective techniques we can use to improve communication and behaviour change. A systematic review on improving diet, published by the Agency for Healthcare Research and Quality in 2002, included goal setting in a list of a few intervention components shown to be associated with improved behavioural outcomes.


A goal-oriented approach to making healthcare decisions, assessing outcomes and measuring success has several advantages:

  • It frames the discussion in terms of what the person wants to do rather than what might be generally accepted as what they should do.

  • It simplifies decision making for people with multiple conditions by focusing on outcomes that span conditions and aligning treatments towards common goals.

  • Goal-oriented plans enable people and their healthcare team to discuss which health problems are important to them and decide on priorities in the context of how they can achieve what is important to them.

  • When priorities are known, people can collaborate with their healthcare team to determine steps to be taken towards achieving their goals and how progress can be monitored.

Goal setting is most successful if it includes follow-up, problem-solving and adjusting activities if goals are not being achieved.


If the patient's goal seems clinically useless, go with it anyway. Starting where the patient is at is more likely to ensure continued success then forcing them to start somewhere else (Mike Hindmarsh).​


Action plans to support behaviour change

Action plans are detailed descriptions of the actions a person will take towards achieving a goal. 

  1. Ask “Is there something you would like to work on to help you achieve your goal?”

  2. Guide development of the plan by asking "What do you want to do?", "When will you do it?" and "How often?"

  3. Gauge the level of importance and score on a scale of 1 to 10. If rated less than 7, adjust goal to something that is more important to the patient/client.

  4. Assess confidence. Again, score from 1 to 10 and adjust the goal to something that is 7 or more. A score of 6 or less suggests the goal is too hard. Likewise, if someone scores 10, then this goal is very easy for them and you could check whether they wish to make it a little more challenging.

  5. Arrange short-term follow-up. A phone call, email or text within 1 or 2 weeks of setting a new significant goal and change can make a significant difference to the likeliness of achieving it. Help the person problem-solve if they are facing barriers or struggling to achieve their goal and action plan.

  6. Document goal and actions/tasks in patient/client’s notes and be sure to ask about it at the next visit.

Read more about goal setting for behaviour change


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Goal setting for behaviour change

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